Background
Methods
Study area
Study design and sampling
Sub-Municipality | Monthly target (x) | Sample fraction × x | Sample size |
---|---|---|---|
Abesim | 80 | \(\frac{424}{{505}}\) × 80 | 67 |
Antwikrom | 53 | \(\frac{424}{{505}}\) × 53 | 45 |
New Dormaa | 122 | \(\frac{424}{{505}}\) × 122 | 102 |
Newtown/Baakoniaba | 93 | \(\frac{424}{{505}}\) × 93 | 78 |
Penkwase | 78 | \(\frac{424}{{505}}\) × 78 | 65 |
Sunyani central | 80 | \(\frac{424}{{505}}\) × 80 | 66 |
Total | 505 | 424 |
Data collection
Data analysis
Results
Socio-demographic characteristics
Characteristic (n = 424) | Frequency | Percentage (%) |
---|---|---|
Sub-Municipality | ||
Abesim | 68 | 16.0 |
Antwikrom | 45 | 10.6 |
Newtown/Baakoniaba | 78 | 18.4 |
New Dormaa | 102 | 24.1 |
Sunyani central | 66 | 15.6 |
Penkwase | 65 | 15.3 |
Age (years) | ||
15–19 | 11 | 2.6 |
20–24 | 46 | 10.9 |
25–29 | 171 | 40.3 |
30–34 | 151 | 35.6 |
35 and above | 45 | 10.6 |
Parent or caregiver | ||
Parent | 421 | 99.3 |
Caregiver | 3 | 0.7 |
Sex | ||
Male | 2 | 0.5 |
Female | 422 | 99.5 |
Marital status | ||
Single | 99 | 23.4 |
Married | 258 | 60.9 |
Cohabiting | 67 | 15.8 |
Number of children alive | ||
1–3 | 378 | 89.2 |
More than 3 | 46 | 10.8 |
Educational status | ||
No formal education | 28 | 6.6 |
Primary education | 141 | 33.3 |
Secondary education | 183 | 43.2 |
Tertiary education | 72 | 17.0 |
Educational status of partner | ||
No formal education | 14 | 3.3 |
Primary education | 72 | 17.1 |
Secondary education | 161 | 38.2 |
Tertiary education | 175 | 41.5 |
Religion | ||
Christianity | 318 | 75.0 |
Islam | 103 | 24.3 |
Traditionalist | 3 | 0.7 |
Occupation | ||
Unemployed | 87 | 20.5 |
Self-employed | 234 | 55.2 |
Farming | 32 | 7.6 |
Civil servant | 71 | 16.8 |
Religion of partner (n = 421) | ||
Christianity | 317 | 75.3 |
Islam | 100 | 23.8 |
Traditionalist | 4 | 1 |
Occupation of partner | ||
Unemployed | 11 | 2.6 |
Self-employed | 220 | 52.3 |
Farming | 40 | 9.5 |
Civil servant | 150 | 35.6 |
Characteristics of children studied, Sunyani Municipality, 2020
Characteristic (n = 424) | Frequency | Percentage (%) |
---|---|---|
Age (months) | ||
13–14 | 79 | 18.6 |
15–16 | 281 | 66.3 |
17–18 | 64 | 15.1 |
Sex | ||
Male | 235 | 55.4 |
Female | 189 | 44.6 |
Place of delivery | ||
Home | 21 | 5.0 |
Health facility | 401 | 94.6 |
Unknown | 2 | 0.4 |
Uptake of RTS,S
Characteristic | Frequency | Percentage (%) |
---|---|---|
Level of uptake | ||
No uptake | 25 | 5.9 |
Partial uptake | 68 | 16.0 |
Full uptake | 331 | 78.1 |
RTS,S 1 uptake | ||
Yes | 399 | 94.1 |
No | 25 | 5.9 |
RTS,S 2 uptake | ||
Yes | 384 | 90.6 |
No | 40 | 9.4 |
RTS,S 3 uptake | ||
Yes | 331 | 78.1 |
No | 93 | 21.9 |
Reason for child receiving some but not all doses of RTS,S | ||
Did not know when next one was due | 31 | 45.6 |
Was not around | 16 | 23.5 |
Not comfortable with side effects | 8 | 11.8 |
Not comfortable with issues surrounding vaccine | 9 | 13.2 |
Did not take previous one on time | 4 | 5.9 |
Reason for child receiving none of the doses of RTS,S | ||
Partner’s (husband) decision to refuse vaccine | 15 | 60.0 |
Personal decision to refuse vaccine | 7 | 28.0 |
Did not know child is eligible | 3 | 12 |
Trend of uptake of malaria vaccine in Sunyani Municipality
Association between Independent variables and level of malaria vaccine uptake
Characteristic | Odds ratio | 95% confidence interval | P value |
---|---|---|---|
Sub-Municipal | 0.79 | 0.69–0.92 | 0.002 |
Penkwase (base) | 1 | ||
Abesim | 2.91 | 1.29–6.57 | 0.010 |
Antwikrom | 5.36 | 1.71–16.79 | 0.004 |
Newtown/Baakoniaba | 2.28 | 1.08–4.83 | 0.031 |
New Dormaa | 1.41 | 0.73–2.73 | 0.303 |
Sunyani central | 2.28 | 1.03–5.08 | 0.043 |
Age of parent (years) | 1.06 | 0.82–1.37 | 0.616 |
20–24 (base) | 1 | ||
15–19 | 3.41 | 0.39–29.59 | 0.266 |
25–29 | 1.03 | 0.48–2.20 | 0.945 |
30–34 | 1.34 | 0.61–2.94 | 0.463 |
35 and above | 1.38 | 0.51–3.73 | 0.522 |
Education level of parent/caregiver | 1.29 | 0.97–1.71 | 0.075 |
Primary education (base) | 1 | 1 | |
No formal education | 1.52 | 0.54–4.30 | 0.432 |
Secondary education | 1.36 | 0.82–2.26 | 0.234 |
Tertiary education | 2.37 | 1.11–5.08 | 0.026 |
Education level of partner | 1.02 | 0.78–1.35 | 0.866 |
Secondary education (base) | 1 | 1 | |
No formal education | 2.56 | 0.55–11.89 | 0.230 |
Primary education | 2.46 | 1.19–5.07 | 0.015 |
Tertiary education | 2.08 | 1.25–3.45 | 0.005 |
Number of children alive | 0.97 | 0.46–2.04 | 0.940 |
1–3 (base) | 1 | 1 | |
More than 3 | 0.97 | 0.46–2.04 | 0.940 |
Marital status | 0.80 | 0.55–1.17 | 0.254 |
Cohabiting (base) | 1 | 1 | |
Single | 1.60 | 0.78–3.27 | 0.199 |
Married | 1.68 | 0.91–3.08 | 0.097 |
Religion of parent/caregiver | 0.73 | 0.44–1.18 | 0.205 |
Traditionalist (base) | 1 | 1 | |
Christian | 2.89 | 0.23–35.94 | 0.409 |
Islam | 2.17 | 0.17–27.63 | 0.551 |
Religion of partner | 0.73 | 0.45–1.19 | 0.204 |
Traditionalist (base) | 1 | 1 | |
Christian | 1.68 | 0.16–17.29 | 0.664 |
Islam | 1.21 | 0.12–12.85 | 0.872 |
Occupation of parent/caregiver | 1.34 | 1.03–1.74 | 0.027 |
Unemployed (base) | 1 | 1 | |
Self employed | 1.33 | 0.76–2.32 | 0.319 |
Farmer | 2.66 | 0.85–8.39 | 0.094 |
Civil servant | 2.21 | 1.00–4.90 | 0.049 |
Occupation of partner | 1.13 | 0.89–1.43 | 0.305 |
Self-employed (base) | 1 | 1 | |
Unemployed | 3.24 | 0.40–26.06 | 0.268 |
Farmer | 3.07 | 1.05–9.01 | 0.041 |
Civil servant | 1.365 | 0.84–2.23 | 0.214 |
Known vaccine preventable diseases | 1.01 | 0.81–1.27 | 0.899 |
Up to 3 vpds mentioned (base) | 1 | 1 | |
No correct vpd mentioned | 3.27 | 1.12–9.56 | 0.031 |
4–8 correct vpds mentioned | 1.06 | 0.51–2.23 | 0.870 |
Any correct disease but including malaria | 1.47 | 0.86–2.51 | 0.164 |
Heard about malaria vaccine | 0.64 | 0.30–1.36 | 0.249 |
No (base) | 1 | 1 | |
Yes | 0.64 | 0.30–1.36 | 0.249 |
Where first heard about malaria vaccine | 0.86 | 0.55–1.35 | 0.510 |
Friends/relatives (base) | 1 | 1 | |
CWC | 20.22 | 1.61–253.71 | 0.020 |
Health facility announcement | 16.78 | 1.18–239.11 | 0.037 |
Radio | 39.68 | 2.14–737.14 | 0.014 |
Number of times a child is expected to take the malaria vaccine | 1.26 | 0.67–2.34 | 0.472 |
Incorrect number (base) | 1 | 1 | |
Correct number | 1.26 | 0.67–2.34 | 0.472 |
Schedule of malaria vaccine | 1.26 | 0.55–3.04 | 0.560 |
Incorrect order (base) | 1 | 1 | |
Correct order | 1.29 | 0.55–3.04 | 0.560 |
Heard about any negative report or issue concerning the malaria vaccine | 1.72 | 1.03–2.88 | 0.040 |
Yes (base) | 1 | 1 | |
No | 1.72 | 1.03–2.88 | 0.040 |
Where issue or report was heard | 1.38 | 0.81–2.34 | 0.232 |
Radio (base) | 1 | 1 | |
Friends/relatives | 2.75 | 1.37–5.51 | 0.004 |
Health worker | 2.28 | 0.55–9.44 | 0.255 |
Other | 1.08 | 0.85–13.60 | 0.954 |
Did issue/report prevent or delay vaccine acceptance | 8.74 | 4.32–17.70 | < 0.005 |
Yes (base) | 1 | 1 | |
No | 8.74 | 4.32–17.70 | < 0.005 |
Given the option of accepting malaria vaccine at CWC | 1.15 | 0.69–1.93 | 0.591 |
Yes (base) | 1 | 1 | |
No | 1.15 | 0.69–1.93 | 0.591 |
Are vaccines becoming many for children with the introduction of the malaria vaccine | 0.60 | 0.38–0.97 | 0.038 |
No (base) | 1 | 1 | |
Yes | 0.60 | 0.38–0.97 | 0.038 |
Will you recommend malaria vaccine to others | |||
No (base) | 1 | 1 | |
Yes | 12.61 | 7.00–22.72 | < 0.005 |
Child ever suffered an adverse reaction following the administration | 1.14 | 0.72–1.80 | 0.576 |
No (base) | 1 | 1 | |
Yes | 1.14 | 0.72–1.80 | 0.576 |
Reaction child suffered | 0.57 | 0.41–0.81 | 0.001 |
Abscess (base) | 1 | 1 | |
Fever | 3.09 | 1.56–6.09 | 0.001 |
Diarrhoea/vomiting | 5.56 | 0.67–46.00 | 0.111 |
Did reaction influence acceptance of other vaccines | 1.87 | 0.56–6.27 | 0.311 |
Yes (base) | 1 | 1 | |
No | 1.87 | 0.56–6.27 | 0.311 |
Time taken to reach vaccination centre | 1.09 | 0.69–1.71 | 0.724 |
Less than 30 min (base) | 1 | 1 | |
30–59 min | 1.06 | 0.65–1.74 | 0.820 |
1–2 h | 1.51 | 0.18–12.98 | 0.706 |
Means of getting to vaccination centre | 1.23 | 0.77–1.99 | 0.385 |
Walking (base) | 1 | 1 | |
Commercial vehicle | 1.43 | 0.85–2.40 | 0.176 |
Personal vehicle | 0.411 | 0.07–2.47 | 0.331 |
Required to pay any money at vaccination centre | 1.24 | 0.62–2.48 | 0.544 |
Yes (base) | 1 | 1 | |
No | 1.24 | 0.62–2.48 | 0.544 |
How to tell when child’s vaccination is due | 0.81 | 0.58–1.12 | 0.195 |
Visit clinic monthly (base) | 1 | 1 | |
Check child’d CWC card | 1.57 | 0.97–2.54 | 0.064 |
Told by nurses | 2.04 | 0.80–5.20 | 0.136 |
Description of CWC nurses’ attitude | 0.95 | 0.69–1.32 | 0.779 |
Excellent (base) | 1 | 1 | |
Very good | 0.50 | 0.22–1.12 | 0.092 |
Good | 0.61 | 0.27–1.40 | 0.242 |
Do you think vaccines have long term side effects | 1.01 | 0.33–3.13 | 0.984 |
Yes (base) | 1 | 1 | |
No | 1.01 | 0.33–3.13 | 0.984 |
Multivariate analysis showing association between level of uptake and independent variables
Characteristic | Crude Odds ratio | 95% Confidence interval | P-value | Adjusted Odds ratio | 95% Confidence interval | P-value |
---|---|---|---|---|---|---|
Sub-Municipal | 0.80 | 0.69–0.92 | 0.002 | 0.82 | 0.66–1.02 | 0.076 |
Penkwase (base) | 1 | 1 | ||||
Abesim | 2.91 | 1.29–6.57 | 0.010 | 2.21 | 0.53–9.17 | 0.276 |
Antwikrom | 5.36 | 1.71–16.79 | 0.004 | 2.01 | 0.16–26.03 | 0.593 |
Newtown/Baakoniaba | 2.28 | 1.08–4.83 | 0.031 | 1.22 | 0.32–4.62 | 0.770 |
New Dormaa | 1.41 | 0.73–2.73 | 0.303 | 0.36 | 0.10–1.29 | 0.117 |
Sunyani central | 2.28 | 1.03–5.08 | 0.043 | 0.98 | 0.27–3.50 | 0.971 |
Education level of partner | 1.02 | 0.78–1.35 | 0.866 | 1.02 | 0.60–1.75 | 0.936 |
Secondary education (base) | 1 | 1 | ||||
No formal education | 2.56 | 0.55–11.89 | 0.230 | 0.93 | 0.02–31.06 | 0.970 |
Primary education | 2.46 | 1.19–5.07 | 0.015 | 4.10 | 1.02–16.47 | 0.047 |
Tertiary education | 2.08 | 1.25–3.45 | 0.005 | 4.72 | 1.27–17.55 | 0.020 |
Occupation of partner | 1.13 | 0.89–1.44 | 0.305 | 1.27 | 0.84–1.92 | 0.257 |
Self-employed (base) | 1 | 1 | ||||
Unemployed | 3.24 | 0.40–26.06 | 0.268 | 1.74 | 0.17–17.42 | 0.637 |
Farmer | 3.07 | 1.05–9.01 | 0.041 | 0.97 | 0.08–11.06 | 0.980 |
Civil servant | 1.365 | 0.84–2.23 | 0.214 | 0.61 | 0.16–2.31 | 0.464 |
Vaccines becoming many for children with the introduction of the malaria vaccine | 0.60 | 0.38–0.97 | 0.038 | 0.29 | 0.14–0.61 | 0.004 |
No (base) | 1 | 1 | ||||
Yes | 0.60 | 0.38–0.97 | 0.038 | 0.29 | 0.14–0.61 | 0.001 |
Experience with AEFI | 0.57 | 0.41–0.81 | 0.001 | 0.58 | 0.41–0.83 | 0.003 |
Abscess (base) | 1 | 1 | ||||
Fever | 3.09 | 1.56–6.09 | 0.001 | 2.27 | 1.13–5.10 | 0.023 |
Diarrhoea/vomiting | 5.56 | 0.67–46.00 | 0.111 | 6.95 | 0.69–69.77 | 0.099 |