Trends and Challenges in Immunization Coverage among Children aged 0-11 Months in Nkambe Health District, North-West Region, Cameroon

Background: Immunization remains a highly effective and affordable disease-prevention measure, yet sociopolitical unrest in Cameroon’s North West Region hampers vaccine uptake. In Nkambe Health District, limited knowledge persists regarding coverage and challenges to immunization. The objective of this study was to determine the trends in immunization coverage among children aged 0–11 months between 2013 and 2019 and identify the challenges faced by caregivers and healthcare providers in the uptake of immunization in Nkambe Health District, North West Region, Cameroon. Methods: A survey was conducted among caregivers of 385 children aged 0–11 months in the Nkambe Health District to determine the immunization status of children, the coverage, challenges and associated factors using a structured questionnaire. Review of hospital records was done to determine the trend of vaccination coverage. In-depth interviews were conducted among healthcare providers to explore challenges of vaccination coverage. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. Logistic regression analysis was used to identify the predictors of complete immunization and triangulated with thematic analysis results. Results: Among 385 guardians, 68.8% of children had completed vaccination. Coverage peaked at 82.0% in 2017 but fell to 40.0% in 2019. Complete vaccination was significantly associated with living <5 km from a vaccination site (aOR = 3.2, 95% CI: 1.81–5.82, p = 0.001), knowledge of the vaccination schedule (cOR = 2.57, 95% CI: 1.43–4.60, p = 0.001), antenatal care attendance (aOR = 10.5, 95% CI: 3.59–31.05, p = 0.001), and postponed vaccination sessions (aOR = 2.97, 95% CI: 1.66–5.32, p = 0.001). Challenges included staff shortages, lack of cold chain, and socio-political unrest. Conclusion: Vaccination coverage in Nkambe Health District has sharply declined in recent years due to the ongoing crisis and other challenges; improving coverage will require stronger community engagement, sensitization, and expanded outreach services.