Peer-reviewed article
Factors contributing to incomplete vaccination among children aged 12 to 59 months in Mbale city, Eastern Uganda: a caregivers and health workers' perspective.
Mary A Bwade, Samuel Olowo, Ashley Nakawuki, Eunice Namubiru, Immaculate Mbwali et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This qualitative study examined why children aged 12-59 months in Mbale city, Uganda have incomplete vaccination coverage by interviewing 18 caregivers and 30 health workers. The research identified multiple barriers including vaccine misconceptions, myths about side effects, transportation challenges, health worker attitudes, and gaps in health information. The study recommends training community health teams, educating health workers, involving male partners, and establishing mobile vaccination clinics to improve vaccination completion rates.
Key points
- Six major themes emerged: misconceptions about vaccination, perceived susceptibility and severity, perceived benefits, barriers to vaccination, information gaps, and strategies for improvement
- Barriers included fear of side effects, transportation challenges, negative health worker attitudes, lack of partner support, peer influence, multiple injections, child illness, and caregivers' busy schedules
- Information gaps were driven by misinformation from social media, delayed or unclear communication, and general ignorance
- Proposed solutions included training village health teams, continuing medical education for health workers, community sensitization, male partner involvement, and improved accessibility to vaccination services
- Incomplete vaccination factors are multifaceted, involving individual, community, and health system-related challenges
Limitations
This qualitative study captured perspectives from only 18 caregivers and 30 health workers in two divisions of one city in Uganda, so findings may not be generalizable to other regions or populations. The study describes barriers and perceptions but does not measure the relative importance or quantify the prevalence of each identified factor.
Abstract
BACKGROUND: Vaccination is one of the most effective public health interventions, substantially reducing morbidity, disability, and mortality among children under five years of age from vaccine-preventable diseases. Despite global progress, vaccination coverage remains suboptimal, with the highest burden of incomplete vaccination reported in sub-Saharan Africa. In 2020, an estimated 14 million infants worldwide did not receive the first dose of diphtheria pertussis tetanus (DPT1) vaccine. Children with zero dose vaccination and those who do not receive all types and doses of vaccines remain highly vulnerable to vaccine-preventable diseases, contributing to outbreaks, morbidity, disability, and mortality. This study explored caregivers' and health workers' perspectives on factors contributing to incomplete vaccination among children aged 12-59 months in Mbale City, Eastern Uganda. MATERIALS AND METHODS: A descriptive qualitative study was conducted in Namatala (Industrial Division) and Nakaloke (Northern Division), Mbale City, Eastern Uganda. Ethical approval was obtained from the Busitema University Research and Ethics Committee. Participants were selected using purposive sampling. Data were collected from 18 caregivers and 30 health care workers and analyzed thematically using Colaizzi's seven-step approach. RESULTS: Six major themes emerged: misconceptions about vaccination; perceived susceptibility to and severity of incomplete vaccination; perceived benefits of vaccination; perceived barriers to vaccination; information gaps; and strategies for ending incomplete vaccination. Misconceptions included myths surrounding vaccination, perceived vaccine-related morbidity, and mortality. Limited understanding and misbeliefs regarding the benefits of vaccination were common. Information gaps were driven by misinformation from social media, delayed, unclear, or inadequate communication, and general ignorance. Identified barriers included fear of side effects, transportation challenges, and negative health worker attitudes, lack of partner support, peer influence, multiple injections, child illness, and caregivers' busy schedules. Proposed solutions included training village health teams (VHTs), continuing medical education (CMEs) for health workers, intensified community sensitization, male partner involvement, and improved accessibility to vaccination services. CONCLUSION: Factors contributing to incomplete vaccination are multifaceted, involving individual, community, and health system related challenges. Strengthening collaboration between health teams and religious and cultural leaders, alongside targeted interventions such as mobile vaccination clinics to address access barriers, is essential to improving vaccination completion rates in this setting.