Globally, immunization coverage dropped from 86% in 2019 to 83% in 2020. An
estimated 23 million children under one year did not receive basic vaccines, which
is the highest number since 2009. Thus, this study aimed at identifying factors
influencing the knowledge and attitude of mothers of under-five children towards
immunization in Farato, The Gambia. A descriptive cross-sectional study was conducted
in the peri-urban community of Farato. A sample of 132 mothers were conveniently
sampled and interviewed using a structured questionnaire. Descriptive statistics
such as percentages, frequencies, and proportions were used to present the results
of this study. The study revealed a low level of knowledge of mothers towards immunization.
About 25% of mothers cannot clearly explain immunization; 23% knew that the first
vaccine dose should be administered to a child at birth or soon after, and 60% were
found to be unaware if their children were immunized. This indicates that the concept
of immunization is not even clear to mothers and also showcased inadequate knowledge.
However, 70% highlighted that immunization prevents infections and enhances child
survival. Inadequate knowledge about immunization,
literacy and education level, occupation of mothers, inadequate information from
health workers, and limited information among mothers were major influencing factors
to drop-out of immunization uptake. The study suggests that mothers need to be taught
what immunization is about and its importance to children. At health facilities
and clinic sites, health workers need to continue communicating to mothers on the
importance of immunization to enlighten them about immunization.
 World Health Organization (2021) Fact sheets: Immunization coverage. https://www.who.int/news-room/fact-sheets/detail/immunization-coverage. Accessed 7 Oct 2021.
 UNICEF (2021) Vaccination and Immunization Statistics. In: UNICEF Data. https://data.unicef.org/topic/child-health/immunization/Accessed 8 Oct 2021.
 Abbas K, Procter SR, van Zandvoort K, et al (2020) Routine childhood immunisation during the COVID-19 pandemic in Africa: a benefit-risk analysis of health benefits versus excess risk of SARS-CoV-2 infection. Lancet Glob Health 8: e1264–e1272.
 World Health Organization (2020) Immunization. In: WHO Reg. Off. Afr. https://www.afro.who.int/health-topics/immunization/Accessed 7 Oct 2021.
 World Health Organization (2018) Business case for WHO
immunization activities on the African continent 2018-2030. In: WHO Reg. Off.
7 Oct 2021.
 Shah MP, Tate JE, Mwenda JM, Steele AD, Parashar UD
(2017) Estimated reductions in hospitalizations and deaths from childhood
diarrhea following implementation of rotavirus vaccination in Africa. Expert
Rev Vaccines 16:987–995.
 Larson HJ, Jarrett C, Eckersberger E, Smith DMD,
Paterson P (2014) Understanding vaccine hesitancy around vaccines and vaccination
from a global perspective: A systematic review of published literature,
2007–2012. Vaccine 32:2150–2159.
 McClure CC, Cataldi JR, O’Leary ST (2017) Vaccine
Hesitancy: Where We Are and Where We Are Going. Clin Ther 39:1550–1562.
 Piot P, Larson HJ, O’Brien KL, N’kengasong J, Ng E,
Sow S, Kampmann B (2019) Immunization: vital progress, unfinished agenda.
 Immunization in Africa. In: Ministry. Conf. Immun.
Afr. http://immunizationinafrica2016.org/immunization-in-africa/Accessed 7 Jul
 Experts caution against the stagnation of immunization
coverage in Africa. In: WHO Reg. Off. Afr. https://www.afro.who.int/news/experts-caution-against-stagnation-immunization-coverage-africa/Accessed
6 Jul 2020.
 Taiwo L, Idris S, Abubakar A, Nguku P, Nsubuga P,
Gidado S, Okeke L, Emiasegen S, Waziri E (2017) Factors affecting access to
information on routine immunization among mothers of under 5 children in Kaduna
State Nigeria, 2015. Pan Afr Med J. https://doi.org/10.11604/pamj.2017.27.186.11191.
 Kg E, Ro E (2018) Perception of Childhood Immunization
among Mothers of Under-Five Children in Onitsha, Anambra State. 6:6.
 Adisa O, Akinleye Ca, Obafisile C, Oke O (2016)
Childhood immunization perception and uptake among mothers of under-five
children attending immunization clinics in Osogbo, Southwestern, Nigeria. Res
J Health Sci 4:186.
 Kyprianidou M, Tzira E, Galanis P, Giannakou K (2021)
Knowledge of mothers regarding children’s vaccinations in Cyprus: A
cross-sectional study. Plos One 16: e0257590.
 Hassan MR, Azman MA, Yong CL, Nazmi TMT, Rashid NNA,
Azmi WNASW, Safian N, Hajib N, Al-Abed AAAA, Ghazi HF (2019) Knowledge and
perception towards supplementary immunization activities (SIA) among mothers in
Cheras, Kuala Lumpur. Malays J Public Health Med 19:126–131.
 Sarfaraz M, Athira A, Lakshmi L, Ravilla S, Nadikudi N,
Doddayya H (2017) Assessment of Knowledge, Attitude and Perception Among
Mothers Towards Immunization in a Tertiary Care Teaching Hospital. Int J
Community Med Public Health 4:3429–3435.
 Negussie A, Kassahun W, Assegid S, Hagan AK (2015)
Factors associated with incomplete childhood immunization in Arbegona district,
southern Ethiopia: a case-control study. BMC Public Health 16:27.
 Ekouevi DK, Gbeasor-Komlanvi FA, Yaya I, Zida-Compaore
WI, Boko A, Sewu E, Lacle A, Ndibu N, Toke Y, Landoh DE (2018) Incomplete
immunization among children aged 12–23 months in Togo: a multilevel analysis of
individual and contextual factors. BMC Public Health 18:952.
 Touray E, Barrow A, Kinteh B, Badjie M, Nget M, Touray
J, Kinteh SLS, Jatta SPS, Ceesay L (2021) Childhood vaccination uptake and
associated factors among children 12–23 months in rural settings of the Gambia:
a community-based cross-sectional study. BMC Public Health 21:1740.
 Abatan B, Agboghoroma O, Akemoke F, et al (2021)
Intense and Mild First Epidemic Wave of Coronavirus Disease, The Gambia. Emerg
Infect Dis 27:2064–2072.
 Mapatano M, Kayembe K, Piripiri L, Nyandwe K (2008)
Immunisation-related knowledge, attitudes, and practices of mothers in
Kinshasa, Democratic Republic of the Congo. South Afr Fam Pract 50:61–61e.
 Almutairi WM, Alsharif F, Khamis F, Sallam LA, Sharif
L, Alsufyani A, Alshulah FN, Alqasimi R (2021) Assessment of Mothers’ Knowledge,
Attitudes, and Practices Regarding Childhood Vaccination during the First Five
Years of Life in Saudi Arabia. Nurs Rep 11:506–516.
 Saso A, Skirrow H, Kampmann B (2020) Impact of
COVID-19 on Immunization Services for Maternal and Infant Vaccines: Results of
a Survey Conducted by Imprint—The Immunising Pregnant Women and Infants
Network. Vaccines 8:556.
 Bell S, Clarke R, Paterson P, Mounier-Jack S (2020)
Parents’ and guardians’ views and experiences of accessing routine childhood
vaccinations during the coronavirus (COVID-19) pandemic: A mixed-methods study
in England. Plos One 15: e0244049.
 Uwaibi NE, Akhimienho IK (2020) Assessment of
knowledge and practice of childhood routine immunization among
mothers/caregivers attending primary health care centres in Benin City, Edo
State, Nigeria. J Appl Sci Environ Manag 24:1703–1710.
 Hu Y, Luo S, Lou L, Zhang B, Li Q (2016) Knowledge,
Attitude and Practice on Immunization among Migrant Mothers: A Questionnaire
Development and Field Application. Open Access 6.
 The Gambia Bureau of Statistics (GBoS), Ministry of
Health (MoH) [The Gambia], and ICF (2020) The Gambia Demographic and Health
Survey 2019-20: Key Indicators Report. Banjul, The Gambia, and Rockville,
Maryland, USA: The Gambia Bureau of Statistics, Ministry of Health, and ICF.
 Gambia Bureau of Statistics (2013) Gambia Demographic
Health Survey 2013.
 Gambia Bureau of Statistics (2019) The Gambia Multiple
Indicator Cluster Survey 2018, Survey Findings Report. Banjul, The Gambia. https://www.unicef.org/gambia/media/776/file/The%20Gambia%20Multiple%20Indicator%20Cluster%20Survey%202018.pdf/Accessed
16 Aug 2020.