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. 2019 Jul 10;14(7):e0218572.
doi: 10.1371/journal.pone.0218572. eCollection 2019.

A multilevel analysis of the determinants of missed opportunities for vaccination among children attending primary healthcare facilities in Kano, Nigeria: Findings from the pre-implementation phase of a collaborative quality improvement programme

Abdu A Adamu  1   2 , Olalekan A Uthman  2   3 , Muktar A Gadanya  4 , Olatunji O Adetokunboh  1   2 , Charles S Wiysonge  1   2   5
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A multilevel analysis of the determinants of missed opportunities for vaccination among children attending primary healthcare facilities in Kano, Nigeria: Findings from the pre-implementation phase of a collaborative quality improvement programme

Abdu A Adamu et al. PLoS One. .

Abstract

Background: We aimed to determine the factors that are responsible for missed opportunities for vaccination (MOV) among children aged 0-23 months attending primary health care (PHC) facilities in Nassarawa, Kano State, Nigeria.

Methods: This cross-sectional study was conducted in the pre-implementation phase of a quality improvement programme. One-stage cluster sampling technique was employed. Data were collected from caregivers of children aged 0-23 months in ten randomly selected PHC facilities in Nassarawa Local Government Area of Kano State. Semi-structured, interviewer administered questionnaires were used. Frequencies and percentages were used to summarize the data. Multilevel logistic regression model with fixed effect and random effect component was fitted to obtain measures of association and variation respectively.

Results: Caregivers of 675 children responded. Among these children, the prevalence of MOV (for at least one antigen) was 36.15%. MOV (for individual antigens) was highest for inactivated polio vaccine followed by measles vaccine. The random effect model yielded an intraclass correlation coefficient of 9.60% for the empty model. The fixed effect model revealed that MOV was more likely among children that were accompanying a caregiver to the health facility (OR = 2.86, 95%CrI: 1.28 to 5.80) compared to those that were visiting the health facility for medical consultation. Failure to receive vaccination on the day of health facility visit (OR = 2.32, 95%CrI: 1.12 to 4.12) and visiting a clinic with three or more vaccinators (OR = 12.91, 95%CrI: 4.82 to 27.14) increased the likelihood of MOV.

Conclusion: The study identified important local factors that are responsible for MOV which can be addressed in the QI programme.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Euler diagram of missed opportunities for vaccination.
See this image and copyright information in PMC

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References

    1. Philip RK, Attwell K, Breuer T, Di Pasquale A, Lopalco PL. Life-course immunization as a gateway to health. Expert Review of Vaccines. 2018;17(10):851–64. 10.1080/14760584.2018.1527690 - DOI - PubMed
    1. Delany I, Rappuoli R, De Gregorio E. Vaccines for the 21st century. EMBO Mol Med. 2014;6(6):708–20. 10.1002/emmm.201403876 - DOI - PMC - PubMed
    1. Ophori EA, Tula MY, Azih AV, Okojie R, Ikpo PE. Current trends of immunization in Nigeria: prospect and challenges. Tropical medicine and health. 2014;42(2):67–75. Epub 04/23. 10.2149/tmh.2013-13 . - DOI - PMC - PubMed
    1. National Primary Health Care Development Agency. The National Immunization Schedule in Nigeria Abuja, Nigeria [cited 2019 5th February 2019]. Available from: http://nphcda.gov.ng/?ddownload=673.
    1. Adedokun ST, Uthman OA, Adekanmbi VT, Wiysonge CS. Incomplete childhood immunization in Nigeria: a multilevel analysis of individual and contextual factors. BMC public health. 2017;17(1):236 10.1186/s12889-017-4137-7 - DOI - PMC - PubMed

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