Factors associated with immunization coverage among children of age 12-23 months: The case of zone 3, Afar regional state, Ethiopia

Abstract

Background: Immunization is one of the most successful and cost-effective public health interventions to prevent illnesses and deaths from vaccine preventable diseases. Nevertheless, universal access and coverage of immunization service is not yet achieved. Objective: To determine vaccination coverage and examine factors associated with vaccination coverage among children of age 12 – 23 months in Zone 3 of Afar Regional State. Methods: A community based cross-sectional study using the WHO modified cluster sampling method was carried out in Zone 3 of Afar Regional State between January 01 and May 31 , 2009. The total sample size calculated was 762 and 740 included in the analysis. The study participants were drawn from respondents who had children of age 12 - 23 months in six woredas of the Zone. The study employed both quantitative and qualitative study methods. The data were entered, cleaned and analyzed using SPSS statistical soft ware version15. Results: Out of the 740 respondents interviewed 342 (46%) reported that their children had ever had vaccination. Penta-3 and fully immunization coverage were found to be 29% and 20.6% by card plus history respectively. Access and utilization were identified as critical problems in the Zone. (Penta-1 cov.= 43% and Penta-1– Penta-3, DOR = 30). The multiple logistic regression model demonstrated that among the socio-demographic, knowledge and family and community factors; age [AOR (95% CI) = 0.36(1.54, 7.77)], and education of respondents [AOR (95% CI) = 0.10(0.11, 0.96)] and spouses [AOR (95% CI) = 0.10(0.12, 0.39)] were found to be significant predictors for child vaccination up-take. The Hosmer-Lemeshow goodness of fit showed a non significant chi-square ratio indicating a good model fit. Conclusion and recommendations: Access & utilization to vaccination services were critical problems identified that shall be addressed. Formal and informal education as well as communication on immunization shall be fostered for the long-term impact on immunization.