Factors influencing routine immunization coverage among children in Nyeri district, Kenya
Njeru, Sammy Kagoiyo
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This study was conducted in Nyeri District of the Republic of Kenya on factors influencing routine immunization coverage among children. The study took place between August, 2004 and covered Mukurweini and Tetu Divisions. Routine immunization coverage in the developing world is low at 60% compared to the developed world, above 80 %. Due to the low coverage many children have died from lack of immunization while others have been disabled. In Kenya the Infant Mortality Rate is currently estimated to be 77 per 1,000 live births while the under five mortality rate is 115 per 1,000 live births. A descriptive cross sectional survey which determined trends of routine immunization coverage in two divisions of Nyeri District was undertaken to find factors that were possible hindrances to the routine immunization and the corrective measures that can be instituted. Information was received from mothers/caretakers who brought their children to the immunizing health facilities and also from health workers and opinion leaders who filled in the questionnaires respondents. The other information was received from the desk reviews in the permanent Register for immunized children. Focus Group Discussion were also done for back up information. The study compared determinants of the social, cultural, economic and operational impacts on the routine immunization in Mukurweini and Tetu divisions to strengthen the mechanisms employed in the routine immunization. Mukurweini division recorded an immunization coverage of 72.06% (1999-2003) compared to 83.93% in Tetu (x2 =27.030, P<0.05, dfl, O.R. 4938). Thus there was a moderate coverage in Mukurweini and a high coverage in Tetu Division. The ratio in male to female of the children immunized was 1:1.2. The higher number of immunized children in both divisions was in the age bracket of 1-4 months (88.7%) depicting a high immunization coverage in the start of the children's lives. This coverage reduced to 0.05% at 12 months of children's age. This indicates that few children appeared for immunizations as they advance in age. Majority of mothers/caretaker (20.9%) expressed fear of side effects associated with vaccines such as fever. They also feared that immunization would cause impotence in their children (17.07%) in both divisions. Only 2.4% indicated that their religious sect did not allow their children to be taken for immunizations or conventional medical treatments. These socao-cultural factors impacted negatively in routine immunizations coverage in both divisions. Poor economic status exemplified by lack of funds for routine purposes, and more so for transport to the immunizing health facilities was also noted as a hindrance to routine immunization. The most affected division was Mukurweini (x2 = 10.295, P<0.001, df 1 OR 2.6963, P<0.05). The negative attitude of some health workers was cited in both divisions as an operational factor impeding routine immunizations (x2 = 2.2836, P<0.001, OR.651). This factor was more likely to weaken immunizations by preventing mothers from bringing their children for routine immunizations. The most likely measure cited in countering the factors which can hinder routine immunizations was recruitment of more health centers staff with 222 (24.8%) responses. To effectively strengthen the routine immunization, elimination of obstacles by policy makers, and radical but careful implementation of the recommendations given should be done. The findings of this study will be important to the policy makers, the GOK and NGO'S in improving and strengthening routine immunizations with a view to achieving a high coverage (80% and above) in Nyeri District. The same information can be replicated to other Districts with low to moderate coverage's to assist them achieve a high coverage.
- MST-Zoological Sciences