Prevalence and Factors Associated with Zero-Dose Children amongst Nomadic and Non-Nomadic Fulani in Yobe State, North-East Nigeria.

Abstract

Background: Immunization is a very cost-effective and readily available intervention capable of preventing Vaccines Preventable Diseases (VPDs). This study aimed to identify and compare the prevalence and factors associated with zero-dose immunization status among children of nomadic and non-nomadic Fulani in Yobe State, North-East Nigeria.

Methodology: A comparative cross-sectional design was used to study 348 nomadic, and 345 non-nomadic under-five children, selected using a multi-staged sampling technique. Data were collected using interviewer administered questionnaire, observation of child immunization card, and recall by the caregivers, and were analysed using IBM SPSS version 22.0 with a statistical significance set at P ≤5%.

Results: The maximum age of the nomadic caregivers was 60 and the minimum was 17 years with a mean ±SD of 28.2±7.7 years. The maximum age of the non-nomadic caregivers was 78 and the minimum was 17 years with a mean ±SD of 33.0±10.0 years. The prevalence of zero dose children among nomadic and non-nomadic Fulani were (70.1%, 242), (61.8%, 63) respectively. The zero-dose children were significantly higher among nomads (87.2%, p<0.001) and non-nomad (54.4%, p<0.001) with no available child immunization card.The children of vaccines hesitant caregivers of nomads and non-nomads were 10 or more times more likely to be zero dose than non-hesitant caregivers (adjusted odds ratio [aOR] =477, 95% CI = [177-13031]), and (Adjusted odds ratio [aOR] =9.7, 95% CI = [2.1-44.3]) respectively.

Conclusion: The burden of zero-dose was alarmingly high among nomads compared to non-nomad Fulani despite widespread immunization outreach services in the study area. The government and relevant stakeholders should intensify Context-specific health promotion activities and outreach services targeting these underserved populations.