Determinants of immunization coverage of under-five children in Kawama Compound of Ndola Urban District

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Masilani, Rosemary Mubotu
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The aim of immunization programme for children is to control infection in the community apart from individual protection. A lower level of herd immunity than what is necessary for solid individual protection can effectively control the incidence of communicable diseases if a high proportion of the susceptible community is immunized to at least 80 percent of all eligible children in the community.The study was conducted in order to determine contributing factors to immunization coverage of children under- five years in Kawama compound of Ndola district.A descriptive cross sectional design was used, comprising 203 mothers/caretakers of children under the age of five years, 5 community volunteers and 15 health workers found in Kawama health centre catchment area. The sample was purposefully selected by identifying mothers/caretakers with children under the age of five years. All the health workers found at the health centre were interviewed. Data were collected using in-depth interview schedule for mothers/caretakers, structured questionnaire for health workers and a focus group discussion guide for community volunteers. Analysis was by SPSS and EPI infor packages with Chisquare and P value outputs. This study revealed that 71 percent (lower than national coverage of 90%) of the children were either fully immunized or on schedule. The results also show that 19 percent of children in the compound had defaulted and 8 percent had delayed receiving certain vaccines. Knowledge of correct age for a child to complete vaccination has an association to immunization status (Chisquare 136.90 and P-value <0.001). Contributing factors to this low coverage for full immunization included: lack of health education about specific vaccines available and correct vaccination schedule, scarce human resources and workload, inadequate support to community volunteers, lack of child tracers, inadequate outreach vaccination services.The study concluded that implementing RED strategy recommendations could help each health facility attain higher coverage rates for immunization; and recommendations were that there should be strengthened data management and utilization, adequate and specific health education messages on value of and schedule of vaccinations, motivation to community volunteers, and increase in number of health workers involved in immunization services as well as frequent technical supervision.