Predictors of vaccination card retention in Tamale Metropolis, Ghana

Abstract

AbstractBackgroundThe home-based vaccination card (HBR) is an important health record for determining vaccination status of children during surveys, particularly in low- and middle-income countries (LMICs). However, there are limited evidence on the factors that influence its retention in Ghana. We assessed the predictors of vaccination card retention in Tamale Metropolis, GhanaMethodsWe conducted a cross-sectional study from 21stDecember 2022 to 10thJanuary 2023 among children aged 0-59 months in the Tamale Metropolis. Multi-stage sampling was used to select caregivers of children aged 0-59 months for enrolment in the study. Data were collected using validated questionnaire through face-to-face interviews of caregivers. A vaccination card was retained if it was presented for physical inspection by research assistants. The factors that influence vaccination card retention were determined in a multivariate logistic regression analysis at p<0.05.ResultsA total of 1,566 eligible children were enrolled in this study. Vaccination card retention was 89.5%. Negative predictors of card retention included: being resident in the Nyohini (AOR=0.26; 95% CI=0.15-0.47) and Tamale Central (AOR= 0.52; 95% CI=0.30-0.92) sub-Metro areas, and children belonging to age group 24-59 months (AOR=0.40; 95% CI=0.23-0.67). On the other hand, paying for the vaccination card (AOR=5.20; 95% CI=2.98-9.04) was a positive predictor of vaccination card retention.ConclusionIn this study, vaccination card retention among children aged 0-59 months was higher than national estimates. Vaccination card retention was mainly influenced by place of residence, age of child and mode of acquisition of the card such as out-of-pocket payment. There is need to design and deliver tailored messages including the importance of vaccination card retention to caregivers of children based on geographic context. Additionally, the vaccination cards should be supplied to health facilities and made readily accessible to caregivers to prevent out-of-pocket payment.