Prevalence and determinants of full vaccination coverage according to the national schedule among children aged 12–35 months in Ghana

Abstract

Universal immunization of children against common vaccine-preventable diseases is crucial in reducing infant and child morbidity and mortality. Assessing the vaccination coverage is a key step to improve utilization and coverage of vaccines for under-five children. Accordingly, vaccination coverage according to the national schedule assesses the vaccination coverage of children aged 12-35 months. However, there is a scarcity of information on the full vaccination coverage according to the national schedule and its determinants in Ghana. Therefore, this study aimed to assess the prevalence and predictors of vaccination coverage according to the national schedule among children aged 12-35 months in Ghana. A cross-sectional study design using the most recent demographic and health survey data from the Ghana Demographic and Health Survey was used. We included a total weighted sample of 1,823 children aged 12-35 months in the five years preceding the survey. We used a multilevel logistic regression model to identify associated factors for vaccination coverage according to the national schedule in Ghana. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of < 0.05 are declared statistically significant. In this study, the full coverage of vaccination according to the national schedule among children aged 12-35 months in Ghana was 56.45% (95% CI 51.77-56.17). Women having an ANC visit were 40% more likely (AOR = 1.40, 95% CI 1.07-1.83), women involved in healthcare decision-making were 35% more likely (AOR = 1.35, 95% CI 1.05-1.75), Women who deliver in a health facility were 1.91 times more likely (AOR = 1.91, 95% CI 1.36-2.66), and communities with high media exposure were 47% more likely (AOR = 1.47, 95% CI 1.06-2.05) to achieve full vaccination coverage as compared to their counterparts. On the other hand, being in the Western (AOR = 0.4, 95% CI 0.18-0.88) and Northern (AOR = 0.33, 95% CI 0.15-0.74) regions decreased the odds of attaining full vaccination coverage according to the national schedule in Ghana. The full vaccination coverage according to the national schedule in Ghana was lower as compared to 90% coverage recommendation by World Health organization, and there is also in-equality among regions. Maternal optimal ANC contact, health facility delivery, women involved in health care decision-making, community media exposure, and region were significantly associated with full vaccination coverage according to the national schedule in Ghana. To improve child immunization coverage, relevant authorities and stakeholders should work together to improve ANC visits, media exposure, facility delivery, and women's empowerment, and attention should be given to deviant regions.