Lakhasly

Routine immunization is important to both individual and public health (Gilmour et al., Citation2011). It is the primary strategy of the Expanded Program on Immunisation (EPI) to protect children from vaccine-preventable diseases (VPDs). Routine immunization is strongly promoted by the World Health Organisation (WHO), Health professionals, and Public Health Authorities worldwide (Gilmour et al., Citation2011). Immunization is one of the most cost-effective interventions with proven strategies which make it accessible to even the hardest to reach and vulnerable populations, as well as a proven tool for controlling and eliminating life-threatening infectious diseases. Immunization averts an estimated 2–3 million deaths each year (Muhammad et al., Citation2018). It prevents illness, disability, and death from vaccine-preventable diseases including diphtheria, measles, whooping cough (pertussis), pneumonia, polio, rotavirus diarrhea, rubella, and tetanus (Dicko & World Health Organization, Citation2018). Immunization also improves substantially the number of children who reach their first birthdays (Anderson, Citation2015). Complete immunization of children less than 1 year of age remains one of the most cost-effective strategies to reduce child mortality and to help achieve Sustainable Development Goals (SDG) (Ekouevi et al., Citation2018). It is recommended that children receive the complete schedule of vaccinations before their first birthday (Ebrahim & Salgedo, Citation2015).

If a child misses at least a dose out of the required vaccines recommended when he/she is under 12 months old that child has not completed the immunization schedule (Anokye et al., Citation2018). This forms the basis of this study. Despite the clear benefits of immunization, many parents choose not to vaccinate their children Anderson (Citation2015). Globally, it is reported that 22.6 million infants under 1 year of age were partially protected (Yenit et al., Citation2015). Of the 12.9 million infants worldwide, who did not receive any vaccinations in 2016, an estimate of 6.6 million infants did not complete the full three-dose of DTP immunization series (DTP3) (World Health Organization/United Nations International children’s fund, Citation2017). A similar study further indicated that 19.9 million infants worldwide under 1 year of age did not receive the three recommended doses of Diphtheria, Tetanus, pertussis (DTP) in the year 2017 (Don, Citation2017).

It is also recommended that children receive the complete schedule of vaccinations before their first birthday and that the vaccinations be recorded on a vaccination card that is given to the parents or guardians. It is also recommended that children receive the complete schedule of vaccinations before their first birthday and that the vaccinations be recorded on a vaccination card that is given to the parents or guardian Children in Uganda are immunized against 11 vaccine-preventable diseases routinely before they reach 1-year old. These vaccines include; polio, tuberculosis, whooping cough, diphtheria, Tetanus, Hepatitis B, measles, haemophilus, PCV (pneumococcal conjugate vaccine), IPV (inactivated polio vaccine), and Rota (World Health Organization and United Nations International Children’s Fund, Citation2018). According to the “Goal” of UNEPI, “every child” must be fully vaccinated against the target diseases. They refer to the word “fully” here to mean completing a vaccination schedule, which is getting several vaccines at different pre-determined points in time. A child is considered fully vaccinated if he/she has received: a bacillus Callmete Guerrin (BCG) vaccination against Tuberculosis, at least three doses of polio vaccine. He/she should also receive one dose of the measles vaccine; three doses of the pentavalent vaccine (DPT-Hep B-Hi-b) to prevent diphtheria, pertussis, tetanus, haemophilus influenza type b, and hepatitis B (Negussie et al., Citation2016). A child should also receive 3 (Three) doses of pneumococcal conjugate vaccine (PCV) (Ninsiima, Citation2013) and one dose of inactivated polio vaccine (IPV) which was included in the infant routine immunization (World Health Organization and United Nations International Children’s Fund, Citation2018). Uganda was among the 10 countries with over 60% of the 18.7 million infants not fully immunized (Adedire et al., Citation2016). According to Vonasek et al. (Citation2016), vaccine coverage rates remain well below the WHO goal of 90%, with 82% of the children receiving the measles vaccine and 78% completing the three-dose series of pentavalent vaccine in the Sub-Saharan African Countries including Uganda. In 2011, Uganda was among the African countries with 8.4 million infants who had not received their third dose of DTP vaccine, out of the 29 million infants who survived to their birthday. Upon a child receiving immunization at birth, most parents fail to return their children for follow up jabs, which increases the risk of children contracting killer but preventable diseases (Lanyero, Citation2012), incomplete immunization.

According to the New vision report of 2013, Lira District was reported among the 11 Districts lagging behind in routine immunization. Torantola, et al. (2013) also reported a failed target of Districts achieving the 80% Coverage of DTP-3 vaccine in all Districts (Bbaale, Citation2013). The URCS quarterly project reports of July 2012–June 2014 showed that there were 738 routine immunizations defaulters out of the households visited in Lira District in 2014 (Mbabazi, Citation2015). These reports indicate a gap which needs to be filled by conducting a research on incomplete routine immunization. One researcher noted that often the socio-cultural context relevant for health-seeking behavior is not considered during program implementation (Babirye et al., Citation2011). For the above reason, this study sought to find out the socio-cultural factors associated with incomplete routine immunization of children aged 0–1 year old in Amach Sub-County in Lira District to ensure that parents support the full immunization of their children thus promoting more infant survival and improved health.

Thus, the manuscript presents the background of the study, study area, problem statement, objectives, methods, and results, among others. Discussion followed the result section.