Factors contributing to delay in commencement of immunization in Nigerian infants

Abstract

Delay in receipt of immunization may result in a child being susceptible to vaccine preventable diseases for prolonged periods. Identification of factors which contribute to delay in receipt of immunization will help in developing targeted interventions. This study examined prospectively factors contributing to delay in the commencement of infant immunization in Benin City, Nigeria. This was a cross-sectional descriptive study of 153 consecutive mothers of infants presenting for their first immunization at the Institute of Child Health Child Welfare Clinic of the University of Benin, Benin City.  Reasons for not presenting in the first 24 hours were ascertained and associations between various factors and delay in commencement of immunization were examined. Of the 153 mothers only 2 (1.3%) brought their babies for immunization within 24 hours of birth while 66 (43.1%) brought their babies in the first week of life.  The most cited reason (30.3%) for not presenting within 24 hours of birth was that BCG, one of the immunizations that should be given at birth is given only on a specific day. Mothers who did not know that immunization should commence at birth (P=0.0054), those from low socioeconomic class (P=0.0056) and those with less than 12 years of schooling (P=0.0001) were significantly less likely to bring their babies for immunization in the first week of life. Delivery outside of health facilities was also associated with later presentation for immunization (P=0.0069). In conclusion, there is significant delay in the receipt of birth doses of immunization. Change in clinic practices to enable daily immunization as well as education of health care personnel on the importance of timely commencement of immunization will ensure timeliness of receipt of birth doses of vaccines.