A multilevel analysis of the determinants of missed opportunities for vaccination among children attending primary healthcare facilities in Kano, Nigeria : findings from the pre-implementation phase of a collaborative quality improvement programme
Date
2019-07-10
Journal Title
Journal ISSN
Volume Title
Publisher
Public Library of Science
Abstract
Background: We aimed to determine the factors that are responsible for missed opportunities for vaccination (MOV) among children aged 0–23 months attending primary health care (PHC) facilities in Nassarawa, Kano State, Nigeria.
Methods: This cross-sectional study was conducted in the pre-implementation phase of a quality improvement programme. One-stage cluster sampling technique was employed. Data were collected from caregivers of children aged 0–23 months in ten randomly selected PHC facilities in Nassarawa Local Government Area of Kano State. Semi-structured, interviewer administered questionnaires were used. Frequencies and percentages were used to summarize the data. Multilevel logistic regression model with fixed effect and random effect component was fitted to obtain measures of association and variation respectively.
Results: Caregivers of 675 children responded. Among these children, the prevalence of MOV (for at least one antigen) was 36.15%. MOV (for individual antigens) was highest for inactivated polio vaccine followed by measles vaccine. The random effect model yielded an intraclass correlation coefficient of 9.60% for the empty model. The fixed effect model revealed that MOV was more likely among children that were accompanying a caregiver to the health facility (OR = 2.86, 95%CrI: 1.28 to 5.80) compared to those that were visiting the health facility for medical consultation. Failure to receive vaccination on the day of health facility visit (OR = 2.32, 95%CrI: 1.12 to 4.12) and visiting a clinic with three or more vaccinators (OR = 12.91, 95%CrI: 4.82 to 27.14) increased the likelihood of MOV.
Conclusion: The study identified important local factors that are responsible for MOV which can be addressed in the QI programme.
Description
CITATION: Adamu, A. A. et al. 2019. A multilevel analysis of the determinants of missed opportunities for vaccination among children attending primary healthcare facilities in Kano, Nigeria: Findings from the pre-implementation phase of a collaborative quality improvement programme. PLoS ONE, 14(7). doi:10.1371/journal.pone.0218572
The original publication is available at https://journals.plos.org/plosone/
The original publication is available at https://journals.plos.org/plosone/
Keywords
Immunization of children -- Nigeria
Citation
Adamu, A. A. et al. 2019. A multilevel analysis of the determinants of missed opportunities for vaccination among children attending primary healthcare facilities in Kano, Nigeria: Findings from the pre-implementation phase of a collaborative quality improvement programme. PLoS ONE, 14(7). doi:10.1371/journal.pone.0218572