Prevalence and contributing factors for missed opportunity for vaccination among children under two years of age attending health facilities in Kinondoni municipal council, Dar es salaam, Tanzania

Abstract

Background: A missed opportunity for vaccination (MOV) is an incident whereby a child visits a health facility service and does not receive all recommended vaccines despite being eligible. Despite the efforts aiming at attaining universal vaccine coverage, anecdotal and reported findings indicate significant MOV in Tanzania. Moreover, several factors play part in contributing to MOV. Such findings, however, are not systematically documented in Tanzania. This study, therefore, aimed at exploring MOV and proposes appropriate measure in Tanzania context. Aim of the Study: This study has a broad aim of determining the prevalence and contributing factors for MOV among children under two years of age attending health facilities in Kinondoni Municipal Council, Dar es Salaam, Tanzania. Materials and Methods: This was a facility based cross-sectional study that used both quantitative and qualitative approach to data collection. A total of 330 parents/caregivers of children under two years of age participated in the quantitative survey and 6 health care workers participated in the qualitative approach of the study. Sample size was allocated in proportion to the target population of the facility. Analysis of quantitative data was conducted using IBM SPSS version 17 through descriptive and regression analyses methods. For the qualitative part, data was transcribed, coded and analysed using content thematic analysis method. Results: A total of 195 out of 330 children recruited were eligible for vaccination during the day of interview, of which 142 (72.8%) received the vaccine during that day and the remaining 53 (27.2%) did not receive vaccine despite being eligible (MOV). The likelihood of experiencing MOV is high in children below 12 months compared to children above 12 months of age (OR 0.13, P<0.001). Moreover, the likelihood of experiencing MOV occurs in children whose main reason for attending health facility is medical consultation compared to those who attend health facility for vaccination (OR 77.43, p=0.001). Health care workers described stock out of vaccines, knowledge /attitude of health care workers, breakdown of cold chain system and timing/days of immunization services as the main contributing factors for MOV. Conclusion and Recommendations: The study highlighted prevalence of MOV and contributing factors in Kinondoni Municipal Council. Proper attention to children below 12 months of age during medical consultation, ensuring availability of vaccines, proper timing of immunization, ensuring functionality of cold chain and change of attitude of health care workers are of paramount importance to reduce MOV.