Abstract
IntroductionAccording to the Ethiopian Health Sector Development Plan IV annual performance report (HSDP IV), Ethiopia targeted to reach 90% coverage with DPT-Hib-HepB 3 (Pentavalent3) vaccine and 86% coverage with measles vaccine in 2010- 2011. However, the actual performance fell-short of the intended targets due to several reasons. Therefore, a nationwide comprehensive study was conducted to examine the behavioral determinants of immunization practices in the Ethiopian context. The study employed the Modified Steps of Behavioral Change (SBC) Model as a theoretical lens.MethodsA cross-sectional study was conducted in May 2012 in all the nine regions and the two city administrations of Ethiopia. The study used a community-based quantitative survey design comprising of multistage cluster sampling to draw relevant data from a sample of 2,328 caretakers whose children were 12-23 months of age at the time of data collection.ResultsOverall, the multivariate analysis findings revealed that caretakers, who had high knowledge were 2.24 times more likely to vaccinate their children than participants had low knowledge (OR= 2.24, 95%CI: 1.68-2.98). Participants who had high approval were 2.45 times more likely to vaccinate their children than participants who had unfavorable approval (OR= 2.45, 95%CI: 1.67-3.59); and participants who had high intention were 6.49 times more likely to vaccinate their children with pentavalent3 vaccines than participants who had low intention(OR= 6.49, 95%CI: 4.83-8). Also, it was clear from the regression analysis that aspects of caretakers' demographic characteristics were significant predictors of their immunization practice for the sample group.ConclusionWe identified that caretakers' knowledge, approval, intention, parents' residence, and religious backgrounds were associated with immunization service utilization. To achieve sustainable behavioral change on immunization service utilization of the caretakers in Ethiopia, this study suggests investing in activities that enhance caretakers' knowledge, approval, intention, and practice components represented in the behavioral change model.
Highlights
Immunization is one of the most cost-effective public health interventions to curb potential health problems globally
We used the immunization coverage survey standard formula recommended by World Health Organization to calculate the sample size for each region; we used Epi Info statistical software (Centers for Disease Control and Prevention, Atlanta, USA) with the following formula: N= DE (Zα/2)2 P (1-P)/d2 where: DE=3; P= Regional pentavalent3 coverage data; Zα/2 = 1.96 (The z-score corresponding to 5% level of significance or 95% confidence interval); and d= Margin of error (10%)
There is a fairly good level of knowledge about immunization services demonstrated through our study (76.7%). This proportion is lower than some previous studies conducted in Ethiopia and Nigeria [7, 8]
Summary
Immunization is one of the most cost-effective public health interventions to curb potential health problems globally. According to the Ethiopian Health Sector Development Plan IV (HSDP IV) annual performance report of 2011, the country aimed to reach 90% coverage with DPT-Hib-HepB 3 (Pentavalent3) vaccine and 86% coverage with measles vaccine in 2010 and 2011. The 2010 and 2011 surveillance reports indicated that 38,288 suspected measles cases and 182 deaths were reported from all regions; the major reasons for the outbreaks were low immunization coverage [4] We conducted a study to identify the potential determinants of immunization service utilization by caretakers from a broader perspective using the Modified Process of Steps of Behavioral Change (SBC) Model [5].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
