Title : Factors associated with the uptake of Second Year of Life vaccines among children 24- 35 months in Western Region One, The Gambia
Abstract:
Introduction: There are gaps in coverage between the vaccines given in infancy to those given in the second year of life. This study assesses the caregivers and health facility service delivery factors and explores programmatic factors associated with the uptake of Second Year of Life vaccines.
Methods: A cross-sectional mixed methods study design was used in this study. The study subjects include 355 caregivers with children aged 24-35 months, 24 health workers who offer immunization services, and 7 key informants of immunization-related programs. A multi-stage cluster sampling strategy based on the WHO 30-cluster survey method and multivariable logistic regression analysis were used.
Results: The DPT and MCV2 vaccines recorded 59.5% and 54.4% coverage respectively. About half (49.9%) of the study participants received OPV Booster. Fathers who did not participate in their children’s routine immunization services [aOR=1.70; CI=1.03–2.80] had 70% increased odds of low 2YL vaccine uptake compared to those who participated. The analysis revealed that Fula [aOR=2.50; CI=1.25–5.04] and Jola [aOR=2.34; CI =1.00–5.44] had increase odds of low 2YL vaccine uptake compared to Mandinka. Mothers whose education ended at the primary level [aOR=0.40; CI=0.18–0.88] and secondary level [ aOR=0.33; CI=0.17–0.65) had reduced odds of low 2YL vaccine uptake compared to those who had no formal education. Some of the health facility factors reported were poor data quality, poor attitude of health workers and human resources gap. The program factors included outdated policy, funding gap, inadequate mobility and weak political commitment.
Conclusion: The 2YL vaccine coverages are relatively low in Western Region One. Mothers' educational level, ethnicity, fathers’ participation, and the awareness of caregivers on MCV schedules were caregiver factors associated with uptake of the 2YL uptake. The Ministry of Health should support in continuous professional development of immunization staff on regular basis.
