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Assessing full immunisation coverage using lot quality assurance sampling in urban and rural districts of southwest
Akinola Ayoola Fatiregun1, Ayo Stephen Adebowale, Rita Ogechi Ayoka
1Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria.
Insights
Child immunisation coverage was unacceptably low in Nigerian local government areas (LGAs). Factors like maternal education and hospital birth predicted complete childhood immunisation schedules.
Area of Science:
- Public Health
- Pediatrics
- Epidemiology
Background:
- Assessed child immunisation coverage in Ibadan North East (IBNE) and Ido local government areas (LGAs), Nigeria.
- Identified administrative wards with unacceptable full child immunisation rates.
- Determined factors associated with achieving a complete childhood immunisation schedule.
Purpose of the Study:
- To identify administrative wards with unacceptable full child immunisation coverage.
- To identify factors associated with achieving a complete child immunisation schedule in IBNE and Ido LGAs, Nigeria.
Main Methods:
- Cross-sectional survey of 1178 mothers with children aged 12-23 months.
- Lot quality assurance sampling used to assess coverage levels.
- Logistic regression analysis identified predictors of complete childhood immunisation.
Main Results:
- Full immunisation coverage was low (40.2% in IBNE, 41.3% in Ido).
- Most wards in both LGAs had unacceptable coverage levels.
- Maternal age ≥30, immunisation card retention, higher education, hospital birth, and first-order birth were significant predictors.
Conclusions:
- Full immunisation coverage was unacceptably low across most wards.
- Targeted educational interventions are needed for young, uneducated mothers, those with home births, and high birth orders.
- Improving maternal education and access to healthcare services can enhance immunisation completion rates.
Background:
This study was conducted to identify administrative wards (lots) with unacceptable levels of full child immunisation coverage, and to identify factors associated with achievement of a complete child immunisation schedule in Ibadan North East (IBNE) and Ido local government areas (LGAs) of Oyo State, Nigeria.
Methods:
A cross-sectional survey involving 1178 mothers, 588 from IBNE LGAs and 590 from Ido LGAs, with children 12-23 months of age was conducted. Children were considered 'fully-immunised' if they received all the vaccines included in the immunisation schedule. Lot quality assurance sampling was used to determine lots with acceptable and non-acceptable coverage. Samples were weighted based on the population by lot to estimate overall coverage in the two LGAs and a logistic regression model was used to identify factors associated with the fully immunised child.
Results:
Mean age of the mothers was 28.5 ± 5.6 and 28.1± 6.0 years in IBNE and Ido LGAs, respectively. Eleven of 12 wards in IBNE and all the wards in Ido had unacceptable coverage. The proportion of fully immunised children was 40.2% in IBNE and 41.3% in Ido. Maternal age ≥30 years, retention of an immunisation card, completion of tertiary education, or secondary education, hospital birth and first-order birth were significant predictors of complete childhood immunisation.
Conclusion:
The level of full immunisation coverage was unacceptable in almost all the wards. Educational intervention on the importance of completion of immunisation schedule should target young, uneducated mothers, mothers who delivered their babies at home and those with a high birth order.
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