Factors Influencing Childhood Immunization Coverage Among Children Aged 12–23 Months at Primary Health Care Centers in Maiduguri (MMC and Jere LGAs), Borno State, Nigeria
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Background: Childhood immunization remains one of the most cost-effective public health interventions, yet coverage in conflict-affected settings such as Borno State, Nigeria, remains suboptimal. This study aimed to determine the factors influencing childhood immunization coverage among children aged 12–23 months attending Primary Health Care centers in Maiduguri Metropolitan Council (MMC) and Jere Local Government Areas.
Method: A descriptive cross-sectional mixed-methods design was employed, involving quantitative surveys of 328 caregivers and qualitative interviews with healthcare workers and selected caregivers. Quantitative data was analysed using SPSS version 27, while qualitative data were thematically analysed with NVivo version 12. A significance level of (p ≤ 0.05).
Result: The findings showed that maternal education, occupation, household wealth, and decision-making autonomy were significantly associated with full immunization. Health system barriers such as vaccine stockouts, long distances to facilities, and weak cold-chain infrastructure reduced uptake, while sociocultural beliefs, misinformation, and the influence of community and religious leaders contributed to vaccine hesitancy. Multivariate analysis identified maternal education, caregiver knowledge, and facility accessibility as the strongest predictors of full immunization.
Conclusion: In conclusion, improving maternal health literacy, strengthening health system capacity, and engaging trusted community leaders are essential to enhancing immunization coverage in conflict-affected settings like Maiduguri. Multisectoral and context-specific strategies are recommended to bridge immunization gaps and support Nigeria’s progress towards achieving the Immunization Agenda 2030 targets.
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