The context of urban immunization services: The case of Sodo town, Wolaita Zone, South Ethiopia

Introduction: The world continued to be urbanized with approximately 55% of the world's population and it is expected to increase to 68 per cent by 2050. Urban areas generally have better healthcare resources and higher immunization coverage compared to rural one. However, the challenge of zero doses and under-immunization exist in urban. These variation within urban communities exist due to factors such as population mobility, socio-economic and demographic disparities, and vaccine hesitancy. Therefore, this study tried to assess factors that enhance or affect the delivery of immunization services in Wolaita Sodo town. Methods A community-based cross-sectional study design was conducted among 411 children aged 0–35 months. Participants were selected using simple random sampling method through a multi-stage approach. Data were collected using a structured questionnaire using ODK (Open Data Kit) mobile app. The collected data were analyzed using the Statistical Package for the Social Sciences software version 25 (SPSS). Bivariate and multivariable logistic regression analysis was performed. Results Fully vaccinated and vaccinated for their age as per the national schedule were 56.7% and 29.4%, respectively. And, 7.8% experienced vaccination dropouts and 6.1% of children were never vaccinated. Significant associations were found between the completion of child immunization schedules and factors such as Antenatal Care follow-up AOR = 0.082 with 95% CI (0.009–0.777), facility delivery AOR = 0.18 with 95% CI (0.046–0.703), Community Health Insurance enrollemen OR = 34 with 95% CI (0.125–0.923), and health service access AOR = 0.11 with 95 CI (0.04–0.32). Conclusion Children aged 0–35 months who properly attended their immunization schedule fell below the required optimum level of 95%. Efforts should be made to strengthen vaccination delivery points, promote ANC follow-up and facility deliveries, and enhance the enrollment of the CBHI scheme to improve immunization services in Sodo town.