Factors contributing to delay in commencement of immunisation in Nigerian infants

Delay in receipt of immunisation may result in a child being susceptible to vaccine preventable diseases for prolonged periods. Identification of factors which contribute to delay in receipt of immunisation will help in developing targeted interventions. This study examined prospectively factors contributing to delay in the commencement of infant immunisation in Benin City, Nigeria. This was a cross-sectional descriptive study of 153 consecutive mothers of infants presenting for their first immunisation at the Institute of Child Health Child Welfare Clinic of the University of Benin, Benin City. Reasons for not presenting in the first 24 hours were ascertained and associations between various factors and delay in commencement of immunisation were examined. Of the 153 mothers only 2 (1.3%) brought their babies for immunisation within 24 hours of birth while 66 (43.1%) brought their babies in the first week of life. The most cited reason (30.3%) for not presenting within 24 hours of birth was that BCG, one of the immunisations that should be given at birth is given only on a specific day. Mothers who did not know that immunisation should commence at birth (P = 0.0054), those from low socioeconomic class (P = 0.0056) and those with less than 12 years of schooling (P = 0.0001) were significantly less likely to bring their babies for immunisation in the first week of life. Delivery outside of health facilities was also associated with later presentation for immunisation (P = 0.0069). In conclusion, there is significant delay in the receipt of birth doses of immunisation. Change in clinic practices to enable daily immunisation as well as education of health care personnel on the importance of timely commencement of immunisation will ensure timeliness of receipt of birth doses of vaccines.