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Abstract
Background Globally, immunization is among the major contributors to public health, preventing 20% of childhood mortality annually. The highest fatality rates from vaccine preventable diseases are usually among children under five. Despite immunization guidelines put in place by the World Health Organization, globally, 1.5 million children die annually related to inadequate vaccination coverage. Existing literature indicate that there is an increase in nonadherence to immunization schedule in developing countries, and therefore, there is an increased demand to improve adherence to immunization schedule. Objective To explore strategies that will improve adherence to immunization schedule among children under 24 months attending the Maternal and Child Health clinic at Kenyatta National Hospital. Methods A cross-sectional mixed method study involving caregivers (n = 214) of well babies attending the Maternal and Child Health clinic. Data was collected using semistructured questionnaires, focus group discussions, and key informant interviews and analyzed using SPSS V.20. Results There was a significant relationship between the level of education and marital status of the caregivers and adherence to immunization schedule. Barriers found that is related to adherence to immunization schedule included far distance from health facility, baby's sickness, and vaccine stock-outs while employment of a caregiver was a constrainer factor. Conclusion The enabling factors to current strategies of improving adherence to immunization schedule were having more health facilities near residential areas, using text messages reminders a day before the clinic date to remind caregivers of the due date for the clinic, and constant availability of vaccines. The health system strategies that would improve adherence to immunization schedules were more flexible clinic hours, availability of vaccines on daily basis, phone call reminders by health care providers, and increasing awareness on the importance of both vaccinations and adherence to immunization schedule.
Highlights
Childhood vaccination is one among the many contributors of major global reductions in morbidity and mortality resulting from vaccine preventable diseases
It is estimated by the World Health Organization (WHO) and the United Nations Children’s Emergency Fund (UNICEF) that 1.5 million children worldwide die from vaccine-preventable diseases annually [2]
92.2%, of those who escorted their children to the clinic were mothers, 6.1% (n = 13) were fathers while the smallest percentage 1.9% were brought by other relatives
Summary
Childhood vaccination is one among the many contributors of major global reductions in morbidity and mortality resulting from vaccine preventable diseases It is an important intervention with an aim of reducing childhood morbidity and mortality as indicated in the Sustainable Development Goals [1]. It is estimated by the World Health Organization (WHO) and the United Nations Children’s Emergency Fund (UNICEF) that 1.5 million children worldwide die from vaccine-preventable diseases annually [2]. This is caused by inadequate vaccination coverage and would otherwise be averted if immunization schedules are adhered to . The health system strategies that would improve adherence to immunization schedules were more flexible clinic hours, availability of vaccines on daily basis, phone call reminders by health care providers, and increasing awareness on the importance of both vaccinations and adherence to immunization schedule
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