Public health challenges · 2026
Determinants of Age-Appropriate Childhood Immunization Uptake: A Cross-Sectional Study of Caregiver, Child, Knowledge, Access, and Attitudinal Factors.
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Ayigu Aruwa Simon, Aremu Stephen Olaide, Akyala Adamu Ishaku, Barkhadle Abdillahi Abdi
Аннотация
BACKGROUND: Childhood immunization is among the most cost-effective public health strategies for reducing under-five morbidity and mortality. However, full immunization coverage for age remains suboptimal in many low- and middle-income countries due to factors related to caregivers, children, health systems, and sociocultural contexts. The study aimed to assess the prevalence of full immunization for age and identify its associated determinants across multiple domains.
METHODS: A community-based cross-sectional study was conducted among 364 caregiver-child pairs. Full immunization for age was the outcome variable. Data were collected using a structured interviewer-administered questionnaire assessing sociodemographic characteristics, child factors, caregiver knowledge and perceptions, access to health services, and attitudes and practices. Chi-square tests identified associations, and variables significant at p < 0.05 were entered into multivariable logistic regression models to determine independent predictors.
RESULTS: Overall, 261 children (71.7%) were fully immunized for age. Caregiver education was a strong predictor: children of caregivers with primary (adjusted odds ratio [AOR] = 3.91), secondary (AOR = 3.30), and tertiary education (AOR = 4.71) were significantly more likely to be fully immunized than those with no education. Rural residence increased the odds of full immunization (AOR = 3.23), as did household size ≥6 (AOR = 2.06). Older child age strongly predicted full immunization, particularly among children aged 12-17 months (AOR = 5.42) and 18-23 months (AOR = 6.83). Health facility delivery nearly quadrupled the likelihood of full immunization (AOR = 3.96). Reliance on non-health worker information sources reduced uptake, whereas shorter travel time to facilities, regular community immunization sessions, intention for catch-up vaccination (AOR = 8.74), and positive community advocacy significantly increased coverage.
CONCLUSION: Full immunization for age is shaped by caregiver education, child age, health service accessibility, and caregiver attitudes. Interventions should prioritize caregiver education, strengthen health-worker-led communication, promote facility-based deliveries, and expand regular community immunization services to improve coverage.
METHODS: A community-based cross-sectional study was conducted among 364 caregiver-child pairs. Full immunization for age was the outcome variable. Data were collected using a structured interviewer-administered questionnaire assessing sociodemographic characteristics, child factors, caregiver knowledge and perceptions, access to health services, and attitudes and practices. Chi-square tests identified associations, and variables significant at p < 0.05 were entered into multivariable logistic regression models to determine independent predictors.
RESULTS: Overall, 261 children (71.7%) were fully immunized for age. Caregiver education was a strong predictor: children of caregivers with primary (adjusted odds ratio [AOR] = 3.91), secondary (AOR = 3.30), and tertiary education (AOR = 4.71) were significantly more likely to be fully immunized than those with no education. Rural residence increased the odds of full immunization (AOR = 3.23), as did household size ≥6 (AOR = 2.06). Older child age strongly predicted full immunization, particularly among children aged 12-17 months (AOR = 5.42) and 18-23 months (AOR = 6.83). Health facility delivery nearly quadrupled the likelihood of full immunization (AOR = 3.96). Reliance on non-health worker information sources reduced uptake, whereas shorter travel time to facilities, regular community immunization sessions, intention for catch-up vaccination (AOR = 8.74), and positive community advocacy significantly increased coverage.
CONCLUSION: Full immunization for age is shaped by caregiver education, child age, health service accessibility, and caregiver attitudes. Interventions should prioritize caregiver education, strengthen health-worker-led communication, promote facility-based deliveries, and expand regular community immunization services to improve coverage.