Determinants of vaccination status among children aged 0 to 23 months: a cross-sectional study in the Gazaoua health district, Niger

Abstract

Objectives: To identify the socio-demographic and structural factors associated with full immunization status among children aged 0 to 23 months in the Gazaoua health district, Niger. Materials and Methods: A cross- sectional analytical study was conducted from October 22 to November 20, 2024. A two-stage cluster sampling method (30 clusters of 20 children) was used to recruit 587 mothers (after data cleaning). Immunization status was verified using vaccination cards or maternal recall. Data were collected via KoBoCollect and analyzed using R Studio. Binary logistic regression was performed to identify independent determinants (p < 0.05). Results: A total of 587 records were analyzed. The prevalence of full immunization status was 54.34%. Multivariate analysis revealed that the factor most strongly associated with full vaccination was antenatal care (ANC) attendance : aOR = 17.22; 95% CI [7,47-50,02]; p < 0.001. Other facilitating factors included the household head's secondary or higher education level (aOR = 1.98; p = 0.01), birth in a health facility (aOR = 1.82; p = 0.001), and child age between 12 and 23 months (aOR = 1.44; p = 0.032). Conversely, the lack of direct access to a fixed health center was a major barrier (aOR = 0.2; p < 0.001). Conclusion: Immunization coverage in Gazaoua remains insufficient to ensure effective herd immunity. The massive impact of prenatal follow-up highlights the need to integrate vaccination awareness during pregnancy and to strengthen local healthcare delivery to reduce structural barriers