title: Utilization of outreach immunization services among children in Hoima District, Uganda: a cluster survey.
abstract: BACKGROUND
  The global vaccine action plan 2011-2020 was endorsed by 194 states to equitably extend the benefits of immunization to all people. However, gaps in vaccination coverage remain in developing countries such as Uganda. One of the strategies used to tackle existing inequities is implementation of outreach immunization services to deliver services to those with poor geographical access. However, reports of inconsistent use of these services prevail; therefore understanding the factors associated with use of these services is critical for improving service delivery. This study examined the factors associated with utilization of outreach immunization services among children aged 10-23 months in Hoima District, Uganda.
  
  
  RESULTS
  Overall, 87.4% (416/476) of the children had ever utilized outreach immunization services. Of these, 3.6% (15/416) had completed their entire immunization schedules from outreach immunization sessions. Use of outreach services was associated with reports that the time of outreach sessions was convenient [adjusted odds ratio (AOR) 2.9, 95% confidence interval (CI) 1.32-6.51], community mobilization was done prior to outreach sessions (AOR 4.9, 95% CI 1.94-12.61), the caretaker knew the benefits of childhood immunizations (AOR 2.1, 95% CI 1.30-4.42), and the caretaker was able to name at least four vaccine preventable diseases (AOR 3.0, 95% CI 1.13-7.88).
  
  
  CONCLUSIONS
  Utilization of outreach immunization services in Hoima District was high but reduced with subsequent vaccine doses. Therefore, strategies targeted at retaining service users for the entire immunization schedule need to be developed and implemented. Such strategies could include health education emphasizing the benefits of childhood immunization.
authors.affiliation: School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
authors.forename: Paul
authors.initials: P
authors.lastname: Oryema
authors.affiliation: School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
authors.forename: Juliet N
authors.initials: JN
authors.lastname: Babirye
authors.affiliation: School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
authors.forename: Charles
authors.initials: C
authors.lastname: Baguma
authors.affiliation: African Field Epidemiology Network (AFENET), P.O. Box 12874, Kampala, Uganda. wasswakit@yahoo.co.uk.
authors.forename: Peter
authors.initials: P
authors.lastname: Wasswa
authors.affiliation: School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
authors.forename: David
authors.initials: D
authors.lastname: Guwatudde
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers / Q000706:statistics & numerical data; D002662:Child Health Services / Q000706:statistics & numerical data*; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys / Q000379:methods* / Q000706:statistics & numerical data*; D006801:Humans; D007114:Immunization / Q000379:methods*; D007223:Infant; D008297:Male; D008875:Middle Aged; D014454:Uganda; D055815:Young Adult
keywords: Child; Cluster survey; Immunization; Outreach; Routine; Uganda; Utilization