Socio-Demographic Determinants of Complete Childhood Immunization Coverage among Caregivers in Rural Nasarawa State, Nigeria

Abstract

Aims: This study examined the socio-demographic determinants of complete childhood immunisation coverage among caregivers in rural communities of Nasarawa State, Nigeria, over the period 2016–2025, with attention to trends, prevalence, associated caregiver-level determinants, and health-system challenges affecting coverage. Study Design: A descriptive cross-sectional survey. Place and Duration of Study: Rural communities served by general health facilities in Lafia, Akwanga, Andaha, Wamba, Nasarawa Toto and New Karu Local Government Areas of Nasarawa State, Nigeria; data collection was conducted in 2025. Methodology: The study population comprised 2,459 parents/caregivers registered for immunisation services at the selected facilities. A sample of 341 caregivers was determined using the Krejcie and Morgan (1970) table and selected through purposive sampling. Data were collected using a sixteen-item, interviewer-administered, structured questionnaire comprising socio-demographic items and four Likert-scale sections addressing trends, prevalence, socio-demographic determinants, and challenges related to complete childhood immunisation uptake. Data were analysed using SPSS with descriptive statistics (frequencies and percentages), while chi-square and logistic regression procedures were applied to examine associations. Results: Most caregivers were aged 15–24 years (44.0%), single (44.0%), tertiary-educated (70.1%) and self-employed (42.1%). The majority (85.3%) affirmed that there was a discernible trend in complete childhood immunisation uptake, and 75.1% agreed that caregivers and parents were aware of this trend. Complete immunisation uptake among children aged 0–23 months was estimated by most respondents (65.7%) at approximately 30%. Antenatal clinic attendance (71.0% strongly agreed) and distance to the general hospital (84.2% strongly agreed) emerged as the socio-demographic and health-system factors most strongly associated with complete immunisation. Key challenges identified included poorly resourced health facilities (54.0% strongly agreed), flooding and environmental disruption of vaccine supply (84.2% strongly agreed), poor physical access in remote areas (96.5% strongly agreed), and persistent misconceptions about children's readiness for vaccination (82.7% agreed). Conclusion: Complete childhood immunisation coverage in rural Nasarawa State remains suboptimal and is shaped jointly by caregiver socio-demographic characteristics, antenatal care engagement, geographic access, and health-system readiness. Targeted, multi-level interventions addressing caregiver awareness, facility strengthening, and access barriers are required to improve coverage.