Utilization of Immunization Services Among Infants 0-12 Months in Juba City

Abstract

Vaccine-Preventable Diseases (VPDs) still kill more than half a million children less than five years of age in Africa every year, representing approximately 56% of global deaths caused by VPDs. Globally, one hundred sixteen million children were immunized against Pentavalent (Diphtheria Tetanus Pertussis, HepB and Haemophilus) (Penta). (UNICEF, 2018). The main objective of the study was to determine utilization of immunization services among children 0-12 months in Juba City. The specific objectives were to determine the current level of immunization services, establish the social, economic, and cultural factors, determine the impact of male involvement and determine the health services factors influencing utilization of immunization services. A descriptive cross-sectional study employing mixed method (both qualitative and quantitative) was conducted among 416 participants in Juba City. This was done through systematic

random sampling of every 9th household. The respondents were interviewed through structured questionnaires and key informant and focused group discussions were conducted. Findings indicated that at multivariate analysis, factors that

statistically influenced immunization of infants aged 0-12 months were; age [x2 = 4.41, p-value 0.005<0.05], gender [x2 = 4.89, p-value 0.009<0.05], marital status [x2 = 2.59, p-value 0.009<0.05], income level [x2 = 1.90, p-value 0.001<0.05], Myths and misconception [x2 = 3.75, p-value 0.002<0.05], availability of health workers [x2 = 4.86, p-value 0.003<0.05], availability of vaccine [x2 = 2.45, p-value 0.006<0.05], and attitude of HWs [x2 = 3.91, p-value 0.004<0.05].It was concluded that the proportion of the children 0-12 months who had been immunized for DPT3 was 87.3% and Measles 55.5% within Juba City which shows incompleteness of immunization within the city; Gender (females), age, marital status and income level were social and economic factors that influenced utilisation of immunisation services. Male involvement factors that have a positive influence on utilisation of immunisation includes father taking their children for routine immunization, reminding the spouse of children’s immunization appointment, providing financial support to go for immunization and accompanying the spouse for routine child immunization. The availability of vaccines, attitude of health workers, and availability of health workers were health services factors that influenced the utilization of immunization services. It was recommended that Government of South Sudan and partners should endeavour to sensitize parents about the importance of completing the immunization schedule, especially with regard to Measles. Mass awareness campaigns be done at the community level together with the community enforce the message. Interventions to improve men's attitude to support their spouses to take their children for immunization be enhanced. Such interventions includes health education or peer education are needed to increase their involvement since their involvement influence immunization uptake positively. Government and partners should employ adequate health workers to address the issue of long waiting time not to discourage parents from bringing their children for services and also purchase and stock all the health facilities with adequate vaccines.