Exploring the reasons for incomplete child immunisation in selected health facilities in Lu-saka: Perspectives from mothers and community health workers

Eddie Kashinka, Chama Mulubwa, Tulani Francis L Matenga, Oliver Mweemba


Background: Immunization is one of the most successful public health initiatives. The World Health Organization in 2017 estimated that immunization averts about 2 to 3 million deaths every year. About 29,000 children worldwide under the age of five die every day, mainly from vaccine-preventable diseases. Uptake of vaccines with multiple doses up to the last dose has been a prob-lem. Incomplete immunization against diseases leads to the reappearance of childhood vaccine-preventable diseases (VPD) and consequently high infant mortality. The paper explored the rea-sons for incomplete of child immunization schedule in Lusaka district, Zambia.
Methods: The study employed a concurrent mixed method design where both quantitative and qualitative methods were used. This particular paper focuses on the results from the qualitative component where Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs) were conducted with mothers and community health workers. Thematic analysis was used to analyse the data.
Results: The study found that mothers were generally aware of vaccines and knew the benefits of the vaccines. The reasons for incomplete child immunisation include the mothers’ negative percep-tions such as the fear of side effects of the vaccines, mothers’ unwillingness to bring the child for immunisation. Bad treatment of mothers by health workers and various social factors such as the mother having to attend to social engagements like funerals and weddings also contributed to in-complete child immunisation. Economic factors included a lack of transport money and mothers having to attend work are additional reasons for incomplete child immunization.
Conclusion: The reasons for incomplete child immunisation revealed by this study reflect complex individual, interpersonal, health systems, and social cultural contexts within which mothers live in their daily lives. There is need for more comprehensive and multi sectoral approach to improve the completion of immunisation schedules in children


Child immunization, incomplete immunisation, mothers, vaccines

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ADEDOKUN, S. T., UTHMAN, O. A., ADEKANMBI, V. T. & WIYSONGE, C. S. 2017. Incomplete childhood immunization in Nigeria: a multilevel analysis of individual and contextual factors. BMC Public Health, 17, 236.

ALI, A. H. M., ABDULLAH, M. A., SAAD, F. M. & MOHAMED, H. A. A. 2020. Immunisation of children under 5 years: mothers' knowledge, attitude and practice in Alseir locality, Northern State, Sudan. Sudanese journal of paediatrics, 20, 152-162.

FAVIN, M., STEINGLASS, R., FIELDS, R., BANERJEE, K. & SAWHNEY, M. 2012. Why children are not vaccinated: a review of the grey literature. Int Health, 4, 229-38.

GLATMAN-FREEDMAN, A. & NICHOLS, K. 2012. The effect of social determinants on immunization programs. Hum Vaccin Immunother, 8, 293-301.

ISMAIL, I. T., EL-TAYEB, E. M., OMER, M. D., ELTAHIR, Y. M., EL-SAYED, E. T. & DERIBE, K. 2014. Assessment of Routine Immunization Coverage in Nyala Locality, Reasons behind Incomplete Immunization in South Darfur State, Sudan. Asian J Med Sci, 6, 1-8.

NEGUSSIE, A., KASSAHUN, W., ASSEGID, S. & HAGAN, A. K. 2016. Factors associated with incomplete childhood immunization in Arbegona district, southern Ethiopia: a case--control study. BMC Public Health, 16, 27.

OFFICE, C. S. 2015. Demographic and Health Survey 2013-2014.

OKU, A., OYO-ITA, A., GLENTON, C., FRETHEIM, A., AMES, H., MULOLIWA, A., KAUFMAN, J., HILL, S., CLIFF, J., CARTIER, Y., OWOAJE, E., BOSCH-CAPBLANCH, X., RADA, G. & LEWIN, S. 2017. Perceptions and experiences of childhood vaccination communication strategies among caregivers and health workers in Nigeria: A qualitative study. PLOS ONE, 12, e0186733.

OZAWA, S., STACK, M. L., BISHAI, D. M., MIRELMAN, A., FRIBERG, I. K., NIESSEN, L., WALKER, D. G. & LEVINE, O. S. 2011. During the 'decade of vaccines,' the lives of 6.4 million children valued at $231 billion could be saved. Health Aff (Millwood), 30, 1010-20.

RUSSO, G., MIGLIETTA, A., PEZZOTTI, P., BIGUIOH, R. M., BOUTING MAYAKA, G., SOBZE, M. S., STEFANELLI, P., VULLO, V. & REZZA, G. 2015. Vaccine coverage and determinants of incomplete vaccination in children aged 12-23 months in Dschang, West Region, Cameroon: a cross-sectional survey during a polio outbreak. BMC Public Health, 15, 630.

SHRESTHA, S., SHRESTHA, M., WAGLE, R. R. & BHANDARI, G. 2016. Predictors of incompletion of immunization among children residing in the slums of Kathmandu valley, Nepal: a case-control study. BMC Public Health, 16, 970.

SHUKLA, V. V. & SHAH, R. C. 2018. Vaccinations in Primary Care. Indian J Pediatr, 85, 1118-1127.

TADESSE, H., DERIBEW, A. & WOLDIE, M. 2009a. Predictors of defaulting from completion of child immunization in south Ethiopia, May 2008 – A case control study. BMC Public Health, 9, 150.

TADESSE, H., DERIBEW, A. & WOLDIE, M. 2009b. Predictors of defaulting from completion of child immunization in south Ethiopia, May 2008: a case control study. BMC Public Health, 9, 150.

TICKNER, S., LEMAN, P. J. & WOODCOCK, A. 2006. Factors underlying suboptimal childhood immunisation. Vaccine, 24, 7030-6.

VENTOLA, C. L. 2016. Immunization in the United States: Recommendations, Barriers, and Measures to Improve Compliance: Part 1: Childhood Vaccinations. P t, 41, 426-36.

WEMAKOR, A., HELEGBE, G. K., ABDUL-MUMIN, A., AMEDOE, S., ZOKU, J. A. & DUFIE, A. I. 2018. Prevalence and factors associated with incomplete immunization of children (12-23 months) in Kwabre East District, Ashanti Region, Ghana. Arch Public Health, 76, 67.

YISMAW, A. E., ASSIMAMAW, N. T., BAYU, N. H. & MEKONEN, S. S. 2019. Incomplete childhood vaccination and associated factors among children aged 12-23 months in Gondar city administration, Northwest, Ethiopia 2018. BMC research notes, 12, 241-241.


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