Factors Associated with Incomplete Childhood Vaccination Among Children Aged 24-35 Months in Kanifing Municipality, The Gambia, 2020.

Abstract

Background Vaccination continues to be the leading public health intervention in the fight against infectious diseases contributing to the drop of morbidity and mortality globally. Improvements in child survival in the developed world are due to childhood vaccination since the 1960s. The attainment of 86% coverage for infants is inadequate in the prevention of vaccine-preventable diseases (VPDs) globally. Kanifing Municipality is one of the administrative areas with low vaccination coverage. According to the Multiple Indicator Cluster Survey report 2018, only 34.6% received all the recommended vaccines. This proportion was less than WHO targets for vaccination coverage at the district level of ≥ 80%. To improve uptake of immunization services and address the existing gaps in vaccination coverage, it is essential to research factors related to incomplete vaccination. The study aimed to determine the prevalence and factors associated with incomplete childhood vaccination among children between the ages of 24-35 months in Kanifing Municipality of The Gambia. Methods We conducted a cross-sectional study. The study enrolled 355 children between the ages of 24-35 months and their caregivers. A two-stage cluster approach was used to identify enumeration areas and caregivers of children. Face-to-face interviews were conducted using semi-structured questionnaires. We collected data on caregiver socio-demographic characteristics, characteristics of the child, and healthcare-related factors. Data were entered into Microsoft Excel version 10 and imported into STATA version 15 for analysis. Bivariate analysis and multiple logistic regression were conducted at a p-value of ≤ 0.05. Results The median age was 30 months with an age range of 24-35 months. Of the children’s caregivers that participated in the study, 89.0% were married. The prevalence of incomplete vaccination was 57.7% (205) (95% CI: 52%-62%) whilst, 42.3% (150) of the children were completely vaccinated. Predictors of incomplete vaccination were the children of caregivers who belong to monogamous family type (aOR=1.90, [95% CI:1.12-3.22]), caregivers who are not aware of diseases for which vaccines are available (aOR=1.62, [95% CI=0 .99-2.64]), caregivers who do not know the age at which the child graduates from routine immunization (aOR=1.66, 95%CI=1.04-2.64) and caregivers who walked to the clinic (aOR=1.78, 95% CI:1.11-2.84). Conclusion There was a high prevalence of incomplete vaccination among children in Kanifing Municipality. Predictors related to incomplete vaccination among children 24-35 months were children of caregivers who belong to monogamous family type, caregivers who are not aware of diseases for which vaccines are available, caregivers who do not know the age at which a child graduate from immunization, and caregivers who walked to the clinic. The EPI should conduct further studies on incomplete vaccination and work with partners to ensure timely and consistent availability of vaccines in the routine schedule. Health facility staff should strengthen health education activities during clinics and encourage male participation in RCH clinics.