Missed Opportunities for Vaccination: A Descriptive Study of Primary and Secondary Health Facilities in Bayelsa State, Nigeria
Abstract:
Immunization is one of the most effective
public health interventions aimed at reducing child morbidity and mortality yet
missed opportunities for vaccination (MOV) and systemic barriers continue to undermine
immunization efforts in Nigeria and Bayelsa state in particular. This study
assessed the prevalence, determinants, and systemic challenges associated with
routine immunization uptake in Bayelsa State. A descriptive cross-sectional
design was employed, involving 354 caregivers of children under five and 50
health workers across selected facilities. Data was collected using structured
questionnaires, facility checklists, and interviews. Quantitative data were
analyzed using SPSS version 26 with descriptive statistics, Chi-square tests,
and logistic regression. Qualitative responses were thematically analyzed.
Findings revealed that 34.5% of children experienced MOV, with measles (44.3%)
and oral polio vaccine (30.3%) being the most frequently missed. Systemic
challenges included vaccine stockouts (54%), cold chain failures (36%), and
poor service integration (58%). Logistic regression showed that stockouts (AOR
= 0.42, p < 0.001), cold chain breakdown (AOR = 0.58, p = 0.030), caregiver
knowledge of immunization schedules (AOR = 2.11, p = 0.005), and service
integration (AOR = 1.89, p = 0.022) significantly influenced adherence. This
study concludes that systemic factors outweigh caregiver-level determinants in
explaining missed opportunities. Addressing supply chain gaps, strengthening
cold chain infrastructure, and services’ integration are crucial steps toward reducing
missed opportunities and improving vaccination coverage in Nigeria.
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