Perception about Child Vaccination and its Determinants among Caregivers in Tehuledere Woreda, North Eastern Ethiopia

Background : In spite of increase in global immunization coverage, many children around the world especially in developing countries still left unvaccinated. Effective vaccination communication with parents is crucial in efforts to overcome barriers to childhood vaccination, tackle vaccine hesitancy and improve vaccination coverage. Objective: To examine caregivers’ perception towards child vaccination and identify factors associated with childhood vaccine hesitancy among children 12-36 months of age in Tehuledere Woreda, South Wollo Zone, North East Ethiopia. Methods and Materials : Explanatory sequential mixed method was used. For quantitative method c ommunity-based cross-sectional study was conducted from September to November 2019. A multistage sampling technique was employed. Study participants were selected systematically. A total of 824 mothers/caregivers of children aged 12 – 36 months were successfully interviewed using structured and pre-tested questionnaire. Data were entered into Epi data version 4.6.0 and exported into SPSS version 20 for analysis. Logistic regression analyses were done. A significant association was declared at a p -value less than 0.05. For qualitative data a phenomenological study design was employed among participants and content analysis was performed . Results : About 596 (72.3%) of the children were completely vaccinated. Widowed mothers (AOR =7.3, CI =2.2,24), home delivery practice (AOR =4.6, CI =1.8,10), long walking time to health facility (AOR =9.5, CI =3.2,27), use of community as vaccine information source (AOR =4.2, CI =1.7,9.6), occurrence of child death in the family (AOR =2.6, CI =1.2,6.8) and mothers health seeking behavior (AOR =2.5, CI =1.1,5.4) were found to be associated with vaccine hesitancy. Conclusion and Recommendations: Acceptance and refusal of child vaccination was found to reflect factors including perceived benefits of vaccine and social environment. Encouraging mothers to attend proper antenatal care and to exploit family planning programs is recommended to improve vaccination status of children in the rural communities. Community awareness programs also should be scaled up by incentivizing community health workers.