Prevalence of Missed Opportunities for Immunization and Associated Factors in Urban and Rural Areas of Southwest, Nigeria

Abstract

Purpose: The study determined and compared the prevalence of missed opportunities for immunization among children aged 12-23months in urban and rural areas of southwest, Nigeria. The study identified and compared the associated factors (cultural, religious, ethnic, political and economic).
 Methodology: This cross -sectional study was carried out among mothers of children aged 12-23 months, community and opinion leaders in urban and rural areas of southwest, Nigeria. The data was collected using semi structured questionnaire, focus group discussion and in-depth interview guides.
 Findings: The prevalence for missed opportunities for immunization was 9.6% with 11.8% in urban as compared with 7.5% in rural areas. The dose specific prevalence of missed opportunities for immunization in rural areas was highest for BCG, HBV0 and OPV0 but lowest for BCG and OPV0 in urban areas. The reasons given in both areas were non-availability of vaccines, long wait time, unscheduled visits, child brought to facility ill but not vaccinated, and distance from the facilities. After controlling for confounders, child factors (age of the child, place of delivery), socio-economic characteristics (mothers and fathers educational and occupational status) were significantly associated with missed opportunities for immunization. Most of the participants of the qualitative survey believed immunization is important as it prevents children from diseases. There were divergent views in both areas on traditions, cultures, and customs as associated factors for missed opportunities for immunization. Government is involved in immunization as reported by participants in both areas.
 Conclusion: The study concluded that missed opportunities for immunization is prevalent in both areas and reasons were non-availability of vaccine, unscheduled visits, long wait time and distance from facilities. Parent socioeconomic characteristics, child’s age, place of delivery and mothers receiving immunization messages were the factors associated with missed opportunities for immunization.
 Recommendation: There is a need for improvement of quality of interventions and advocacy to the government for continual support for immunization to reduce missed opportunities for immunization.