Determinants of full vaccination among children aged 12-23 months in Katheka Kai location, Machakos County, Kenya

Abstract

Since inception of the Expanded Programme on Immunization (EPI) by WHO in 1974, immunization coverage has been steadily increasing and currently stands at 86% globally. Consequently, this has led to a significant reduction in child mortality and morbidity. It is estimated that two to three million deaths from polio, diphtheria, tuberculosis, pertussis, measles, and tetanus are averted through EPI. According to the Kenya Demographic and Health Survey (KDHS 2014), 75% of children aged 12-23 months were fully vaccinated with BCG, measles, Diphtheria, Pertussis, Tetanus, Haemophilus Influenza type B, Hepatitis B and polio vaccines under the Kenta Program (KEPI). As a result, millions of lives of children have been saved over the years. Despite these obvious benefits, vaccination coverage remains low especially in developing countries. This cross sectional study was undertaken to determine vaccination coverage and to determine vaccination coverage and its determinants among children aged 12 – 23 months in Katheka Kai Location Machakos County. A total of 384 households with children aged 12- 23 months were sampled using simple random sampling for interviews. Respondents were mothers/caretakers of the children in those households. Random sampling was used to identify households for inclusion in the study and then mothers or caregivers in the identified households interviewed. Data was collected using an interviewer administered questionnaire and an immunization checklist. Data was coded and input into SPSS version 19 for analysis. Slightly more than half of the respondents 230 (59.9%) had at least secondary education and above and 276 (71.9%) of the households earned a monthly income of KES 5000 and above. More than half of the households 217 (56.5%) dwelt less than four kilometers to the nearest health facility. The study found that 83% of the children were fully vaccinated. Knowledge on immunization was high , 360 (93.8%) knew the reasons why children get vaccination and slightly more than half 212, (55.4%) knew at least three correct vaccines that are administered to children, while almost an proportion (58.1%), knew at least three vaccine preventable childhood diseases. Factors associated with full immunization were education level of respondents (χ 2=82.178, P < 0.001), knowledge on routine childhood vaccinations (χ 2 = 119.275, P<0.001) and vaccine preventable diseases among children, (χ 2 = 17.579, P = 0.004), mothers antenatal clinic (ANC) attendance (χ 2 = 115.52, P<0.001) and distance from the respondents’ home to the health facility (χ 2= 45.332, P<0.000). Other factors were place of birth of child (χ 2=204.714, P<0.001) and household income (χ 2= 84.178, P<0.000). Predictors of full immunization were level of education of mother/caretaker, place of delivery for the child and number of ANC visits. The vaccination coverage for the Sub Location (83%) was below the County’s coverage (90%) and below the national target of 90%. Efforts need to be stepped up to reach the children who are no fully immunized so as to reach the national target. Strategies to increase health facility deliveries should be implemented as this significantly leads to increased vaccination coverage. Since inception of the Expanded Programme on Immunization (EPI) by WHO in 1974, immunization coverage has been steadily increasing and currently stands at 86% globally. Consequently, this has led to a xvi significant reduction in child mortality and morbidity. It is estimated that two to three million deaths from polio, diphtheria, tuberculosis, pertussis, measles, and tetanus are averted through EPI. According to the Kenya Demographic and Health Survey (KDHS 2014), 75% of children aged 12-23 months were fully vaccinated with BCG, measles, Diphtheria, Pertussis, Tetanus, Haemophilus Influenza type B, Hepatitis B and polio vaccines under the Kenya Program (KEPI). As a result, millions of lives of children have been saved over the years. Despite these obvious benefits, vaccination coverage remains low especially in developing countries. This cross sectional study was undertaken to determine vaccination coverage and to determine vaccination coverage and its determinants among children aged 12 – 23 months in Katheka Kai Location Machakos County. A total of 384 households with children aged 12- 23 months were sampled using simple random sampling for interviews. Random sampling was used to identify households for inclusion in the study and then mothers or caregivers in the identified households interviewed. Data was collected using an interviewer administered questionnaire and an immunization checklist. Data was coded and input into SPSS version 19 for analysis. Slightly more than half of the respondents 230 (59.9%) had at least secondary education and above and 276 (71.9%) of the households earned a monthly income of KES 5000 and above. More than half of the households 217 (56.5%) dwelt less than four kilometers to the nearest health facility. The study found that 83% of the children were fully vaccinated. Knowledge on immunization was high, 360 (93.8%) knew the reasons why children get vaccination and slightly more than half 212, (55.4%) knew at least three correct vaccines that are administered to children, while almost an equal proportion (58.1%), knew at least three vaccine preventable childhood diseases. Factors associated with full immunization were education level of respondents (χ 2=82.178, P < 0.001), knowledge on routine childhood vaccinations (χ 2 = 119.275, P<0.001) and vaccine preventable diseases among children, (χ 2 = 17.579, P = 0.004), mothers antenatal clinic (ANC) attendance (χ 2 = 115.52, P<0.001) and distance from the respondents’ home to the health facility (χ 2= 45.332, P<0.000). Other factors were place of birth of child (χ 2=204.714, P<0.001) and household income (χ 2= 84.178, P<0.0001). Predictors of full immunization were level of education of mother/caretaker, place of delivery for the child and number of ANC visits. The vaccination coverage for the Sub Location (83%) was below the County’s coverage (90%) and below the national target of 90%. Efforts need to be stepped up to reach the children who are no fully immunized so as to reach the national target. Strategies to increase health facility deliveries should be implemented as this significantly leads to increased vaccination coverage