Factors Associated to the Non-adherence to Vaccination Appointments in the Ngambe Health District, Littoral Region, Cameroon: A Case Control Study

Abstract

Background: Vaccination is what is strongly recommended in protecting against childhood diseases. The Expanded Program of Immunization (EPI) in Cameroon started in 1976 as a pilot project and became operational all over the country in 1982 where vaccination is seen a fundamental right of every child in the country. However, rural areas have lots of constrains to the effective implementation of vaccination programs some of which are population-related. Purpose: This study aimed to assess the association between some factors and adherence to vaccination appointments in Ngambe Health District; a typical rural health district in Cameroon. Methods: This was a case control study where the vaccination records of health facilities in the district were reviewed and parents who respected their vaccination appointments formed the controls while those who missed a vaccination appointment were the cases. They were then traced for interviewed and data analyzed using Epi infos version 3.5.4. Results: Out of 94 parents, 37.2% had missed a vaccination appointment. In parents older than 36, the odds of missing an appointment was 11 (95%CI 3.69-34.43) while those with <4 children were 0.10 less likely to miss an appointment (95%CI 0.04-0.28). Parent’s education, household size and ANC attendance also influenced adherence to vaccination appointments. After adjustment, only age and whether or not child was born in the hospital remained statistically significant associated with adherence. Conclusion: User related factors influence uptake of vaccination services in the Ngambe Health District of Cameroon; a rural area, some of which are age of the parents, number of children the parent has and the total household size. Therefore, adding to the availability of vaccines, a high-level political commitment aimed at increasing utilization of health services and effectively taking vaccination to the population are indispensable.