Peer-reviewed article
Determinants of Routine Childhood Immunization Uptake Among Caregivers of Children Under Five Years in Mali: Knowledge, Access to Services, and Vaccination Practices
Korotoumou Togola, Ghislain Poda ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This community-based cross-sectional study surveyed 361 caregivers of children under five in the Kayes Health District, Mali. It looked at caregiver knowledge, access to vaccination services and vaccination practices. Reported vaccination coverage was high, but many caregivers had gaps in knowledge, lived far from health facilities, or had received little explanation from health workers. The authors call for targeted interventions for low-education caregivers and for communities far from facilities.
Key points
- 92% of children were reported to be up to date with their vaccination schedule, and 99% of caregivers had a vaccination card.
- 81% of caregivers knew vaccination should start at birth.
- 47% of caregivers could not identify vaccine-preventable diseases.
- 32% of caregivers had not received explanations about the benefits of vaccines.
- 33% lived more than 5 km from a health facility, and 62% had no formal education or only primary education.
Limitations
The study is cross-sectional and descriptive, in one health district, so it cannot show what causes vaccination uptake or be generalised to all of Mali. Coverage was reported by caregivers rather than independently verified, and the abstract reports only descriptive statistics.
Abstract
ABSTRACTBackground. Routine childhood immunization is one of the most effective public health interventions for preventing morbidity and mortality from vaccine-preventable diseases among children under five. However, vaccination uptake may be influenced by caregiver knowledge, access to health services, and vaccination-related practices. In Mali, disparities in immunization coverage persist across regions and socioeconomic groups, with limited data on the combined influence of these factors in the Kayes Health District. This study aimed to assess the determinants of routine childhood immunization uptake among caregivers of children under five years in the Kayes Health District, Mali. Methods. We conducted a community-based cross-sectional study among 361 caregivers of children under five years using a structured interviewer-administered questionnaire. Data covered sociodemographic characteristics, access to vaccination services, caregiver knowledge, vaccination practices, service availability, and satisfaction. Descriptive statistics were used to summarize the findings. Results. Most respondents were female (99%), and 59% were aged 17–25 years. Educational attainment was low, with 62% having no formal education or only primary education. One-third (33%) lived more than 5 km from a health facility, and 27.7% walked to vaccination sites. Most respondents knew that vaccination should start at birth (81%), and 99% possessed a vaccination card. Reported vaccination coverage was high, with 92% of children up to date with their vaccination schedule. However, 47% of respondents could not identify vaccine-preventable diseases, and 32% had not received explanations about vaccine benefits. Conclusion. Routine immunization uptake was high, but gaps remain in caregiver knowledge, geographic accessibility, and communication between healthcare providers and caregivers. Targeted public health interventions are needed to sustainably strengthen vaccination coverage, particularly among low-education caregivers and communities living far from health facilities.RÉSUMÉ Introduction. La vaccination de routine est l'une des interventions de santé publique les plus efficaces pour prévenir la morbidité et la mortalité chez les enfants de moins de cinq ans. Cependant, l'adoption de la vaccination peut être influencée par les connaissances des aidants, l'accès aux services de santé et les pratiques vaccinales. Au Mali, des disparités persistent dans la couverture vaccinale entre les régions et les groupes socio-économiques. Cette étude avait pour but d'évaluer les déterminants de la vaccination de routine chez les enfants de moins de cinq ans dans le district sanitaire de Kayes, au Mali. Méthodes. Nous avons mené une étude transversale communautaire auprès de 361 aidants d'enfants de moins de cinq ans à l'aide d'un questionnaire structuré administré en entretien direct. Les données couvraient les caractéristiques sociodémographiques, l'accès aux services de vaccination, les connaissances des aidants, les pratiques vaccinales, la disponibilité des services et la satisfaction. Des statistiques descriptives ont résumé les résultats. Résultats. La plupart des répondants étaient des femmes (99 %), et 59 % avaient entre 17 et 25 ans. Le niveau d'instruction était faible, avec 62 % n'ayant aucune éducation formelle ou seulement l'école primaire. Un tiers (33 %) vivaient à plus de 5 km d'un centre de santé, et 27,7 % s'y rendaient à pied. La plupart savaient que la vaccination devait débuter à la naissance (81 %), et 99 % possédaient un carnet de vaccination. La couverture vaccinale déclarée était élevée, avec 92 % des enfants à jour de leur calendrier vaccinal. Cependant, 47 % ne pouvaient identifier les maladies évitables par la vaccination, et 32 % n'avaient pas reçu d'explications sur les bénéfices des vaccins. Conclusion. La couverture vaccinale était élevée, mais des lacunes persistent dans les connaissances des aidants, l'accessibilité géographique et la communication entre les prestataires et les aidants. Des interventions ciblées sont nécessaires pour renforcer durablement la couverture vaccinale.