RESUMO
Improving immunization coverage is vital to promoting child health and reducing childhood diseases and deaths. In spite of being actively promoted as a major public health intervention for national development since the late 1970s, immunization coverage in Ghana remains low. We investigated factors that influence attendance to immunization sessions in the Komenda-Edina-Eguafo-Abrem District of Ghana. The major factors hindering attendance were poor knowledge about immunization, lack of suitable venues and furniture at outreach clinics, financial difficulties, long waiting times, transport difficulties, poorly motivated service providers and weak intersectoral collaboration. The timing of immunization sessions, length of prior notice to the community, attitude of service providers and fear of side-effects generally did not deter attendance.
PIP: Although childhood immunization has been a major national development goal in Ghana since the late 1970s, coverage rates remain low. In 1992, coverage for the third dose of diphtheria-pertussis-tetanus (DPT) was 43% for children under 12 months of age. The present study, conducted in August 1993, used focus group discussions and interviews with 469 mothers of children under 2 years of age, 17 service providers, and 10 heads of health-related sectors, to investigate factors influencing attendance to immunization sessions in Ghana's Komenda-Edina-Eguafo-Abrem District. 73% of mothers reported they attended child welfare clinics regularly. The main factors motivating mothers to attend were the perceived benefits of immunization for disease prevention, its impact on socioeconomic development, the relatively low cost of disease prevention, and the need for vaccination cards for school entry. The major factors hindering attendance were poor knowledge about immunization, lack of suitable venues and furniture at outreach clinics, financial difficulties, long waiting times, transportation problems, poorly motivated service providers, and weak intersectoral collaboration. The timing of immunization sessions, length of advance notice to the community, attitude of service providers, and fear of side effects generally did not deter attendance. Attention to the obstacles to compliance with childhood immunization schedules is essential if Ghana is to achieve the goal of 80% coverage by the year 2000.