Childhood immunization in Mmakaunyane village in the North West Province of South Africa

Abstract

ABSTRACT

BACKGROUND AND OBJECTIVE:

Immunization is one of the most cost effective preventative health care interventions that is available to communities; it has greatly reduced the burden of infectious diseases in childhood. Since the W orId Health Organization launched the expanded programme of immunization in 1974, routine childhood immunization is widely available and it forms an integral part of preventative healthcare. Unfortunately, many children lack access to this life saving health care intervention. Communities in poor, rural areas often lack access to basic services, including health care and immunization services. We studied immunization coverage in a poor, rural community in South Africa and further explored what factors put children in this community at risk for under-immunization.

METHOD:

This was a cross sectional study, in which the immunization status of children from birth to six years of age living in Mmakaunyane was assessed. The primary caregivers of these children were also interviewed to determine their knowledge, attitudes and their practices with regards to immunizations; they were further asked about their perception of healthcare service delivery in the village. Using a map of the village, it was divided it into 30 blocks with 4 clusters in each block. Field workers were looking for a maximum of 5 eligible children in each cluster. We used the Road to Health Card to check if immunization was

complete for age according to the SA EPI.

RESUL TS:

There were 567 children enrolled in the study. The majority of the children were above 18 months of age (64.4%) We found that 92.1 % of children were in possession of a RHC. In total, 432 (76.2%) of the children were fully immunized for their age, 97 (17.1%) had incomplete immunizations and immunization status was unknown for 38 (6.7%). The primary caregiver for most of the children was the biological mother (85.5%). There was a low level of education amongst the primary caregivers with only 15.3% having completed matric or attained higher level of education. Caregiver knowledge of immunization was poor and only 21.1 % of caregivers correctly mentioned three diseases that can be prevented by immunization. The majority of the caregivers (96.0%) believed that immunizations help to keep children healthy.

Approximately half (49.9%), of the caregivers perceived immunization service delivery in Mmakaunyane village to be good. Factors that were found to be associated with incomplete immunization included age of caregiver, gender of the child and knowledge of the caregiver on immunization.

CONCLUSION:

Only 76.2% of children were fully immunized for their age in Mmakaunyane village. This immunization coverage rate is less than the National target of 90% for all children aged one year. The proportion of children under one year of age that are fully immunized is higher than that of the whole group. This indicates that the older children have a lesser level of immunization coverage (>18 months: 74.2%). The major factors that were found to be associated with under-immunization include lack of knowledge about immunizations, older age of the caregiver as well as poor accessibility of health care services. Female children were also found to be at increased risk for under-immunization. Measures to improve immunization coverage in this community need to take all these factors into consideration