FACTORS AFFECTING IMMUNISATION STATUS - PowerPoint Presentation

1. FACTORS AFFECTING IMMUNISATION STATUS OF CHILDREN UNDER ONE YEAR ATTENDING IMMUNISATION SERVICES AT ISHAKA ADVENTIST HOSPITAL, BUSHENYI DISTRICTMUTESI JAMIRAHDCM/0011/151/DUA RESEARCH REPORT FOR THE AWARD OF DIPLOMA IN CLINICAL MEDICINE AND COMMUNITY HEALTH OF KAMPALA INTERNATIONAL UNIVERSITY WESTERN CAMPUS

2. INTRODUCTION Immunization is the administration of attenuated vaccine to protect the person against subsequent infection or disease (UNICEF, 2017).In 2015, an estimated 19.4 million infants worldwide were not reached with routine immunization services (WHO, 2014).Canavan et al. (2014) reported mortality rate of 83 deaths per 1000 live births for children under 5 years in sub-Saharan Africa In Uganda, only 78% of children received the third dose of DPT-HepB+Hib vaccine in 2015 (UNICEF and WHO, 2017). Partial immunization of children in Uganda has increased mortality among infants (Bbaale, 2015).Thus, this study was to clearly figure out the factors affecting immunization status of children under 1 year at Ishaka Adventist Hospital.

3. PROBLEM STATEMENTAccording to Bbaale, (2015) reported that despite the continuous massive campaigns for full immunization of children; Over 24,000 children still die of vaccine-preventable diseases every day worldwide. With a bigger proportion of 4.4 million annual death in sub-Saharan Africa.Furthermore, studies reported only 58% full immunization coverage in Western Uganda including Bushenyi (Bbaale, 2015). Therefore, the factors contributing to partial childhood immunization if well addressed would significantly increase full immunization coverage.

4. OBJECTIVESGeneral objectivesTo assess the immunization status and factors affecting it among children under one year attending immunization services at Ishaka Adventist Hospital Bushenyi district.Specific objectivesTo determine the immunization coverage among children under one year towards the nine vaccine preventable diseases at Ishaka Adventist Hospital Bushenyi district.To determine the socio-demographic, maternal, child and health service factors affecting full immunization status of children under one year at Ishaka Adventist Hospital Bushenyi district.

5. METHODOLOGYStudy Design.It was a descriptive cross-sectional study done at Ishaka Adventist Hospital, Bushenyi District.Study was done between July to September, 2017.Study populationThe study was conducted among children under one year who attended immunization services. The study population was 220 children at this study area.According to Krejcie and Morgan table, 140 respondents were randomly selected.

6. METHODOLOGY CONT’D…Data collection methods.Structured questionnaires were used to collect raw data.Pre-tested questionnaires before collecting data.|These were interviewed in a private room one at a time.The respondents were guided on how to fill the questionnaires. Data analysisData was analyzed using SPSS version 16 statistical software.Both bivariate and multivariate analysis were done.Statistical significance was considered at p ≤0.05.Results were computed as percentage, median in tables & graphs.

7. RESULTSImmunization coverage among children under one year at Ishaka Adventist HospitalOut of the 140 participants studied, majority 123 (88%) of the participants’ children were fully immunized.17(12%) were partially immunized as shown in figure 1.Figure 1; Immunization coverage among children under one year at Ishaka Adventist Hospital

8. RESULTS CONT’D…Factors affecting Immunization status of children under one year at Ishaka Adventist Hospital (table 1)Socio-demographic factors; parents’ education level was not significant at multivariate analysis although it was at bivariate.Maternal and child factors; the parents without immunization cards were 83.3% less likely to have their children fully immunized this was statistically significantHealth facility related factors; parents who travelled more than 5 km and 3 to 5 km to the health facility were significantly less likely to have their children fully immunized as compared to those who travelled less than 2 km.Availability of vaccines significantly increased the full immunization status of children by 3.947 times

9. Table 1; Multivariate analysis of risk factors affecting immunization status of children under 1 year.Predictors Adjusted OR95% CIP-valueHave immunization card   No 0.1670.033-0.8520.031 ⃰Yes 1.000  Distance to health facility (km)   ≤ 20.1060.024-0.4600.003 ⃰3-50.1040.019-0.5720.009 ⃰≥51.000  Availability of vaccine   Yes3.9471.113-13.9960.033 ⃰No 1.000  Education level   Primary 5.4630.953-31.3310.057Secondary 3.2520.554-19.0780.191Tertiary 1.00  ⃰ Statistically significant factors at 95% level of confidence.

10. DISCUSIONS & CONCLUSIONSThe full immunization coverage obtained in this study was consistent with the Global Vaccine Action Plan of at least 80% coverage in every district by 2020 (Bbaale, 2015).However, this was higher than that reported Western Uganda (58%) by (Bbaale, 2015), 23% in Kenya (Elizabeth et al., 2015), 24.3 % (Lakew et al., 2015) and 30.5% (Town & Ayano, 2015) in EthiopiaFull immunization status was lowered due to lack of immunization cards which was in agreement with the findings of similar studies in Uganda by Bbaale, (2015) and in Ethiopia by Lakew et al. (2015b)Having vaccination cards facilitate the follow up of different vaccines, schedules and doses and remind mothers to avoid dropout doses

11. .Travelling distances longer than 2km lowered full immunization status which was parallel to the findings reported by Farzad et al. (2017) in Malaw, probably due to high transport costs incurred yet parents are local peasants farmers. Availability of vaccine was in agreement with a study done in Kenya (Town & Ayano, 2015). This was enhanced by presence of free vaccination services (92.9%) provided by the government of Uganda ConclusionsMajority 123 (88%) of the participants’ children were fully immunized while 17(12%) were partially immunized. Risk factors that affected full immunization of children were; lack of immunization cards, travelling longer distances more than 2 kmy and availability of vaccines at the health facilities

12. REFRENCESBbaale, E. (2015). Immunization in Uganda, 31(1), 118–129.Canavan, M. E., Sipsma, H. L., Kassie, G. M., & Bradley, E. H. (2014).Correlates of Complete Childhood Vaccination in East African Countries, 9(4), 1–7. Elizabeth Kiptoo, Moses Esilaba, G., & Ngure, K. and R. (2015). Factors influencing Low Immunization Coverage Among Children Between 12 – 23 months in East Pokot , Baringo, 1(2), 1–6.Farzad, F., Reyer, J. A., Yamamoto, E., & Hamajima, N. (2017). Socio-economic and demographic determinants of full immunization among children of 12–23 months in Afghanistan, 179–188. Town, H., & Ayano, B. (2015). Factors Affecting Fully Immunization Status of children Aged 12- 23, 2(5). UNICEF and WHO. (2017). Uganda: WHO and UNICEF estimates of immunization coverage: 2015 revision, 1–20.WHO. (2014). Global Immunization Data, (July), 82–85.