Reasons for Childhood Immunisation Drop-out in Rural Health Facilities in Abakaliki, Nigeria

Background: High rate of childhood vaccination drop-outs is a significant public health problem in rural areas of developing countries especially in Nigeria. The reasons for immunisation drop-out are poorly understood and little or no data is available to explain the phenomenon that could support the decision making. This study, therefore, determined the reasons for immunisation drop-out in the rural areas of Abakaliki, Nigeria.

Materials and Methods: Descriptive analytical cross- sectional study design was used for the survey. Data were collected using pretested, semi-structured interviewer administered questionnaire from 290 mothers/caregivers accessing childhood immunisation services in Mile Four and St. Vincent hospitals selected using systematic random sampling technique. Reasons for immunisation drop-out were gotten from caregivers when they brought their children for immunisation in subsequent immunisation dates after the drop-out interval. Analysis was done using SPSS version 22 and level of statistical significance set at p< 0.05 and confidence level at 95%. Ethical approval was obtained from the Research and Ethics Committee (REC) of the Federal Teaching Hospital Abakaliki (FETHA), Ebonyi State, Nigeria.

Results: The mean age of respondents in Mile Four hospital was 26.6 ±4.9 years while 27.1±4.2 years in the St.Vincent hospital. The reasons for immunisation drop-out in Mile Four were no money for transport (2.1%), caregiver travelled (1.4%), baby was sick (1.4%), far distance to health facility (0.7%). In St.Vincent reasons cited were- Far distance to health facility (6.2%), no money for transport (4.8%), Mother was sick (2.8%), caregiver travelled (2.1%) and baby was sick (2.1%).Far distance to health facility was a predictor of immunisation drop-out in St. Vincent group. It is 2.8 times more likely to cause immunisation drop-out than near distance to health facility.

Conclusion: High rate of immunisation drop-outs need to be addressed collectively both by individuals and government in order to achieve the targeted 95% immunisation coverage necessary for the sustained control of vaccine preventable diseases.