Abstract:
Childhood immunization is regarded as key to preventive and promotive health care
in any community. Low immunization coverage is indicative of poor health status in
children under-five years. Vitamin A supplementation is also important in
strengthening the immune system as well as preventing blindness in children underfive years. In Kenya, about three quarters of children aged between 12-23 months are
reported to receive all recommended vaccinations while more than half of them
receive Vitamin A Supplements. However, there exist variation within
provinces/Counties on the coverage of both immunization and Vitamin A
Supplementation. The study was a cross-sectional study conducted at the household
level to assess the immunization and vitamin A supplementation and associated
factors among children aged 12-23 months in Mwaluphamba Sub-County Kwale
County. The primary sampling units were households within Health Demographic
Surveillance Site. A total of 285 households were sampled. A structured
questionnaire was used to capture socio demographic, socio economic and health
provision characteristic. Data analysis was done using SPSS software version 20 and
p-value was set at < 0.05. Coverage for individual immunizations were BCG 99%,
OPV3 31.6%, Pentavalent three 83.2% and Measles 67.8%. Polio vaccination
coverage was significantly associated with level of education (p=0.035), type of
employment (p=0.002), distance to health facility (p=0.031), time taken to health
facility (p=0.008), place of last delivery (p<0.001) and facilitator during delivery
(P<0.001). Pentavalent vaccination coverage had significant association with gender
of the child (p=0.030), place of delivery (p=0.047), type of facilitator during delivery
(p=0.034) and time (p=0.013). Measles vaccination coverage had significant
association with place of last delivery (p=0.006) and type of facilitator during
delivery (p=0.003). First dose of VAS coverage was significantly associated with by
gender of the child (p=0.034), religion of the respondents (p=0.047), place of last
delivery (p<0.001) and delivery assistant. (p=0.019). Second dose of VAS had
significant association with age of the respondent (p=0.009), place of last delivery
(p=0.001) and type of facilitator during delivery (p=0.036). Immunization coverage
was lower than 77% reported in KDHS 2014 and the 80% recommended by WHO.
The dropout rate between those who received BCG at birth and those who received
measles vaccine at 9 months was high 31.2%. There was discrepancies in coverage
of OPV3 and third dose of pentavalent vaccines which are given concurrently
where polio vaccine (31.6%) was lower than pentavalent vaccine (83.2%). Vitamin
A coverage at first dose was 45% while at second dose was 29.5%. Effective
vaccination outreach services need to be put in place to target those who miss out on
receiving vaccinations during immunization days. More efforts to be put in place in
improving delivery rates in health facilities and with assistance by health workers, as
these are positively associated with higher vaccination coverage. Health education
and sensitization on the importance of child vaccinations and Vitamin A supplements
should be provided in the study area.