Barriers in immunization of children under two years of age in Mohmand Agency, Federally Administered Tribal Area, Pakistan

Muhammad Naeem, Aisha Imtiaz, Hamid Hussain, Naeem ullah, Shama Hidayat


Background: Immunization is vital in children health care, however, many studies have shown that child immunization is influenced by many factors.

Objective: To determine the barriers associated with immunization among children less than two years of age.

Material & Methods: A cross-sectional study was conducted in Tehsil Halimzai of Mohmand agency, Federally Administered Tribal Area, Khyber Pakhtunkhwa, from July to December 2014. Sample size was 421. Chi-square test was applied to determine association of socio-demographic factors to immunization.

Results: The socio-demographic data of participants showed that 197 (46.8%) participants were between 31 - 40 years of age. Mean age of the participants was 35.79 + 8.03. 245 (58%) were uneducated and 268 (89.8%) had monthly income between 5000 and10,000 Pakistani Rupees (PKR). Among 421 children under two years of age, 287 (68.2%) were immunized and only 102(35.5%) were fully immunized. Importance of child immunization was recognized by 286 (67.9%) parents, however, most of the parents 286 (67.9%) did not retain the immunization cards of their children. The socio-demographic factors found to be associated with immunization status of children included age (P = 0.02), income and education level of participants (P < 0.01). The other factors included psychological fear of being attacked (P = 0.04), awareness of the community about child immunization by the health care providers (P < 0.001). Lack of education of the community regarding immunization by health care providers was reported by 84.4% respondent. The opinion of Imam Masjid (P = 0.011) and community elders (P = 0.019) regarding immunization and its importance for child health were also identified as key factors for child immunization .

Conclusion: Parental age, education and income level, psychological fear of being attacked, awareness of the community about child immunization by the health care providers and opinion of Imam Masjid and community elders were identified as key factors for child immunization.

Keywords: Child Health, Immunization, Pakistan, Clergy, Fear, Parents

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