Childhood immunization is a vital public health strategy for reducing morbidity and mortality associated with vaccine-preventable diseases. However, despite ongoing efforts by government and health agencies in Nigeria, immunization coverage remains suboptimal in many rural communities, including Jada Local Government Area of Adamawa State. This study examines the factors affecting the utilization of childhood immunization programmes in the area. The study adopts a descriptive research design, focusing on mothers and caregivers of children within the immunization age group. Data are collected using structured questionnaires, interview and analyzed to identify key determinants influencing immunization uptake. Findings reveal that limited knowledge and awareness of immunization benefits, misconceptions about vaccine safety, and negative cultural or religious beliefs significantly affect participation in immunization programmes. Additionally, socioeconomic factors such as low income, illiteracy, and competing domestic responsibilities hinder caregivers’ ability to access immunization services. Health system-related challenges are also identified, including inadequate healthcare facilities, long distances to vaccination centers, irregular vaccine supply, and insufficient healthcare personnel. Poor communication and lack of effective community mobilization further contribute to low immunization coverage. The study concludes that a combination of socio-cultural, economic, and institutional factors affects the success of childhood immunization programmes in Jada Local Government Area. It recommends intensified public health education, improved accessibility of immunization services, strengthening of healthcare systems, and active community engagement to enhance immunization uptake and safeguard child health.
Vaccine equity remains a major public health challenge in many low-and middle-income countries, where socioeconomic and spatial disparities continue to limit equitable access to childhood immunization services.Evidence regarding the independent drivers of vaccine equity in Plateau North Senatorial District, Nigeria, remains scarce.A cross-sectional study conducted in district among 400 mothers aged 15-49 years whose youngest child was aged 12-23 months.A multistage stratified sampling technique was used to select respondents across the six Local Government Areas of Plateau North Senatorial District.Data were collected using structured questionnaires and in-depth interviews.Descriptive statistics summarized respondents' characteristics, while Chi-square tests and binomial logistic regression analyses were used to identify factors associated with childhood immunization at a 5% significance level.Most respondents were aged 25-29 years (28.8%),tertiary education (51.0%), lived in rented accommodation (77.3%), resided in peri-urban communities (48.0%), travelled 3-4 km to access health facilities (58.5%) and 1-7 antenatal care visits (58.0%).Chisquare analysis showed that housing ownership status (χ² = 7.647, p = 0.022) had significant associations with childhood immunization.Binomial logistic regression revealed that housing ownership status (AOR = 2.074; 95% CI: 1.315-3.270;p = 0.002) and settlement type (AOR = 0.730; 95% CI: 0.545-0.978;p = 0.035) were significant independent predictors of childhood immunization.Maternal age, maternal education, distance to health facilities, and means of transportation were not significantly associated with childhood immunization after adjustment.The study concludes that vaccine equity in Plateau North Senatorial District is primarily influenced by socioeconomic and spatial inequalities.Interventions aimed at improving childhood immunization should prioritize disadvantaged households and underserved settlements through targeted outreach programmes, equitable healthcare delivery, and policies that reduce financial and geographic barriers to vaccination.
Introduction:Child malnutrition is a persistent global challenge. It is the cause of nearly 45% of global child mortalities. To ensure positive child health outcomes, integrated multisectoral approaches among families, communities, and government systems to ensure positive child health outcomes are neccesary.Objectives:This study identifies how different care support systems can be linked to ensure optimal childhood nutrition outcomes in South Africa. This is through multisectoral approaches from the early childhood development (ECD) practitioners' perspective.Materials and Methods:We integrated the components of the different support systems and multisectoral approaches. The conceptional framework of the causes of malnutrition by The United Nations Children's Fund (UNICEF) recognizes that malnutrition is due to inadequate care services, diet, and care practices influenced by individual, household, community, and structural determinants. While the Nurturing Care Framework, which looks at how policies and services can support families, parents, and other communities in providing nurturing care.Design:A sequential mixed methods approach was used. For the quantitative method, we did a cross-sectional descriptive analysis of 2 966 children who were under-five years' old in the 2017 South African National Income Dynamics Study (NIDS) between July and August 2022, we conducted five in-depth interviews with ECD practitioners using this qualitative method, and the data was analyzed using thematic analysis. Data was triangulated to understand the factors influencing children’s nutritional outcomes and to provide the narratives of ECD practitioners. This enabled us to highlight challenges and opportunities in linking children to services they need.Results:This study showed that 22.16% of children were stunted, 16.40% were overweight, and 5.04% were underweight. ECD practitioners reported a lack of support received at health facilities and other social services when making referrals, a lack of parental support in nutrition programmes, systemic challenges experienced in getting ECD centers registered, and the ECD's inability to qualify for subsidized nutrition grants.Conclusion:It is critical for us to understand the challenges and opportunities for multisector collaboration. This understanding will enable strategies and policies aimed at providing efficient and effective service referral and service delivery to improve childhood malnutrition in South Africa.
Background Childhood vaccine hesitancy is a significant public health concern. In Nigeria, it remains a major barrier to achieving optimal immunization uptake, contributing to preventable morbidity and mortality. Yet there remains a significant research gap on the synthesis of health communication strategies to address parental hesitancy to childhood vaccination. The primary aim and original contribution of the present review is to synthesize health communication strategies to address parental hesitancy to childhood vaccination in Nigeria. Method The review strategy was underpinned by the Population, phenomenon of interest and context (PICo) model. Hence, the population (parents, carers, or primary caregivers of children between the ages of 0 and 3 years), the phenomenon of interest (health communication strategies to address parental hesitancy to childhood vaccination), and the context (vaccine hesitancy). For qualitative studies, the PICo strategy, which is a modified version of PICO, was used. Boolean operators (AND/OR/NOT) were used to ensure rigor in adopting informed search terms. Six databases were searched for published articles between 2017 and March 2026. N = 12 studies met the inclusion criteria, and the relevant data were synthesized and analyzed using a thematic synthesis approach. The review protocol was pre-registered on the PROSPERO Registry (no. CRD420261303323). Findings The synthesized studies and analyses yielded the following main findings: (i) Media campaign strategies, (ii) State-sponsored communication strategies, (iii) Community-centered strategies, and (iv) Phone-based strategies. Conclusion Childhood vaccine hesitancy remains a major challenge in Nigeria. The review recommends that vaccine communication be culturally attuned and multi-channeled (e.g., embedding community-centered mechanisms—particularly those involving trusted religious and traditional leaders, media platforms, and mobile phone text messaging). It also recommends that vaccine communication be responsive to both structural constraints and community information need to address parental hesitancy to childhood vaccine uptake.
BACKGROUND: Childhood immunization is an important part of public health efforts to reduce morbidity and mortality from diseases that can be prevented by vaccination. Sub-Saharan Africa (SSA) has the lowest childhood immunization coverage and the highest child mortality rate in the world. Therefore, this study aimed to assess community variation in childhood immunization and to identify determinant factors associated with childhood immunization using mixed effect count regression models. METHOD: This study used data from the 2012-2022 Demographic and Health Survey (DHS), which included 195,000 children between the ages of 12 and 23 months in 33 SSA countries. A various mixed-effects count regression model were employed to identify the variables associated with the prevalence of childhood vaccination. RESULT: In SSA, the mean average childhood immunization was 5.47 (95% CI = 5.46, 5.48), with an 8.38 variance. The mixed effect zero-inflated Poisson model fit the data the best, with the lowest DIC, AIC, and BIC values. The results of the model showed that working mothers, mothers with secondary or higher education (IRR = 1.119; 95% CI: 1.114, 1.125), rich wealth status (IRR = 1.077; 95% CI: 1.073, 1.082), having a health card (IRR = 1.265; 95% CI: 1.258, 1.271), being exposed to the media (IRR = 1.082; 95%CI: 1.077, 1.086), institutional delivery (IRR = 1.168; 95% CI: 1.163, 1.174), receiving eight or more ANC visits (IRR = 1.301; 95% CI: 1.288, 1.314), receiving vitamin A (IRR = 1.350; 95% CI: 1.344, 1.355), using a contraceptive (IRR = 1.187; 95% CI: 1.182, 1.192) and receiving Postnatal Care (PNC) (IRR = 1.075; 95% CI: 1.071, 1.080), were associated with a higher incidence of childhood immunization. While children in rural areas (IRR = 0.972; 95%CI: 0.968, 0.976) had a lower prevalence of childhood vaccinations than children in urban areas. CONCLUSION: SSA had a low coverage of childhood vaccination with significant disparities among countries. Therefore, it is essential to prioritize public health initiatives that target low-income households, rural mothers, uneducated parents, and those who have not utilized maternal health care services for the sake of increasing the coverage of childhood immunizations that in turn enhances the health of children. Furthermore, it is imperative to create policies and initiatives that tackle regional and national variations in childhood immunization rates and to actively work toward their implementation.
Abstract Understanding the intricate dynamics which underscore early childhood growth is a pivotal pursuit within child development research. This longitudinal study delves into developmental pathways of grade R and 1 pupils, across five primary schools in Gauteng. Employing an inclusive survey administered to educators, guardians, and healthcare practitioners, the study seeks to capture insights spanning factors such as education, nutrition, health, material well-being, and protection or care dimensions. The sample of 138 participants, encompassing a balanced gender distribution, boasts an average child age of 7 years. Employing advanced statistical techniques, this study employs Exploratory Factor Analysis to unearth distinctive latent factors, thereby constructing a holistic framework for further inquiry. Structural Equation Modelling illuminates substantial correlations between emotional regulation and safety and well-being factors, highlighting their pivotal roles in children's comprehensive development. Acknowledging the evolving nature of child growth, Latent Growth Modelling introduces a temporal dimension, facilitating the analysis of growth trajectories to discern alterations and trends in latent variables across multiple time points. Children's emotional regulation exhibits consistent baseline intercepts, whereas safety and well-being factors manifest baseline variability and nuanced covariances. These findings underscore the intricate interplay between initial levels and rates of change. In addition to shedding light on latent factors that shape child development, this research underscores the importance of advanced statistical methodologies. By influencing evidence-based interventions and policy decisions, the study contributes to discourse surrounding the cultivation of healthy childhoods, fostering a deeper comprehension of multifaceted factors that influence children's well-being.
Arnesh Telukdarie, Godfrey Mpho Nkadimeng, Leila Patel et al.
Mortality following severe acute malnutrition (SAM) remains high in Africa. Some children with SAM have altered immune responses and impaired neurodevelopment; however, whether vitamin D deficiency contributes to these poor outcomes remains unclear. We conducted a cross-sectional analysis of circulating 25-hydroxyvitamin D [25(OH)D] concentrations at hospital discharge (25(OH)D) in 442 children aged 0-59 months with SAM at one hospital in Lusaka, Zambia, and two hospitals in Harare, Zimbabwe. Also, we investigated the relationship between 25(OH)D concentrations and host factors. In 442 children, plasma 25(OH)D concentrations were measured using ELISA. Vitamin D deficiency was identified in 33/442 (7.5%; 95% CI: 5.2-10.3) children, all of whom were from Zimbabwe. A multivariable regression model that included age, sex, HIV status, season, oedema, cerebral palsy, and country demonstrated significantly higher 25(OH)D levels among children aged 6-11 months (adjusted (adj) ratio; 1.3; 95% CI: 1.1, 1.6; P = 0.003), 12-23 months (adj ratio; 1.5; 95% CI: 1.3, 1.8; P < 0.001), and 24-59 months (adj ratio; 1.5; 95% CI: 1.3, 1.8; P < 0.001) compared with those <6 months. Sampling during the cool season (adj ratio; 1.2; 95% CI: 1.1, 1.3; P = 0.002), absence of cerebral palsy (adj ratio; 1.2; 95% CI: 1.1, 1.4; P = 0.002) and residence in Zambia (adj ratio; 1.2; 95% CI: 1.1, 1.2; P < 0.001) were associated with higher concentrations of 25(OH)D, even after excluding children <6 months. These findings indicate that vitamin D status among children with SAM is significantly influenced by age, seasonality, cerebral palsy, and geographical location. To facilitate management and improve clinical outcomes in these children, we recommend further investigation into whether the current vitamin D content in ready-to-use therapeutic foods is sufficient for all children and whether additional supplementation improves clinical outcomes, especially in high-risk groups. If deficiency is present, we recommend that children be managed in accordance with local guidelines and policies.
Tracy Naomi Phiri, Cherlynn Dumbura, Kuda Mutasa et al.
This paper examines the persistent urban–rural divide in early childhood care and education (ECCE) teacher professional development in South Africa. Drawing on peer-reviewed literature, policy analysis, and comparative data, the study explores how geographic location influences access to accredited training, qualification levels, institutional support, material resources, and professional identity. Urban ECCE teachers benefit from proximity to higher education institutions, regular workshops, and structured career pathways, while rural practitioners often face isolation, under-resourcing, and lack of formal recognition. The paper further analyses structural and contextual constraints in rural settings, such as infrastructural deficits, digital exclusion, and policy implementation failures. Through teachers’ lived experiences, the paper presents a grounded understanding of the inequities that shape professional development trajectories. Comparative indicators highlight the systemic nature of these inequalities and the urgent need for targeted, context-sensitive policy interventions. The paper concludes with practical recommendations to strengthen rural ECCE teacher development through inclusive governance, localized training models, resource redistribution, and the recognition of experiential knowledge.
How to cite: Stofile, S & Ngece, S 2026, ‘Writing anxiety: A barrier to early isiXhosa literacy development’, in T Moodley, S Stofile & R Govender (eds.), Holistic and inclusive education practices for young learners in South Africa: From early childhood to Foundation Phase, The University of the Western Cape Faculty of Education Book Series, vol. 2, AOSIS Books, Cape Town, pp. 247–263. https://doi.org/10.4102/aosis.2026.BK568.12
INTRODUCTION: Recent reports from Kampala indicate low uptake and completion of the human papillomavirus (HPV) vaccine among adolescents, especially amongst those living with HIV. However, the drivers of this low uptake are poorly understood. This study aimed to determine the current HPV vaccine coverage; assess the knowledge, attitude and practices influencing HPV vaccine uptake among adolescent girls living with HIV; and pilot an HPV vaccination program while documenting lessons learned and experiences at two urban HIV treatment centres the Joint Clinical Research Centre (JCRC) and Mildmay Uganda in Kampala, Uganda. METHODS: This was a descriptive cross-sectional mixed methods study employing both qualitative and quantitative data collection methods, carried out between 03/12/2024-30/08/2025, among adolescent girls living with HIV in Kampala, Uganda. A total of 371 were enrolled, of which 182 from JCRC and 189 from Mild May Uganda. At enrolment, 11 adolescents declined consent to participate. Quantitative data on knowledge of HPV and HPV vaccination was collected through interviews, with any additional demographic data being obtained from medical records at the treatment centres. Qualitative data included four focused group discussions (FGDs) of adolescent girls and 32 key informant interviews (KIIs) with focal health workers (Paediatricians, nurses, counsellors) at the two centres were conducted. RESULTS: Overall, 138/371 (37%) of the adolescents reported having heard about the HPV vaccine, while 233/371 (63%) had not. At enrolment, only 51 out of 371 (14%) participants had initiated vaccination. Among those who initiated vaccination, 51% had received only the first dose. By the end of the study, 342/371 (92%) of adolescents had completed the recommended two doses of the HPV vaccine. This study focused on increasing vaccine uptake amongst the HIV positive adolescents at the two centres. Most adolescents with a good level of knowledge about HPV or those attending school reported to have initiated vaccination. Identified barriers to vaccine uptake included inadequate knowledge about HPV and the benefits of vaccination; limited availability of HPV vaccines, and the absence of routine HPV immunisation programs within HIV treatment centres or programs specifically targeting adolescents living with HIV. CONCLUSION: In these two urban HIV care and treatment centres, vaccination against HPV among eligible adolescents is way lower than recommended 90 percent. Adolescent girls living with HIV demonstrated low levels of knowledge about the HPV vaccine and poor access to vaccination services, despite being receptive to vaccination. This study showed that HPV vaccine uptake can be substantially improved within HIV care and treatment centers by reducing barriers to HPV vaccination uptake when the vaccines are made readily available and accessible, either in existing HIV care and treatment centres or in the new integrated care centres in areas where government programs have moved to implement HIV care integration into mainstream medical services.
Oliver Ombeva Malande, Deogratias Munube, Julia Jerono Songok et al.
