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Prevalence and factors associated with immunization non-completion among children aged 12–23 months at Kisoro General Hospital, Uganda: a cross-sectional study
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DOI：10.1186/s12889-026-29002-8.png)
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Abstract
En 中文
Immunization non-completion, defined here as a child missing at least one age-appropriate vaccine dose under Uganda’s national immunization schedule (UNEPI), remains a critical public health problem in sub-Saharan Africa, exposing children to preventable diseases. In Uganda, coverage falls substantially below the WHO target of 90%, particularly in rural districts. This study determined the prevalence of immunization non-completion among children aged 12–23 months at Kisoro General Hospital and identified associated socio-economic and healthcare-related factors. A cross-sectional study was conducted from October to December 2024 at Kisoro General Hospital among 275 caregivers of children aged 12–23 months attending the immunization clinic, selected by systematic random sampling. Immunization non-completion was defined as failure to receive at least one age-appropriate dose per the UNEPI schedule (BCG, OPV, pentavalent, PCV, rotavirus, measles, and yellow fever vaccines) by 12–23 months of age. Data were collected via structured, pre-tested questionnaires and verified immunization card records. Descriptive statistics, bivariate chi-square tests, and multivariable logistic regression were performed using Stata version 15.1 (StataCorp, College Station, TX, USA). The participation rate was 90.5% (275/304). Caregivers who declined participation (n = 10), were excluded after consent due to absent immunization records (n = 12), or whose children fell outside the 12–23-month age range (n = 7) are reported in full in the Results section. The prevalence of immunization non-completion was 34.2% (94/275; 95% CI: 28.5–39.8%). In multivariable analysis, significant predictors included lack of formal caregiver education (aOR = 3.3, 95% CI: 0.93–11.49; p = 0.044), delayed initiation of immunization beyond three weeks of birth (aOR = 7.3, 95% CI: 3.66–14.72; p < 0.001), unfriendly health worker attitude (aOR = 5.8, 95% CI: 1.29–11.46; p = 0.022), and vaccine stock-outs (aOR = 6.1, 95% CI: 1.71–14.67; p = 0.005). Children of caregivers aged 25–34 years were less likely to have incomplete immunization than those of caregivers aged over 34 years (aOR = 0.3, 95% CI: 0.16–0.76; p = 0.008). One in three children attending Kisoro General Hospital had incomplete immunization, far below national and global targets. Modifiable determinants at both caregiver and health system levels were identified. Targeted interventions including caregiver education, timely postnatal vaccination, health worker training, and vaccine supply strengthening are urgently needed.
Keywords:
Immunization completion
Vaccine coverage
Childhood immunization
Uganda
Sub-Saharan Africa
Vaccine-preventable diseases
Rural health
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