Barriers for full immunization coverage among under 5 years children in Mogadishu, Somalia

Authors: Mohamed Hayir T. Mohamud , Mohamed A. Magan , Lul M. Mohamed , Mohamed A. Mohamud , Abdishakur A. Muse 
Faculty of Medicine and Surgery, Jazeera University, Mogadishu, Somalia.
Background: Immunization is amongst the most cost‑effective public health interventions for reducing childhood morbidity and mortality. However, globally 9 million deaths of children occur as a result of vaccine‑preventable diseases in which 4.4 million are from the sub‑Saharan region. Therefore, this study aimed to assess barriers for complete vaccination coverage among under five years children in Mogadishu, Somalia.
Methods: A community‑based cross‑sectional study was conducted between April to July 2019 in Mogadishu‑Somalia. Two‑stage cluster sampling with systematic random sampling was used to select a sample of 820 households. Data was collected through a structured, interviewer administrator questionnaire. In case more eligible children found at a single selected household, one child was randomly selected and the information related to immunization was interviewed from his/her caregiver.
Results: The overall, fully vaccinated under 5 years children were found to be 45.2%. Immunization was found to be increased by being a younger caregiver (β=-0.024, P-Value=0.019) being father with secondary and above education (AOR = 1.755, 95% CI = 1.161–2.655, P-value = 0.008), being a young child (β = −0.018, P-value = 0.011), being children from birth order of fifth and above (AOR = 1.539, 95% CI = 1.011–2.343, P-value = 0.044), being a married caregiver (AOR = 4.101, 95% CI=1.062-15.835, P-value = 0.041), increased monthly family income (β =0.003, P-value = 0.000), availability of vaccine at the time of visit (AOR = 6.147, 95% CI = 1.943–19.441, P-value = 0.002), cost affordability of vaccine (AOR = 1.951, 95% CI = 1.238–3.076, P-value = 0.004), being born at health facility (AOR = 1.517, 95% CI = 1.104–2.086, P-value = 0.010), having good knowledge on immunization (AOR = 1.125, 95% CI = 1.070–1.181, P-value = 0.001), having good practice on immunization (AOR = 2.756, 95% CI = 2.233–3.402, P-value = 0.001) and having good perception on vaccine (AOR = 4.976, 95% CI = 2.183–11.340, P-value = 0.001).
Conclusion: The result of this study has revealed that the proportion of fully immunized under‑5 children in Mogadishu is very low. Several factors were found to the barriers achieving full immunization coverage. Steps to promote health education and vaccine availability should be lounged

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