Prevalence and factors associated with incomplete immunization among children aged 12 to 35 months in Eswatini: analysis of the Eswatini multiple indicator cluster survey

Abstract

Introduction: incomplete childhood immunization is a significant public health challenge as children continue to succumb to vaccine-preventable diseases in most developing countries. Studies on childhood immunization conducted in Eswatini are sparse. Therefore, the present study assessed the prevalence of incomplete childhood immunization in Eswatini and further explored associated factors among children aged 12 to 35 months.

Methods: using data from Eswatini multiple indicator cluster survey 5 (EMICS5), a cross-sectional analysis with 978 children aged 12 to 35 months was conducted. This is the latest available data in the public domain. The survey was conducted from July 2014 to October 2014. The primary outcome variable was incomplete immunization. Univariate and multivariate logistic regressions were used to examine the association between selected variables and incomplete immunization.

Results: the mean age of the children was 23.45±6.92 months, 50.2% were boys, and 74.1% lived in rural areas. The prevalence of incomplete immunization was 31.5%. Increased child´s age, being a girl, increased caregiver´s age, and increased number of children under-five years in the household and residing in the Manzini or Hhohho region were significantly associated with incomplete immunization.

Conclusion: the EMICS 5 revealed a high prevalence of incomplete immunization in Eswatini. Health promotion activities such as empowering women and caregivers of children through health education about child health should be emphasized. Where feasible, outreach services and door-to-door immunization should be strengthened to improve immunization coverage in the country and cover dropouts.