title: Level of immunization coverage and associated factors among children aged 12-23 months in Lay Armachiho District, North Gondar Zone, Northwest Ethiopia: a community based cross sectional study.
abstract: BACKGROUND
  Immunization against childhood disease is one of the most important public health interventions with cost effective means to preventing childhood morbidity, mortality and disability. However, complete immunization coverage remains low particularly in rural areas of Ethiopia. This study aimed to assess the level of immunization coverage and associated factors in Lay Armachiho District, North Gondar zone, Northwest Ethiopia. A community based cross-sectional study was conducted in March, 2014 among 751 pairs of mothers to children aged 12-23 months in Lay Armachiho District. A two stage sampling technique was employed. Logistic regression analysis was carried out to compute association between factors and immunization status of children. Backwards stepwise regression method was used and those variables significant at p value 0.05 were considered statistically significant.
  
  
  RESULTS
  Seventy-six percent of the children were fully immunized during the study period. Dropout rate was 6.5% for BCG to measles, 2.7% for Penta1 to Penta3 and 4.5% for Pnemonia1 to Pnemonia3. The likelihood of children to be fully immunized among mothers who identified the number of sessions needed for vaccination were higher than those who did not [AOR = 2.8 (95% C1 = 1.89, 4.2)]. Full immunization status of children was higher among mothers who know the age at which the child become fully immunized than who did not know [AOR = 2.93 (95% CI = 2.02, 4.3)]. Taking tetanus toxoid immunization during pregnancy showed statistically significant association with full immunization of children [AOR 1.6 (95% CI = 1.06, 2.62)]. Urban children were more likely to be fully immunized than rural [AOR = 1.82 (95% CI = 1.15, 2.80)] and being male were more likely to be fully immunized than female [AOR = 1.80 (95% CI = 1.26, 2.6)].
  
  
  CONCLUSIONS
  Vaccination coverage was low compared to the Millennium Development Goals target. It is important to increase and maintain the immunization level to the intended target. Efforts should be made to promote women's' awareness on tetanus toxoid immunization, when the child should start vaccination, number of sessions needed to complete immunization, and when a child become complete vaccination to improve immunization coverage through health development army and health professionals working at antenatal care, postnatal care and immunization units.
authors.affiliation: Armachiho District Health Office, North Gondar Zone, Amhara Regional State, Ethiopia. hpes14@gmail.com.
authors.forename: Melkamu Beyene
authors.initials: MB
authors.lastname: Kassahun
authors.affiliation: Department of Health Service Management and Health Economics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia. gashawab@gmail.com.
authors.forename: Gashaw Andargie
authors.initials: GA
authors.lastname: Biks
authors.affiliation: Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia. alemayehushimeka@gmail.com.
authors.forename: Alemayehu Shimeka
authors.initials: AS
authors.lastname: Teferra
mesh_terms: D001428:Bacterial Vaccines / Q000008:administration & dosage* / Q000276:immunology; D003430:Cross-Sectional Studies; D005002:Ethiopia; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D017589:Immunization Programs; D007223:Infant; D016015:Logistic Models; D008297:Male; D008457:Measles / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control*; D018743:Perinatal Care; D011018:Pneumonia, Pneumococcal / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control*; D012424:Rural Population; D011795:Surveys and Questionnaires; D013742:Tetanus / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control*; D014397:Tuberculosis, Pulmonary / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control*; D014505:Urban Population; D014765:Viral Vaccines / Q000008:administration & dosage* / Q000276:immunology
chemical_list: D001428:Bacterial Vaccines; D014765:Viral Vaccines