Disparities in Vaccination Coverage and Timeliness among Children Aged 12 to 23 Months within Calabar South, Cross River State, Nigeria
Abstract:
Immunization serves as a cost-effective shield against
vaccine-preventable diseases, promoting population health and sustainable
prosperity. This study aimed to determine vaccination coverage and assess the
timeliness of vaccination (BCG, PENTA1, and measles vaccines) among children
aged 12 to 23 months in the wards of Calabar South Local Government Area (LGA)
in Cross River State. A community-based cross-sectional descriptive design was
employed, with the number of children sampled being 460 to account for
non-response and design. Information about children were obtained through
interviews with proxy caregivers. Data analysis was performed using SPSS
version 25.0. Ethical approval was obtained from the CRS Ministry of Health.
There were 190 male children (41.3%) and 275 female children (58.7%) in the
study. The age group of 12-15 months (55.2%) represents the largest category.
The overall vaccination coverage was 88.3%, varying across wards (100% in ward
4, followed by 96.1% in ward 8, then 96% in ward 5, 91.6% in ward 12, and 80.8%
in ward 11). The proportion of overall timely vaccination was 71.5%, with
PENTA1 having the highest timeliness (88.3%). The proportions of timely
vaccination for BCG and PENTA1 were highest in ward 4, followed by ward 5, but
lowest in ward 11. Timeliness for all vaccines was also highest in ward 4,
followed by ward 12, then ward 5, ward 8 and ward 11. Vaccination coverage and
timeliness differed between locations, highlighting the need for Government
interventions to be context-specific, addressing challenges within different
ward locations rather than applying a one-size-fits-all approach.
References:
[1] World Health
Organization, 2020, World health
statistics 2020: Monitoring health for the SDGs, sustainable development goals.
World Health Organization.
https://www.who.int/gho/publications/world_health_statistics/2020/en/.
[2]
Keja, K., Chan, C., Hayden, G. H. R., 1988, ‘Expanded
Programme on Immunization. World Health Stat Q, 1988; 41:59-63.
[3]
Galles, Natalie C. et al., 2021, ‘Measuring Routine Childhood
Vaccination Coverage in 204 Countries and Territories, 1980–2019: A Systematic
Analysis for the Global Burden of Disease Study 2020, Release 1’. The Lancet
398(10299): 503–21.
[4]
NPHDA, 2016, ‘National Primary Healthcare Development Agency
and National Bureau of Statistics. Nigeria, National Immunization Coverage
Survey 2016/17, Final Report. Abuja, Nigeria: National Primary Healthcare
Development Agency and National Bureau of Statistics.
[5]
WHO/UNICEF, 2005, ‘World Health Organization, UNICEF. Global
Immunization Vision and Strategy 2016-2015. Geneva, Switzerland: World Health
Organization; 2005. Available at
Http://Www.Who.Int/Vaccines-Documents/Docspdf05/Givs_final_en.Pdf.
[6]
WHO, 2013, ‘Global Vaccine Action Plan 2011–2020. Available
at: Https://Www.Who.Int/Publications/i/Item/Global-Vaccine-Action-
Plan-2011-2020 (Accessed May 16, 2023)’. Available at
Http://Www.Who.Int/Vaccines-Documents/Docspdf05/Givs_final_en.Pdf.
[7]
CDC, 2009, ‘CDC. Global Routine Vaccination Coverage, 2009, MMWR
2010;59:1367--71.
[8]
MOH-Napal, 2018, Department of Health Services, Ministry of
Health and Population, Government of Nepal. Annual Report 2018. Kathmandu:
Ministry of Health and Population , Government of Nepal, 2017/18.
[9]
Haider, E. A., Willocks, L. J., Anderson, N., 2019,
Identifying Inequalities in Childhood Immunisation Uptake and Timeliness in
Southeast Scotland, 2008-2018: A Retrospective Cohort Study. Vaccine.
2019, 37(37), 5614–24. Https://Doi.Org/10.1 016/j.Vaccine.2019.07.080.
[10] World Health
Organization, 2013, Global status report
on road safety 2013: Supporting a decade of action. World Health
Organization. https://www.who.int/publications/i/item/9789241564564.
[11] Causey, K.,
Fullman, N., Sorensen, R. J. D., Galles, N. C., Zheng, P., Aravkin, A.,
Danovaro-Holliday, M. C., Martinez-Piedra, R., Velandia-González, M. P. &
Sodha, S. V., 2021, Estimating global and regional disruptions to routine
childhood vaccine coverage during the COVID-19 pandemic.
[12]
Ota, M. O. C., Badur, S., Romano-Mazzotti, L., Friedland, L. R.,
2021, ‘Impact of COVID-19 Pandemic on Routine Immunization’. Ann. Med.
53: 2286–2297.
[13]
Dadari, Ibrahim et al., 2023, ‘Achieving the IA2030 Coverage
and Equity Goals through a Renewed Focus on Urban Immunization’. Vaccines
11(4): 1–16.
[14]
UN. 2016. ‘United Nations Sustainable Development Goals: 17
Goals to Transform Our World. Http://www.un.org/Sustainabledevelopment/.
Accessed 1st June, 2023.
[15]
Prakash R, Kumar A., 2013, ‘Urban Poverty and Utilization of
Maternal and Child Health Care Services in India. J Biosoc Sci., 2013, 45(4),
433–49.
[16] Cutts, F. T., Izurieta, H. S., Rhoda,
D. A., 2013, Measuring Coverage in MNCH: Design, Implementation, and
Interpretation Challenges Associated with Tracking Vaccination Coverage Using
Household Surveys. PLoS Med, 10(5), e1001404.
https://doi.org/10.1371/journal.pmed.1001404.
[17] Chang, A. Y., Riumallo-Herl, C.,
Perales, N. A., Clark, S., Clark, A., Constenla, D., Garske, T., Jackson, M. L.,
Jean, K., Jit, M., Jones, E. O., Li, X., Suraratdecha, C., Bullock, O., Johnson,
H., Brenzel, L., Verguet S., 2018, The Equity Impact Vaccines May Have On
Averting Deaths And Medical Impoverishment In Developing Countries. Health
Aff (Millwood)., 37(2):316-324. doi: 10.1377/hlthaff.2017.0861. PMID:
29401021.
[18]
Li, X., Mukandavire, C., Cucunubá, Z. M., et al., 2021,
‘Estimating the Health Impact of Vaccination against Ten Pathogens in 98
Low-Income and Middle-Income Countries from 2000 to 2030: A Modelling Study.’ Lancet
397: 398–408.
[19]
McGovern, M. E., Canning, D., 2015, ‘Vaccination and
All-Cause Child Mortality from 1985 to 2011: Global Evidence from the
Demographic and Health Surveys.’ Am J Epidemiol 182: 791–98.
[20]
Patel, M. K., Goodson, J. L., Alexander, J. P. Jr. (2020).
‘Progress toward Regional Measles Elimination —Worldwide, 2000–2019.’ MMWR
Morb Mortal Wkly Rep, 69: 1700–1705.
[21]
Johns N. E.,
Hosseinpoor A. R., Chisema M., Danovaro-Holliday, M. C., Kirkby, K.,
Schlotheuber, A., Shibeshi, M., Sodha, S. V., Zimba, B.,
2022, ‘Association between Childhood Immunisation Coverage and Proximity to
Health Facilities in Rural Settings: A Cross-Sectional Analysis of Service
Provision Assessment 2013-2014 Facility Data and Demographic and Health Survey
2015-2016 Individual Data in Mal’. BMJ Open 12(7).
[22]
Peretti-watel, and Cortaredona S., 2020, Determinants of
Childhood Immunizations in Senegal : Adding Previous Shots to Sociodemographic
Background. Human Vaccines & Immunotherapeutics 16(2): 363–70.
https://doi.org/10.1080/21645515.2019.1649553.
[23] National Bureau of
Statistics (NBS) and United Nations Children’s Fund (UNICEF), 2017, Multiple
Indicator Cluster Survey 2016-17, Survey Findings Report. Abuja, Nigeria:
National Bureau of Statistics and United Nations Children’s Fund.
[24] Adeloye, D.,
Jacobs, W., Amuta, A. O., Ogundipe, O., Mosaku, O., Gadanya, M. A. & Oni,
G., 2017, Coverage and determinants of childhood immunization in Nigeria: A
systematic review and meta-analysis. Vaccine,
35(22), 2871-2881.
[25] Gelaye, S. S., Yenit, M. K. &
Baraki, A. G., 2021, Rural vaccination coverage among children aged 12-23
months was higher than the Urban Counterparts: A comparative cross-sectional
study in Pawi District, Ethiopia. Pediatric
Health Med Ther, 12, 119-127.
[26] Darebo, T. D., Oshe, B. B. &
Diro, C. W., 2022, Full vaccination coverage and associated factors among
children aged 12 to 23 months in remote rural area of Demba Gofa District,
Southern Ethiopia. Peer Journal, 14,
10, e13081.
[27] Mekonnen, A. G., Bayleyegn, A. D.
& Ayele, E. T., 2019, Immunization coverage of 12-23 months old children
and its associated factors in Minjar-Shenkora district, Ethiopia: A
community-based study. BMC Pediatr.
19(1), 198.
[28] Okoro, K. J., Ibekwe, R. C.,
Ibekwe, M. U. & Ibe, B. C., 2015, Factors associated with missed
immunization opportunities in Abakaliki, South-Eastern Nigeria. West African Journal of Medicine, 34(1),
15-19.
[29] Farrenkopf, B. A., Zhou, X., Shet, A., Olayinka,
F., Carr, K., Patenaude, B., Chido-Amajuoyi, O. G. & Wonodi, C., 2023,
Understanding household-level risk factors for zero dose immunization in 82
low- and middle-income countries. PLoS
One. 18(12):e0287459.
[30] Dejene, H., Girma, D., Geleta, L. A.
& Legesse, E., 2022, Vaccination timeliness and associated factors among
children aged 12-23 months in Debre Libanos district of North Shewa Zone,
Oromia Regional State, Ethiopia. Front
Pediatr. 10, 867846.
[32] Kamya, C., Namugaya, F., Opio, C.,
Katamba, P., Carnahan, E., Katahoire, A., Nankabirwa, J., Okiring, J. &
Waiswa, P., 2022, Coverage and drivers to reaching the last child with
vaccination in urban settings: A mixed-methods study in Kampala, Uganda. Global Health Science Practices, 10(4),
e2100663.
