Factors acting as barriers to routine measles immunization on children morbidity in Homa Bay district, Kenya
Odanga, Aluoch Josephine
MetadataShow full item record
Measles remains a major cause of vaccine-preventable illness and death; it is therefore a major public health problem in developing countries, due to low trends of immunization coverage. A descriptive cross sectional survey was conducted in Nyagonyi and Asego Divisions of Homa Bay District, Kenya, between October and December 2002. The survey determined the trends of routine measles immunization on measles epidemiology, with an aim of identifying the factors that were possible barriers to the immunization strategy and ways of strengthening it. Trends of routine measles immunization coverage and morbidity were determined through review of records of children with previous measles infection. Socio-cultural, economic, operational factors impeding routine measles immunization and intervention measures for strengthening measles immunization were also established through systematic interview of mothers who visited health facilities with their children. Focused group discussions were held with members of CBOs while key Informant Interviews were also held with DHMT members who were selected purposively. Nyagongi Division recorded immunization coverage (1999-2002) of 20.3% compared to 35.05% of Asego (c2=61.899,p<0.001 and O.R. 9932, p>0.05), thus the coverage considered to be low in both Divisions. The female to male ratio of measles occurrence by sex was 1.1:1. The measles age-specific morbidity rate was high in the 0-4 years age cohort, than in the 10-14 years age cohorts, more in Nyarongi than Asego (c2=4.085, p<0.05 and O.R 396.6624, p>0.05). This reflected the low trends of routine measles immunization in both Divisions. Majority of the children from both Divisions had their immunization status (c2=3.059, p>0.05 and O.R. 7791.9708, p>0.05), reflecting a weal system of reporting in both Divisions, leading to an incomplete evaluation of measles epidemiology. Lack of money emerged more of a barrier to routine measles immunization (c2=16.721, p<0.001 and O.R. 2.4702, p<0.05) than other socio-economic related factors cited. More mothers from Nyarongi than Asego walked to the health facilities for immunization services (c2=16.658, p>0.001 and O.R. 138.5384, p>0.05). The higher the charges on travel and other expenses reduced mothers' chances of presenting children the charges on travel and other expenses reduced mothers' chances of presenting children for immunization in Nyarongi than Asego (c2=11.706, p<0.001 and O.R. 17.5793, P<0.05). The socio-cultural factors that impeded routine measles immunization had less chances of increasing immunization coverage in both Divisions (c2=14.149, p<0.001 and O.R. 0242, p<0.001). Altitude of health workers as an operational factor was more likely to bar mothers from taking their children for immunization than other factors cited (c2=38.152, p<0.001 and O.R 5.6685, p<0.001). There is therefore need to strengthen routine measles immunization strategy by elimination of the obstacles through; vigorous advocacy with policy makers, health managers, health managers and health care providers at all levels; and in addition intersectoral collaboration and partnership with members of the provincial administration, community based organizations, opinion leaders and Non Governmental organizations in the District.
- MST-Zoological Sciences