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

Abstract

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-preventa-ble diseases. Uptake of vaccines with multiple doses up to the last dose has been a problem. Incomplete immunization against diseases leads to the reappearance of childhood vaccine-preventable diseases (VPD) and consequently high infant mor-tality. The paper explored the reasons for incomplete of child immunization schedule in Lusaka dis-trict, Zambia. Methods: The study employed a con-current mixed method design where both quantita-tive and qualitative methods were used. This partic-ular 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 perceptions such as the fear of side effects of the vac-cines, 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 incomplete child immunisation. Economic factors in-cluded 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.