Factors Associated with Uptake of Immunizations for Vaccine-Preventable Childhood Diseases in a Peri-Urban Settlement; A Case Study of Nansana Municipality, Uganda

Abstract

Immunization uptake for childhood vaccine-preventable diseases remains low in urban areas of Uganda, leading to repeated outbreaks of diseases like measles, despite easy communication and accessibility to services. The objectives of this study were to establish immunization coverage and to identify the factors that affect the uptake of immunization among the children aged 10 – 23 months in Nansana Municipality, Wakiso District, Uganda. This was a cross-sectional mixed methods study, utilizing both qualitative and quantitative approaches. Assessment of immunization uptake was carried out on 344 parents/guardians of children aged 10–23 months, using simple random sampling on pre-tested structured questionnaires. Data was analyzed using SPSS 20.0 software. Additionally, 2 focus group discussions with parents and key informant interviews with immunization focal persons were also conducted. Immunization coverage was found to be 90.4% for BCG, 89.3% for Penta1, 80.7% for Penta2, 72.5% for Penta3 and 73.9% for measles1. Availability of vaccines (AOR= 33, 95% CI, 1.44 – 792, p=0.03), accessibility to immunization services (AOR = 32, 95% CI, 2.0 – 513, p=0.01) and communication between the parents and health workers about the return dates (AOR = 0.03, 95% CI, 0.01 – 0.83, p=0.03), were the factors that were independently associated with immunization uptake. The coverage rates were higher than the national average, with the health care service-related factors identified as being critical for improving immunization uptake. There is a need for improved vaccine supply and communication about immunization services, which should be designed considering the local context in collaboration with slum-dwelling communities.