Routine Vaccination Coverage and Related Factors Among Children Aged 12-23 Months in One Rural Area of Nangarhar Province, Afghanistan

Abstract

Vaccination has been shown to be one of the most cost effective health interventions worldwide, through which a number of childhood diseases have been successfully prevented or eradicated. The objectives of this study were to assess vaccination status of children aged 12-23 months living in a rural area, Kama District-Afghanistan, to identify the factors associated with full vaccination, and common reasons for non-vaccination. In this cross sectional survey the data were gathered via a structured pre-tested questionnaire form. Overall responses from 882 of the participants were analyzed by using IBM SPSS Statistics 21 Program. Findings were presented in marginal and contingency tables. Mainly Chi Square test was used with α=0.05 to find out significance level of differences and then binary logistic regression was used to assess the strength of association, between full-vaccination status and independent factors. Vaccination coverage with vaccination card plus mother’s verbal report was higher than card only coverage and highest for OPV1 (92.3%; 59.3%), followed by BCG (90.8%; 59.2%), Penta1 (90.0%; 59.3%), OPV2 (87.9%; 57.4%), Penta2 (85.6%; 57.1%), OPV3 (77.2%; 52.7%), Penta3 (73.1%; 51.8%), and it was lowest for measles vaccine (70.9%; 49.8%). Drop-out rate for major antigens was much higher than the acceptable level. In total (card plus mothers’ recall) out of 882 children, 69.7% were fully vaccınated (only card 48.9%; only mothers’ recall 20.8%), 23.0%, were partially vaccinated (only card 10.5%; only mothers’ recall 12.5%), and 7.3% (from mothers’ recall) were non-vaccinated. Child sex, family size, maternal education, paternal education, utilization of maternal health services by mothers and existence of mothers’ knowledge on vaccines and vaccination were the common predictors for fully vaccinated status of the children. The most common primary reason for non-vaccination was family problems (25.6%), followed by rumors (16.9%), and fear of side effects (16.6%).