DETERMINATS OF UPTAKE OF ROUNTINE IMMUNIZATIONS SERVICES AMONG MOTHERS OF UNDER-FIVE CHILDRED IN MAIDUGURI METROPOLITAN COUNCIL, BORNO STATE, NIGERIA

Abstract

Routine immunization (RI) remains a critical public health intervention for reducing morbidity and mortality from vaccine-preventable diseases (VPDs) among under-five children. However, Maiduguri Metropolitan Council (MMC), Borno State, Nigeria, continues to experience suboptimal immunization coverage due to multifaceted barriers. This study examines the determinants influencing RI uptake among mothers of under-five children in MMC, focusing on maternal, health system, socio-cultural, and conflict-related factors. Findings indicate that maternal knowledge and education significantly predict immunization behavior, with educated mothers being 3.2 times more likely to fully vaccinate their children compared to those with no formal education. Despite high awareness (92.5 %), misconceptions persist, with 19% of mothers believing vaccines cause infertility or violate Islamic principles. Health system challenges, including vaccine stock outs (reported in 68% of facilities) and long travel distances (74% of caregivers), further hinder access. Negative experiences with healthcare workers also reduce trust in immunization services. Conflict and displacement exacerbate these barriers, with 67% of local government areas (LGAs) in Borno experiencing service disruptions due to Boko Haram insurgency. Internally displaced persons (IDPs) face additional logistical challenges, such as lost vaccination cards. Socio-cultural norms, including patriarchal decision-making (63% of immunization decisions require husband’s approval) and preference for traditional remedies, further limit uptake. Interventions such as community engagement with religious leaders, mobile clinics, and SMS reminders have shown promise in improving coverage. However, sustained efforts are needed to address misinformation, strengthen health systems, and ensure conflict-sensitive service delivery. This study underscores the need for integrated strategies to enhance RI uptake in MMC, aligning with global immunization targets and reducing child mortality from VPDs.