Level of and Factors Influencing Utilization of Measles Immunization Services for Children Under 5 Years in Lira District

Abstract

Background: Measles remains a critical global health issue, with the World Health Organization targeting 95% vaccination coverage for herd immunity. In sub-Saharan Africa, the first dose utilization of the measles vaccine is 74%, and in Lira District, Uganda, 58% of children under five have received the recommended two doses of measles immunization. This study investigated the level of and factors influencing utilization of measles immunization services among children under 5 years in Lira district. Methodology: A cross-sectional study was conducted in Ogur and Agali Sub-counties of Lira District, using both quantitative and qualitative methods. The quantitative component involved a survey of 409 children under 5 years, selected through systematic random sampling, and data were analyzed using Statistical Package for the Social Sciences (SPSS) for univariate, bivariate, and multivariate logistic regression analyses. The qualitative component comprised in-depth interviews with healthcare providers, opinion leaders, and district health officials, with thematic analysis to extract themes. Ethical approval was sought from LUREC. Results: Measles vaccination completion among children was 19.6%. The analysis confirmed that factors positively influencing vaccination utilization included ANC attendance (Adjusted OR=1.65, p=0.002), higher education (Adjusted OR=1.40, p=0.023) and vaccine availability (Adjusted OR=1.40, p=0.020) Major barriers were high transportation costs (OR=0.60, p=0.010), cultural beliefs against vaccination (OR=0.55, p=0.006) and being denied vaccination on non vaccination day (Adjusted OR= 0.65, p=0.010). Qualitative results showed lack of awareness, cultural belief, vaccines shortage and access to health facility were barriers. Conclusion: The level of uptake in Ogur and Agali was quite low (19.6%) and associated factors influencing measles immunization uptake in Lira District are antenatal care, higher education, vaccine availability, transportation costs and cultural beliefs against immunization.