Determinants of immunization defaulters among children aged 12–23 months in Ambo town, Oromia, Ethiopia: A case–control study

ABSTRACT

Immunization is a public health intervention to reduce morbidity and mortality among children. However, vaccination becomes more effective if the child can receive the full course of recommended vaccination doses according to the schedule. Many children fail to complete the full course of vaccination. To identify the determinants of immunization defaulters among children aged 12–23 months in Ambo town, Oromia, Ethiopia. A community-based, unmatched, case–control study was done from October 1 to 25, 2021. A simple random sampling was used to select 317 (106 cases and 211 controls). Data were collected by using a pretested and structured questionnaire. Data were coded and entered to Epi-data version 3.1 and then transported to SPSS version 21.0 for statistical analysis. Descriptive analysis like frequency, mean, and percentage was calculated. Binary and multivariable logistic regression analysis was done. Finally, variables with a p value  < .05 were considered statistically significant. Urban residences (AOR = 0.288, 95% CI, 0.146, 570), government employee (AOR = 0.179, 95% CI, 0.057, 0.565), number of family members more than four (AOR = 2.696, 95% CI, 1.143, 6.358), higher income (AOR = 0.250, 95% CI, 0.099, 0.628), attending ANC (AOR = 0..237, 95% CI, 0.107, 0.525), and good awareness (AOR = 0.070, 95% CI, 0.005, 308) were significant predictors of immunization defaulters. This study has found that urban residences, government employee by occupation, number of family members more than four, higher monthly income, and attending ANC were identified as determinants of childhood immunization defaulters. Social Behavior Change intervention programs should focus on providing health information about the importance of the vaccine and vaccine schedule. Due attention should be given for rural residents and farmers who had limited access to information and are more prone to defaulting. Policy-makers should consider those identified factors while designing intervention programs to enhance vaccination coverage.

KEYWORDS:

• Childhood immunization
• defaulters
• determinants
• 12–23 month children
• vaccination
• Ethiopia

Abbreviations and acronyms

ANC: Antenatal care; AOR: Adjusted Odds Ratio; BCG: Bacillus Calmette Guerin; CHI: Childhood Immunization; COR: Crude Odds Ratio; DHS: Demographic Health Survey; DOR: Dropout Rate; DPT: Diphtheria, pertussis, tetanus; EDHS: Ethiopian Demographic Health Survey; eHMIS: electronic Health Management Information System; EPI: Expanded Program on Immunization; ETB: Ethiopian birr; HEWs: Health extinction workers; HPV: Human papilloma virus; HSTP: Health Sector Transformation Plan; MCH: Maternal and Child Health; MCV: Measles Vaccine; OPV: Oral Polio Vaccine; PCV: Protein conjugated polysaccharide vaccine; PNC: Postnatal Care; SBA: skill birth attendant; SPSS: Statistical Package for Social Science software; TTBA: traditional birth attendant; TT: Tetanus toxide; UHEPs: Urban Health Extension professionals; VPD: Vaccine-Preventable Disease; WHO: World Health Organization.

Acknowledgments

We would like to express our deepest gratitude to Ambo University, College of Health Sciences, and Department of Public Health for timely approval of the topic. Our special thanks go to the Ambo town Administrative and Health office staff that supported me in providing preliminary information about the study subjects’ family health team for giving me the town information relevant to this thesis. Last but not least, we are also pleased to thank the study participants, data collectors, and supervisors for their time and contribution to the study.

Author contributions

All authors made substantial contributions to the conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethical approval and consent to participate

Ethical clearance was obtained from Ambo University, College of Medicine and Health Sciences by institutional review board. Permission letter was obtained from the district health office and from each selected Kebeles. After the purpose and objective of the study was informed, written informed consent was obtained from each study participants. All participants were informed that participation was on a voluntary basis and they could withdraw from the study at any time if they were not comfortable with the questionnaire. To maintain confidentiality, data were collected and analyzed anonymously. All methods were carried out in accordance with the Declaration of Helsinki.

Availability of data and material

The datasets used and/or analyzed during the current study are available from the first author on reasonable request.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.