East African Medical Journal

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Client factors that contributes to non-adherence to the immunization schedule for children under five years of age in Chepsaita Location

J.K. Too, J.N. Mangeni, S.K. Musyoki


Background: Worldwide about 29,000 children under the age of five die every day, mainly from preventable diseases. Every year around 8 million children in developing countries die before they reach their fifth birthday; many during the first year of life. By 2016, child mortality rate for Kenya was 49.2 deaths per 1,000 live births.

Objective: The main objective of the study was to assess client factors that contributes to non-adherence to the immunization schedule for children under five years in Chepsaita location.

Study Setting: This study was carried out in Chepsaita location , Turbo Sub county, in Uasin Gishu County

Study Subjects: The study population was all households with children aged below five years within Chepsaita location consisting of 300 households. The proxies were their mothers or caretakers found at home at the time of data collection. The health workers at the health centre who offer MCH services as well as community volunteers were included in the study as key informants.

Methods: This study adopted a cross-sectional study design. Purposive and Snowball sampling techniques were used to select households. Further, the staff working at the immunization clinic were purposively selected for in-depth interview at the health facility.

Results: A total of 172 households participated in this study. Majority of the respondents were from the age brackets of 35-39 years (22.7%) and 30-34 years (22.1%). Most of the participants were married (91.9%). Most of the mothers indicated their highest level of education as primary (53.5%). Majority of the study area residents were found to be protestants (64.5%). The immunization coverage rate according to the findings from the present study was 74.4%. Client factors associated with non-adherence to the immunisation schedule were; maternal age (X2 =48.611, P <0.001), education level (X2 = 50.351, P <0.001), Marital Status (X2 = 11.993, P <0.001), place of delivery (X2 =0.175, P<0.001), family size (X2 =5.307, P =0.021) and maternal knowledge about immunization (X2 =10.872, P <0.001).

Conclusion: Adherence to immunization is still low in Chepsaita location. Client related factors associated with adherence to EPI immunization schedule for children under five years of age include; older maternal age, lower maternal education level, marital status, mother’s occupation and lower family monthly income, place of delivery, large family size and lower maternal level of knowledge on immunization.

Recommendation: Based on the study findings, its recommended that mothers should be educated on importance of adherence to EPI immunization schedule for children under five years which it was found to be low in Chepsaita location. The study recommends the collaboration of national government, county government, community-based organization (CBOs), NGOs and other health sector actors to come up with sensitization campaigns on adherence to EPI immunization which will benefit all mothers.

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