Assessment of routine immunization default rates and evaluation of catch-up strategies among mothers of children aged 0–59 months in Ido Local Government Area, Oyo State, Nigeria

https://doi.org/10.35912/rnhr.v1i1.3378
Published: Aug 28, 2025

Abstract:

Purpose: This study aimed to determine the prevalence and determinants of routine immunization default among mothers of children aged 0–59 months in Ido Local Government Area (LGA), Oyo State, Nigeria, and to evaluate the effectiveness of implemented catch-up strategies.

Methodology/approach: A descriptive cross-sectional study was conducted with 420 mothers selected through multi-stage sampling. Data were obtained using structured interviewer-administered questionnaires and analyzed with SPSS version 26. Descriptive statistics summarized sociodemographic and immunization variables, while logistic regression identified predictors of defaulting. Key informant interviews with healthcare providers were thematically analyzed to assess catch-up strategies and contextual barriers.

Results/findings: The study revealed an immunization default rate of 34.8%. The main reasons cited for defaulting included lack of awareness of return dates (41.2%), long distances to health facilities (26.5%), and vaccine stock-outs (19.3%). Significant predictors were maternal education level (p=0.002), place of delivery (p=0.015), and knowledge of immunization schedules (p<0.001). Catch-up strategies such as house-to-house visits, SMS reminders, and mobilization by religious and traditional leaders were moderately effective but insufficient in hard-to-reach areas.

Conclusions: Routine immunization defaulting persists as a significant public health challenge in Ido LGA. Socioeconomic, educational, and systemic barriers hinder full coverage, necessitating more robust interventions

Limitations: The cross-sectional design restricts causal inference, and self-reported data may introduce recall bias.

Contribution: The study provides empirical evidence to strengthen catch-up strategies and guide policy toward equitable immunization coverage.

Keywords:
1. Immunization Default
2. Maternal Health
3. Primary Healthcare
4. Routine Immunization
5. Vaccination Coverage
Authors:
1 . Aibinuomo Ayomide Oluwaseyi
Texila American University, Georgetown, Guyana
2 . Joy Anorue
Enugu State University of Science and Technology, Enugu, Nigeria
3 . Akande Deborah Tolulope
University of Ibadan, Ibadan, Nigeria
4 . Agboola Abimbola Akoje
University Teaching Hospital, Ibadan, Nigeria
5 . Daniels Florence Tola
University of Ibadan, Ibadan, Nigeria
6 . Idowu Oluwatoyin Margaret
Leadcity University, Ibadan, Nigeria
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Vol. 1 No. 1 (2025): August
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References

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  1. Abad, N., Uba, B. V., Patel, P., Barau, D. N., Ugochukwu, O., Aliyu, N., . . . Bolu, O. (2021). A rapid qualitative assessment of barriers associated with demand and uptake of health facility-based childhood immunizations and recommendations to improve immunization service delivery in Sokoto State, Northwest Nigeria, 2017. The Pan African Medical Journal, 40(Suppl 1), 10. doi:https://doi.org/10.11604/pamj.supp.2021.40.1.23793
  2. Adamu, A. A., Jalo, R. I., Ndwandwe, D., & Wiysonge, C. S. (2024). Informal health sector and routine immunization: making the case for harnessing the potentials of patent medicine vendors for the big catch-up to reduce zero-dose children in sub-Saharan Africa. Frontiers in Public Health, 12, 1353902. doi:https://doi.org/10.3389/fpubh.2024.1353902
  3. Adenike, O.-B., Adejumoke, J., Olufunmi, O., & Ridwan, O. (2017). Maternal characteristics and immunization status of children in North Central of Nigeria. The Pan African Medical Journal, 26, 159. doi:https://doi.org/10.11604/pamj.2017.26.159.11530
  4. Aigbogun Jr, E. O., Ibrahim, R., Yusufari, Y., Igbokwe, U., Okongwu, C., Abdulkarim, A., . . . Aina, M. (2023). Impact of the COVID-19 pandemic on routine immunization programs in Northern Nigeria. Sustainability, 15(17), 12966. doi:https://doi.org/10.3390/su151712966
  5. Ali, H. A., Hartner, A.-M., Echeverria-Londono, S., Roth, J., Li, X., Abbas, K., . . . Ferguson, N. M. (2022). Vaccine equity in low and middle income countries: a systematic review and meta-analysis. International journal for equity in health, 21(1), 82. doi:https://doi.org/10.1186/s12939-022-01678-5
  6. Atteraya, M. S., Song, I. H., Ebrahim, N. B., Gnawali, S., Kim, E., & Dhakal, T. (2023). Inequalities in childhood immunisation in South Asia. International journal of environmental research and public health, 20(3), 1755. doi:https://doi.org/10.3390/ijerph20031755
  7. Babatunde, O., Olatunji, M., Omotajo, O., Ikwunne, O., Babatunde, A., Nihinlola, E., . . . Dairo, M. (2022). Impact of COVID-19 on routine immunization in Oyo State, Nigeria: trend analysis of immunization data in the pre- and post-index case period; 2019-2020. Pan African Medical Journal, 41. doi:http://dx.doi.org/10.11604/pamj.2022.41.54.28575
  8. Brown, D. W., Burton, A. H., Gacic-Dobo, M., & Karimov, R. I. (2014). A comparison of national immunization programme target population estimates with data from an independent source and differences in computed coverage levels for the third dose of DTP containing vaccine. World Journal of Vaccines, 4(1), 18-23. doi:http://dx.doi.org/10.4236/wjv.2014.41004
  9. Costa, F., Neves Silva, L., Cata-Preta, B., Santos, T., Ferreira, L., Mengistu, T., . . . Victora, C. (2024). Child immunization status according to number of siblings and birth order in 85 low- and middle-income countries: a cross-sectional study. EClinicalMedicine, 71. doi:http://dx.doi.org/10.1016/j.eclinm.2024.102547
  10. Esimai Olapeju, Ogum, E., & Olodu, M. (2023). Prevalence of Missed Opportunities for Immunization and Associated Factors in Urban and Rural Areas of Southwest, Nigeria doi:https://doi.org/10.58425/jphs.v2i1.129
  11. Ezenwaka, U., Manzano, A., Onyedinma, C., Ogbozor, P., Agbawodikeizu, U., Etiaba, E., . . . Uzochukwu, B. (2021). Influence of conditional cash transfers on the uptake of maternal and child health services in Nigeria: insights from a mixed-methods study. Frontiers in Public Health, 9, 670534. doi:https://doi.org/10.3389/fpubh.2021.670534
  12. Forshaw, J., Gerver, S. M., Gill, M., Cooper, E., Manikam, L., & Ward, H. (2017). The global effect of maternal education on complete childhood vaccination: a systematic review and meta-analysis. BMC infectious diseases, 17(1), 801. doi:https://doi.org/10.1186/s12879-017-2890-y
  13. Inoyatovna, A. K. (2025). Strategies for fostering functional literacy in medical students during biochemistry instruction. Studies in Medicine and Public Health, 1(1), 31-41. doi:https://doi.org/10.35912/simph.v1i1.3318
  14. Jean Baptiste, A. E., Wagai, J., Hahné, S., Adeniran, A., Koko, R. I., de Vos, S., . . . Hak, E. (2024). High-Resolution Geospatial Mapping of Zero-Dose and Underimmunized Children Following Nigeria's 2021 Multiple Indicator Cluster Survey/National Immunization Coverage Survey. The Journal of infectious diseases, 230(1), e131-e138. doi:https://doi.org/10.1093/infdis/jiad476
  15. Kehinde, O., Abdul, R., Afolabi, B., Vir, P., Namblard, C., Mukhopadhyay, A., & Adereni, A. (2024). Deploying ADVISER: Impact and Lessons from Using Artificial Intelligence for Child Vaccination Uptake in Nigeria. Proceedings of the AAAI Conference on Artificial Intelligence, 38, 22185-22192. doi:http://dx.doi.org/10.1609/aaai.v38i20.30223
  16. Malande, D. O. (2019). Barriers to effective uptake and provision of immunization in a rural district in Uganda. Plos one, 14.
  17. Mardiyanti, F. (2021). Ergonomic and hazard risk assessment on meatball sellers. Studies in Medicine and Public Health, 1(1), 1-14. doi:https://doi.org/10.35912/simph.v1i1.795
  18. Mohammed, Y., Reynolds, H., Waziri, H., Attahiru, A., Olowo-okere, A., Kamateeka, M., . . . Nguku, P. (2024). Exploring the landscape of routine immunization in Nigeria: A scoping review of barriers and facilitators. Vaccine: X, 20, 100563. doi:http://dx.doi.org/10.1016/j.jvacx.2024.100563
  19. Mohammed, Y., Reynolds, H. W., Waziri, H., Attahiru, A., Olowo-Okere, A., Kamateeka, M., . . . Garba, R. (2024). Exploring the landscape of routine immunization in Nigeria: A scoping review of barriers and facilitators. Vaccine: X, 20, 100563. doi:https://doi.org/10.1016/j.jvacx.2024.100563
  20. Ogundele, O. A., Ogundele, T., Fehintola, F. O., Fagbemi, A. T., Beloved, O. O., & Osunmakinwa, O. O. (2022). Determinants of incomplete vaccination among children 12-23 months in Nigeria: an analysis of a national sample. Tzu Chi Medical Journal, 34(4), 448-455. doi:https://doi.org/10.4103/tcmj.tcmj_220_21
  21. Ogunniyi, T. J. (2024). Revealing the challenges and efforts of routine immunization coverage in Nigeria. Health Science Reports, 7(8), e70000. doi:https://doi.org/10.1002/hsr2.70000
  22. Olufadewa, I., Adesina, M., Oladele, R., Shonubi, A., Bamidele, D., & Obigwe, E. (2024). Trends and predictors of full immunization coverage in Nigeria. Discover Public Health, 21(1), 151. doi:https://doi.org/10.1186/s12982-024-00283-x
  23. Salako, J., Bakare, D., Uchendu, O. C., Bakare, A. A., Graham, H., & Falade, A. G. (2023). Factors associated with immunization status among children aged 12-59 months in Lagelu local government area, Ibadan: a cross-sectional study. Pan African Medical Journal, 46(1). doi:https://doi.org/10.1186/s13643-019-1054-0
  24. Wee, M. K., Cabantog, J., Magpayo, D. D., Sabido, N. L., Samson, E., & David, P. (2021). Factors causing vaccine hesitancy among parents in Bulacan. Studies in Medicine and Public Health, 1(1), 15-29. doi:https://doi.org/10.35912/simph.v1i1.715
  25. Williams, S. V., Akande, T., & Abbas, K. (2024). Systematic review of social determinants of childhood immunisation in low-and middle-income countries and equity impact analysis of childhood vaccination coverage in Nigeria. Plos one, 19(3), e0297326. doi:https://doi.org/10.1371/journal.pone.0297326
  26. Yunusa, U., Garba, S. N., MacDonald, S. E., Bello, U. L., Ibrahim, A. H., Abdulrashid, I., . . . Ladan, M. A. (2024). Utilization of mobile reminders in improving the completeness and timeliness of routine childhood immunization in Kano Metropolis, Nigeria: a randomized controlled trial. Journal of Pediatric Health Care, 38(5), 727-736. doi:https://doi.org/10.1016/j.pedhc.2024.03.002