title: Missed opportunities and caretaker constraints to childhood vaccination in a rural area in Uganda.
abstract: BACKGROUND
  Despite concerted support to vaccination programmes, coverage remains low. While health service reasons for this are known, there is little information on caretaker constraints to vaccination in Africa.
  
  
  OBJECTIVE
  To establish the prevalence of missed vaccination opportunities and caretaker constraints to childhood vaccinations.
  
  
  METHODS
  Cross-sectional descriptive study.
  
  
  METHODS
  Caretakers of 408 children aged 12-23 months were interviewed.
  
  
  METHODS
  Kiyeyi, a rural area in Eastern Uganda.
  
  
  RESULTS
  Complete vaccination coverage by card was 26.7% while by history and card it was 44.6%. Of the 215 eligible children who sought treatment in a health facility where vaccination could be offered, 59.6% missed an opportunity to be vaccinated while 24.4% of the children missed an opportunity during routine vaccination sessions. Reasons for non-completion of vaccination included caretaker 'not bothered', being busy, or ill and fear of rude health workers. While most caretakers were aware of vaccination and its benefits, none knew the immunisation schedule. The major caretaker constraints were low level of formal education, fear of vaccine side effects, and perceived contraindications to vaccinations.
  
  
  CONCLUSIONS
  Promotion of formal education for girls and educating mothers and health workers on the timing of vaccinations, their side effects and management might contribute to higher vaccination coverage.
authors.affiliation: Department of Paediatrics and Child Health, Makerere University Medical School, Kampala, Uganda.
authors.forename: F
authors.initials: F
authors.lastname: Tugumisirize
authors.forename: J K
authors.initials: JK
authors.lastname: Tumwine
authors.forename: E A
authors.initials: EA
authors.lastname: Mworozi
mesh_terms: D000328:Adult; D001722:Birth Order; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004522:Educational Status; D005239:Fear; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D009042:Motivation; D020380:Needs Assessment; D010290:Parents / Q000193:education* / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015995:Prevalence; D019035:Rural Health Services / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014454:Uganda; D014611:Vaccination / Q000706:statistics & numerical data*; D016526:Workload