Missed opportunities and caretaker constraints to childhood vaccination in rural areas of Uganda

Background: Despite concerted support to vaccination programmes, coverage remains low. While health service reasons for this are known, there is little information on caretaker constraints to vaccination in Africa. Objective: To establish the prevalence of missed vaccination opportunities and caretaker constraints to childhood vaccinations. Design: Cross-sectional descriptive study. Subjects: Caretakers of 408 children aged 12-23 months were interviewed. Setting: Kiyeyi, a rural area in Eastern Uganda. Results: Complete vaccination coverage by card was 26.7% while by history and card it was 44.6%. Of the 215 eligible children who sought treatment in a health facility where vaccination could be offered, 59.6% missed an opportunity to be vaccinated while 24.4% of the children missed an opportunity during routine vaccination sessions. Reasons for non-completion of vaccination included caretaker ‘not bothered', being busy, or illand fear of rude health workers. While most caretakers were aware of vaccination and its benefits, none knew the immunisation schedule. The major caretaker constraints were low level of formal education, fear of vaccine side effects, and perceived contraindications to vaccinations. (East African Medical Journal: 2002 79(7): 347-354) Conclusion: Promotion of formal education for girls and educating mothers and health workers on the timing of vaccinations, their side effects and management might contribute to higher vaccination coverage