Utilization of immunization services among children aged under five in Kirinyaga County, Kenya

Margret W. Njeru, Priscilla N. Kabue, Albert G. Gachau


Background: Immunization is the key strategy to curb communicable diseases which are the number one killer of children under five years of age. Immunization prevents mortalities of approximating three million children under five years annually. This study aimed to assess utilization of immunization services among children aged under five in Kirinyaga County, Kenya.

Methods: This was a descriptive cross-sectional study conducted among 388 participants in the five sub-counties of Kirinyaga County through systematic random sampling. Data was collected using a structured interview and review of recorded data from the Children immunization record card. Data was analyzed using SPSS and chi-square tests used to measure the association between independent and dependent variables. Statistical significance was set at p0.05.

Results: Immunization at birth and at 6 weeks was highly utilized at 91%. However, there was a decline during the subsequent visits. Age, gender, profession and level of income were significant factors that affected timely immunization. Health service barriers to utilization included long ques and waiting time, stock out of vaccine and rescheduling of vaccination and clinic return dates. Other identified factors were myths and misconception, side effects, parity and lack of information.

Conclusions: The results showed that utilization of immunization services was not in compliance with the expanded programme on immunization schedule. There is therefore need for health education programs to be carried out to improve utilization of immunization services and a door to door campaign to trace and immunize defaulters. 


Utilization, Immunization, Under-fives

Full Text:



WHO and UNICEF. Levels and Trends in Child Mortality, (2014). Available at: https://www.who. int/maternal_child_adolescent/documents/levels_trends_child_mortality_2014/en/. Accessed on 19 November 2018.

Etana BW. Deresa W. Factors Associated With Complete Immunization Coverage of children aged 12-24 months in Ambo Woeda. Central Ethiopia: BioMed Central ltd; 2012.

Kenya Expanded Programme on Immunization. National policy guidelines on immunisation, (2013). Available at: preview. Accessed on 19 November 2018.

World Health Organization. “WHO Recommendations for routine Immunization”, (2013). Available at: immunization/policy/immunization_tables/en/. Accessed on 19 November 2018.

Hill HA, Elam-Evans LD, Yankey D, Singleton JA, Kang Y. National immunisation survey-children (19-35 months). Morbidity Mortality Weekly Report. 2018;67(40);1123–8.

Center for Disease Control (CDC). Under five Mortality Rates In Kenya, (2015). Available at: Accessed on 19 November 2018.

Koskei A, Tabu S, Malalu P. Immunisation services of children under five years old in Kalichemba divsion, Pokot county, Kenya. Sci J Public Health. 2014;2(6):617-23.

County Health Information System (CHIS) (2014); Health Sector Strategic and Investment Plan, Kirinyaga County.

Canavan M, Sipsma H, Kassie G, Bradley E. Correlates of complete childhood vaccination in East African countries. PLoS One. 2014;9(4):e95709.

Karanja S, Kombich J. Immunization coverage and its determinants among 12-23 months in a Peri-Urban area of Kenya. Pan Afr Med J. 2013;14:3.

Abdi M, Feleke A,Worku W, Kifle M, Sharma R. Immunisation coverage of 12- 24 months old children and associated factors in the uran and rural areas of Jigiga District. MC Public Health. 2014;14:865.

Sembuche S. Uptake of vaccination services and associated factors among under five, Banada District Shinyange region Tanzania. 2010.

Mutua M, Kimani M, Remare E. Childhood Vaccination in Informal Urban Settlements in Nairobi, Kenya. BMC Public Health. 2011;11:6.

Onsuma O, Abuya A, okech N Moore D, Collins J. Maternal Education and Immunization Status Among Children in Kenya. Matern Child Health J. 2015;1-10.

Onyango D, Kikuvi G, Amukoya E, Omolo J. Risk factors of severe pneumonia among children aged 2-59 months in western Kenya. Pan Afr Med J. 2012;13:45.

Favina M, Steinglass R, Fields R, Kauhik B, Monica S. Why children are not vaccinated: Review of the grey literature international health. Int Health. 2012;4(4):229-38.

Gupta P, Prakash D, Srivastava P. Determinants of immunisation coverage in Locknow District. N Am J Med Sci. 2015;7(2):36–40.

Roberts J, Hsiao P, Reich R. Trends revealing local barriers, myths and misconceptions in Pakistan. 2010.

Samra S, Anwar S, Khan A, Jeelani G. Impact of Mother’s Employment on Child vaccination, A Case Study of Bangladesh. J Finance Economics. 2015;3(4):64-6.