Maternal satisfaction toward childhood immunization service and its associated factors in Mogadishu, Somalia

Immunization is a critical and cost-effective public health intervention, yet Somalia continues to face low coverage and high child mortality. This study assessed maternal satisfaction with childhood immunization services and its associated factors in Mogadishu, Somalia. A community-based cross-sectional study was conducted from September to November 2024 among 400 mothers or caregivers whose children received immunization. Data were collected using a structured interviewer-administered questionnaire covering socio-demographics, access, process-related experiences, and satisfaction, and analyzed using SPSS version 24. Logistic regression was employed to identify factors associated with maternal satisfaction. Overall, 49.3% of mothers were satisfied with the immunization services. In the multivariable logistic regression, several factors were significantly associated with maternal satisfaction. Mothers residing outside Mogadishu had higher odds of satisfaction compared to those residing within the city (AOR = 5.677; 95% CI: 2.057-15.707). Male children were associated with higher odds of maternal satisfaction compared to females (AOR = 1.690; 95% CI: 1.057-2.701). Children of second or third birth order had lower odds of maternal satisfaction than first-borns (AOR = 0.383; 95% CI: 0.209-0.700). Mothers with primary education (AOR = 0.293; 95% CI: 0.171-0.503) and high school education (AOR = 0.217; 95% CI: 0.078-0.602) had lower odds of satisfaction compared to those with no formal education. Finally, mothers who were self-employed had higher odds of satisfaction compared to housewives (AOR = 5.678; 95% CI: 2.310-13.954). The findings underscore the need to strengthen caregiver education, address service disparities, and enhance communication for improved immunization outcomes.