Evaluation report

Are children on track with their routine immunisation schedule in a fragile and protracted conflict state of South Sudan?

Israel Oluwaseyidayo Idris, Janet Tapkigen, Germaine Kabutaulaka, Gabriel Omoniyi Ayeni, Francis Ifeanyi Ayomoh et al. · 2 Sept 2021

Abstract

Abstract Objectives The objective of this study was to assess if children aged 0–23 months in a conflict-affected state of South Sudan were on track with their immunisation schedule and to identify predisposing factors that affected this study population from being on track with their routine immunisation schedule. Design Community-based cross-sectional study using a semi-structured questionnaire. The binary outcome of interest was defined as being on or off track with routine vaccination schedule. Multivariable logistic regression was used to analyse for the association between the predisposing factors surveyed and being off track with one’s routine immunisation schedule. Setting Rural communities in four counties (Rumbek Centre, Rumbek North, Rumbek East and Wulu) of the Western Lakes state in South Sudan during January 10, 2020 to June 10, 2020. Participants We surveyed 428 children aged 0–23 months and their mothers/caregivers who lived in either of the four counties in the Western Lakes State. Participants were selected using random ballot sampling. Results More than three-quarters of the children surveyed (75.5%) were off track with their vaccination schedule. Children with an immunisation card had 71% reduced odds of being off track with their immunisation (AOR = 0.29; 95% CI 0.10–0.83, p-value = 0.021) compared to children without immunisation cards. Children who reside near health facilities and do not require transportation to facilities had 87% reduced odds of being off track with their immunisation compared to those who lived far and required transport to facilities. Giving an adequate immunisation notice before conducting immunisation outreach visits to communities was also associated with reduced odds (AOR = 0.27; 95% CI 0.09–0.78. p-value = 0.016) of children being off track with their immunisation. Conclusion This study revealed that most children were off track with their vaccination schedule in South Sudan, which is not only influenced by maternal characteristics but mainly by community- and state-level immunisation service delivery mechanisms. Interventions to improve child immunisation uptake should put these contextual characteristics into high health agenda consideration.