Barriers for full immunization coverage among under 5 years children in Mogadishu, Somalia

Background: Immunization is amongst the most cost-effective public health interventions for reducing childhood morbidity and mortality. However, globally 9 million deaths of children occur as a result of vaccine-preventable diseases in which 4.4 million are from the sub-Saharan region. Therefore, this study aimed to assess barriers for complete vaccination coverage among under five years children in Mogadishu, Somalia. Methods: A community-based cross-sectional study was conducted between April to July 2019 in Mogadishu-Somalia. Two-stage cluster sampling with systematic random sampling was used to select a sample of 820 households. Data was collected through a structured, interviewer administrator questionnaire. In case more eligible children found at a single selected household, one child was randomly selected and the information related to immunization was interviewed from his/her caregiver. Results: The overall, fully vaccinated under 5 years children were found to be 45.2%. Immunization was found to be increased by being a younger caregiver (beta=-0.024, P-Value=0.019) being father with secondary and above education (AOR = 1.755, 95% CI = 1.161-2.655, P-value = 0.008), being a young child (beta = -0.018, P- value = 0.011), being children from birth order of fifth and above (AOR = 1.539, 95% CI = 1.011-2.343, P- value = 0.044), being a married caregiver (AOR = 4.101, 95% CI=1.062-15.835, P-value = 0.041), increased monthly family income (beta =0.003, P- value = 0.000), availability of vaccine at the time of visit (AOR = 6.147, 95% CI = 1.943-19.441, P- value = 0.002), cost affordability of vaccine (AOR = 1.951, 95% CI = 1.238-3.076, P- value = 0.004), being born at health facility (AOR = 1.517, 95% CI = 1.104-2.086, P- value = 0.010), having good knowledge on immunization (AOR = 1.125, 95% CI = 1.070-1.181, P- value = 0.001), having good practice on immunization (AOR = 2.756, 95% CI = 2.233-3.402, P- value = 0.001) and having good perception on vaccine (AOR = 4.976, 95% CI = 2.183-11.340, P- value = 0.001). Conclusion: The result of this study has revealed that the proportion of fully immunized under-5 children in Mogadishu is very low. Several factors were found to the barriers achieving full immunization coverage. Steps to promote health education and vaccine availability should be lounged.