Assessment of the Burden and Factors Associated with Missed Opportunities for Vaccination in a South-Western State of Nigeria: Toward Immunization Agenda 2030

Abstract

ABSTRACT Background: Immunization Agenda 2030 prioritized the tackling of certain factors stalling immunization progress globally, among which are missed opportunities for vaccination (MOV), when eligible children have contact with health facilities without being vaccinated. Aim: This paper presents the baseline of an implementation research aimed at assessing the burden and identifying the factors leading to MOV in a South-Western Nigerian state. Materials and Methods: The 10-step World Health Organization MOV strategy was used to select local government areas and health facilities in Lagos State purposively. Children 0–23 months and healthcare workers were sampled through exit interviews with caregivers and knowledge, attitude, and practice surveys with health workers. MOV was estimated using documented (child health card or health facility register) vaccination histories included in the National Immunization Programme (NIP). Result: Among the caregivers, 475 (79.2%) had complete documentation of vaccination histories among which 292 (61.5%) children were eligible for vaccination. About 15% of the eligible children had one or more MOVs at the survey dates. Among curative service visits, 80% of the children had MOVs compared to 6.7% for vaccination visits. Among the healthcare workers, about two-thirds have poor knowledge of NIP and are not aware that the immunization status of children should be screened at each visit. Conclusion: The findings showed that MOV occurs especially in non-vaccination visits, where healthcare workers care less about immunization statuschecks. Active immunization status checks and providing linkages for immunization services may help in reducing MOV and improving immunization coverage rates in Lagos State towards fulfiling immunization Agenda 2030.