Determinants Of Vaccine Uptake Among Children Under 23 Months In Functional Community Units In Mukuru Kwa Njenga Settlement In Nairobi Citycounty, Kenya

ABSTRACT

Immunization alone averts 2-3 million deaths annually. Immunization coverage of above 80% is need for herd immunity. Kenya’s immunization coveragefor childhood vaccines is at 68%, which is below herd immunity levels and continues to experience decline trajectory. Vaccine coverage is not uniform across the regions in the country and varies by type of vaccine. Urban informal settlements experiences low coverage, which leaves many children at risk of vaccine preventable diseases.The main objective of this study was establish the determinants of vaccine uptake in functional community units in Mukuru Kwa Njenga. The specific objectives were to assess the prevalence of vaccine uptake among children under 23 months, to determine socio-demographic, religious and health system factors influencing vaccine uptake among children under 23 months in the informal settlements of Mukuru Kwa Njenga.Using a cross-sectional design, 266 children aged under 23 months of consenting caregivers were studied. Quantitative data was collected using interviewer administered questionnaires. Review of vaccination information recorded in the mother and child health booklets were used to validate the vaccination data as per the KEPI schedule. Data was analyzed using descriptive statistics, bivariate and binary logistic regression at 95% confidence interval. Vaccine uptake for BCG, oral polio birth dose, and three doses for Pentavalent, Oral Polio, pneumococcal and rotavirus vaccines were each over 90%. Measles vaccine uptake was 84.9% and 40% for the second measles vaccine. Overallvaccine uptake was 84.5%, which is below the WHO recommended 90% coverage. Factors significantly associated with positive uptake of vaccines were age of the caregiver above 30 years, (OR 6.389, C.I 2.388-10.086), having knowledge on childhood vaccines (OR 1.937, C.I 1.058-3.544), history of recent treatment at a health facility (OR 2.49, C.I 1.319-2.973) and retention of mother-child health booklet (OR 5.25, C.I 1.728-15.984). Vaccine uptake in the study area had reached the threshold for herd immunity, safe for 2nd measles vaccine. Targeted efforts are necessary to boost uptake of the 2nd measles vaccine and rotavirus vaccines. The overall impact of community health on immunization coverage needs further investigations.