Factors associated with utilization of immunization service among under 3 years old children in urban slums of Chanmyathazi Township, Mandalay, Myanmar

Abstract

Child immunization is one of the most cost-effective public health interventions and it plays as a key role in reducing child mortality and occurrence of lifelong diseases. This cross-sectional study was designed to identify the prevalence of immunization and factors associated with utilization of immunization service among under 3years old children in urban slums of Chanmyathazi Township, Mandalay. The outcome variables used for this study were whether the child received complete types of EPI immunization, immunization with timeliness and utilization of immunization service. Cluster sampling was applied to select 429 primary caregivers of under 3years old children. Face to face interview was conducted using structured questionnaires. Chi-square test and multiple logistic regression were used to examine associations between the selected factors and outcome variables. In the study result, 24.1% of the children were with complete type of immunization according to national schedule and 64.8% were partial, whereas 11.1% of them were never immunized. Regarding timeliness, 26.5% of the immunized children had the timely vaccinations, while about three-fourth 73.5% of those had delayed immunization. In terms of utilization of immunization status, 23% of the caregiver utilized the service with quality immunization and 77% of them did not utilize the service. In multiple logistic regression analysis, child age (AOR: 3.49; 95%CI: 1.63-7.50), income (AOR: 6.36; 95%CI: 2.35-17.18), migration status (AOR: 3.28; 95%CI: 1.05-10.29), ANC visit (AOR: 4.77; 95%CI: 1.55-14.67), receiving additional vaccine (AOR: 6.27; 95%CI: 2.72-14.44) and having immunization card (AOR: 3.15; 95%CI: 1.33-7.46) were associated with the utilization of the immunization service (P-value<0.05). The finding of this study suggested that not only strengthening of Effective Health Information Management Systems with a focus on slum migrants but also keeping health records in forms of electronic registration by using appropriate software which will reduce dependency of immunization card. The study also indicated that it is needed to implement comprehensive maternal and child health care system that promotes ANC together with immunization uptake and health promotion programs on additional vaccine preventable diseases such as Rotavirus infection and Japanese encephalitis in community level.