Factors Affecting Vaccination Uptake Among Children Under Five Years In Baidoa District, Somalia
Abdirahman Isack Hussein
Abdirahman Isack Hussein, Department of Health Sciences, Zamzam University of Science and Technology, Baidoa, Somalia
Faysal Mohamed Bakaal
Faysal Mohamed Bakaal, Department of Public Health, Daffodil International University, Bangladesh
Mohamed Abdinur Ali
Mohamed Abdinur Ali, Department of Public Health, Zamzam University of Science and Technology, Baidoa, Somalia
Mohamed Hussein Abdirahman
Mohamed Hussein Abdirahman, Department of Public Health. Zamzam University of Science and Technology, Baidoa, Somalia
Ali Hassan Ahmed
Ali Hassan Ahmed, Department of Public Health, Zamzam University of Science and Technology, Baidoa, Somalia
Ahmed Abdullahi Mohamed
Ahmed Abdullahi Mohamed, Department of Public Health, Zamzam University of Science and Technology, Baidoa, Somalia
DOI: https://doi.org/10.59429/mmr.v3i2.12207
Keywords: Vaccination uptake; caregivers; cultural factors; health facility factors; Baidoa, Somalia
Abstract
Background: Vaccination stimulates the body’s immune system to provide protection against infectious diseases. It is one of the most cost-effective health interventions, preventing millions of deaths annually. Despite its benefits, immunization programs face challenges such as negative public perception and poor planning, particularly in low-resource settings.
Objective: To determine the proportion of vaccination uptake and identify factors influencing vaccination, including access, awareness, and cultural practices, among caregivers in Baidoa district, Somalia.
Methods: A descriptive cross-sectional study was conducted over five months (September 2022 to January 2023) among 52 caregivers of children under five years in Baidoa district. Four villages—Berdale, Horsed, Isha, and Howl Wadag—were selected using simple random sampling, and eligible households were chosen via systematic random sampling. Structured questionnaires were administered to assess vaccination uptake and influencing factors. Data were analyzed using SPSS, with descriptive statistics.
Results: Full vaccination coverage was less than 4.4%, partial coverage was 69.7%, and 25.9% of children had not received any vaccines. Health facility factors significantly influencing uptake included healthcare provider friendliness (Crude OR = 0.27, 95% CI = 0.151–0.499, P < 0.001) and vaccine availability (Crude OR = 0.482, 95% CI = 0.323–0.720, P < 0.001). Cultural and religious factors, such as perceptions of vaccine safety (Crude OR = 0.285, 95% CI = 0.195–0.417, P < 0.0001) and religious influence (Crude OR = 0.671, 95% CI = 0.474–0.951, P = 0.025), also significantly affected vaccination uptake.
Conclusion: Vaccination coverage in Baidoa remains critically low. Strategies to improve uptake should include ensuring accessible quality health services, employing professional healthcare providers, utilizing mobile clinics, and engaging religious leaders in vaccination campaigns to achieve national coverage targets and support Sustainable Development Goal 3.
References
1.Datta SS, O'Connor PM, Jankovic D, Muscat M, Mamou MC, Singh S, Kaloumenos T, Reef S, Papania M, Butler R. Progress and challenges in measles and rubella elimination in the WHO European Region. Vaccine. 2018 Aug 28;36(36):5408-15.
2.World Health Organization. WHO and UNICEF estimates of immunization coverage: 2015 revision. Available online:[accessed on October 6th, 2017]. 2016.
3.Orenstein WA, Cairns L, Hinman A, Nkowane B, Olivé JM, Reingold AL. Measles and Rubella Global Strategic Plan 2012–2020 midterm review report: Background and summary. Vaccine. 2018 Jan 11;36:A35-42.
4.Patel MK, Gibson R, Cohen A, Dumolard L, Gacic-Dobo M. Global landscape of measles and rubella surveillance. Vaccine. 2018 Nov 19;36(48):7385-92.
5.World Health Organization, United Nations Children's Fund. Protect the progress: rise, refocus and recover: 2020 progress report on the Every Woman Every Child Global Strategy for Women's, Children's and Adolescents’ Health (2016-2030). World Health Organization; 2020 Oct 26.
6.Roy SG. Risk factors for childhood immunization incompletion in Ethiopia (Doctoral dissertation, ScholarWorks@ Georgia State University).
7.Renne E. Perspectives on polio and immunization in Northern Nigeria. Social science & medicine. 2006 Oct 1;63(7):1857-69.
8.Danovaro-Holliday MC, Gacic-Dobo M, Diallo MS, Murphy P, Brown DW. Compliance of WHO and UNICEF estimates of national immunization coverage (WUENIC) with Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) criteria. Gates Open Research. 2021 May 10;5:77.
9.Centers for Disease Control and Prevention. (2015). Morbidity and Mortality Weekly Report (MMWR). MMWR Weekly, 63(53), 1233–1240.
10.Azhar, S. S., Nirmal, K., Nazarudin, S., Rohaizat, H., Noor, A. A., & Rozita, H. (2012). Factors influencing childhood immunization defaulters in sabah, malaysia. International Medical Journal Malaysia, 11(1), 17–22.
11.Nasir, S. G., Aliyu, G., Ya’U, I., Gadanya, M., Mohammad, M., Zubair, M., & El- Kamary, S. S. (2014). From intense rejection to advocacy: How muslim clerics were engaged in a polio eradication initiative in northern nigeria. PLoS Medicine, 11(8), 1– 6.
12.World Health Organization, United Nations Children's Fund. Protect the promise: equal access and opportunity for every woman, child and adolescent. 2022 progress report on the Every Woman Every Child Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030). World Health Organization; 2022 Oct 31.
13.Regmi, J. (2014). Socio-Cultural Influences on Vaccination-Vaccinators Perspective, Study from Nepal. Finland: University of Eastern Finland.
14.Onyiriuka, an. (2009). Vaccination default rates among children attending a static immunization clinic in Benin City, Nigeria. Journal of Medicine and Biomedical Research, 4(1), 71–77.
15.Corsi, D. J., Bassani, D. G., Kumar, R., Awasthi, S., Jotkar, R., Kaur, N., & Jha, P. (2009). Gender inequity and age-appropriate immunization coverage in India from 1992 to 2006. BMC International Health and Human Rights, 9(SUPPL.1), 1–12.
16.Cockcroft, A., Andersson, N., Omer, K., Ansari, N. M., Khan, A., Chaudhry, U. U., & Ansari, U. (2009). One size does not fit all: local determinants of measles vaccination in four districts of Pakistan. BMC International Health and Human Rights, 9(Suppl 1), S4.
17.Ministry of Education Culture and Higher education Somalia. (2017). Federal government of somalia ministry of education , culture and higher education Education Sector Analysis , 2012-2016. Somalia: Ministry of Education Culture and Higher education Somalia.
18.Kidane, T., Yigzaw, A., Sahilemariam, Y., Bulto, T., Mengistu, H., Belay, T., … Olusegun, B. (2009). National EPI coverage survey report in Ethiopia, 2006. Ethiopian Journal of Health Development, 22(2), 148–157.
19.Harris, J. B., Gacic-dobo, M., Eggers, R., Brown, D. W., & Sodha, S. V. (2017). Global routine vaccination coverage, 2016. Releve Epidemiologique Hebdomadaire, 92(46), 701–707.
20.Gordis, L. (2002). Epidemiology (4th ed.). Philadelphia: Elsevier Inc. Gust, D. A., Darling, N., Kennedy, A., & Schwartz, B. (2008). Parents With Doubts About Vaccines: Which Vaccines and Reasons Why. Pediatrics, 122(4), 718–725.