Peer-reviewed article

Vaccines to Prevent or Treatment to Recover: Immunisation Compliance Among Caregivers of Infants Aged 0–18 Months in Pager Cell, Northern Uganda

Abacha Geoffrey · 28 Jul 2026

Abstract

Routine childhood immunisation is a critical public health intervention for preventing vaccine-preventable diseases and reducing under-five mortality, yet adherence and completion remain sub-optimal in many low-resource settings, including Northern Uganda. This study examined immunisation adherence and compliance among mothers and caregivers of children aged 0–18 months in Pager Cell, Kitgum Municipality, using a P-factors analytical framework that considers provider and parental factors, procedures and practices, policy and programme influences, and political–contextual determinants. A cross-sectional analytical mixed-methods design was used, collecting data from 323 caregivers through structured questionnaires, child health card reviews, and key informant inputs. Quantitative data were analysed using descriptive statistics, while qualitative findings were thematically analysed within the P-factors framework. Results showed that full immunisation coverage was below national targets, with significant drop-out between early and later vaccine doses, influenced by caregiver knowledge and trust, health facility operational practices, programme implementation gaps, and broader political and infrastructural constraints. Overall, the findings demonstrate that immunisation adherence in Northern Uganda is shaped by interconnected individual providers and parental factors, health system procedure and practices, programme policy, and politico-contextual factors, highlighting the usefulness of the P-factors framework for understanding and improving routine immunisation performance in low-resource and post-conflict settings.