Determinants of Uptake of Immunization Services Among Children Aged Below 12 Months in Aldai Sub-county, Nandi County.

Abstract

Immunization remains as one of the most powerful tool of disease prevention and control worldwide and is thus considered to be a very crucial part of global and national disease prevention and control policies. Kenya’s immunization uptake, currently at 83.2% remains below WHO recommended uptake of 90% indicating that there is a good proportion of children exposed to vaccine preventable diseases. Uptake of immunization varies across regions with some regions doing better in uptake of some vaccines and worse in others. The main purpose of undertaking this study was to investigate the elements capable of influencing uptake of immunization services for children below 12 months in Nandi County, Aldai Sub-County. The study used a cross – sectional survey design. Three immunizing health facilities in the following categories: Sub-County hospital, health centre and dispensary were sampled. Primary data was collected by use of a self-administered questionnaire from caregivers at the Child Welfare Clinic. A binary response model was used for this study with the dependent variable immunization service uptake being denoted as Y with only 2 possible outcomes 1 and 0. A probit analysis provided statistically significant of which the independent variables increase or decrease the probability of uptake. The study findings reveal that the uptake of immunization decreases with the increase in the caregiver’s age. Regarding the marital status of the care giver, the probit model results reveal that married care givers are more likely to have their children fully immunized compared to unmarried care givers. Educated caregivers were found to have a higher likelihood of having the children vaccinated compared to the children of parents who have no formal education at all. Regarding occupation type, the findings posit that engagement in skilled occupation was found to increase uptake of immunization among the households compared to engagement in semi and unskilled occupations. Further, the possession of the knowledge in vaccines was found to increase the likelihood of having the child being fully vaccinated compared to lack of knowledge on vaccines. For child characteristics, adherence to full vaccination was found to increase with lower child’s age. In terms of child gender, the regression model results posit that male children are less likely to be fully vaccinated compared to female children. The childbirth order was found to increase the likelihood of the child being fully immunized. Regarding environmental or health system characteristics, distance was found to have a negative effect on immunization uptake. The rural residence was found to increase the likelihood of seeking for immunization services among the households compared to urban residence. Women who had received ANC services had a higher likelihood of having their children as opposed to those who missed out on the ANC services. Similar findings were reported for place of delivery whereby facility – based delivery was found to increase the likelihood of immunization uptake compared to home delivery. Lastly, vaccine stock outs were found to increase the likelihood of children being fully vaccinated compared to absence of vaccine stock outs. The study recommends the need for the county government to educate and sensitize women and caregivers on the need to adhere to the immunization schedule for children. Further, expansion of the healthcare services in the rural areas would be helpful in enhancing healthcare access among the rural dwellers.