A Comparative Analysis of the Factors Contributing to the Non-Completion of Childhood Immunization among Children Aged 12–23 Months in Urban and Rural Communities of the Federal Capital Territory, Abuja, Nigeria

Abstract

Background: Childhood immunization is a proven and cost-effective public health intervention for preventing vaccine-preventable diseases. However, incomplete immunization remains a major challenge in Nigeria, including the Federal Capital Territory (FCT), Abuja, where disparities exist between urban and rural communities.

Objectives: This study comparatively analyzed the factors contributing to the non-completion of childhood immunization among children aged 12–23 months in urban and rural communities of the FCT, Abuja.

Methodology: A descriptive cross-sectional study was conducted among 320 caregivers of children aged 12–23 months, comprising 192 (60.0%) from rural and 128 (40.0%) from urban communities. A multistage sampling technique was employed. Data were collected using a structured, interviewer-administered questionnaire and analyzed using SPSS version 26.0. Associations between variables were tested using chi-square analysis at a 5% level of significance.

Results: 64.7% of children were fully immunized, while 35.3% had incomplete immunization. Immunization completion was higher in urban areas (71.9%) compared with rural areas (59.9%). Caregiver educational level was significantly associated with immunization completion (p = 0.001), with completion rates highest among caregivers with tertiary education (78.6%) and lowest among those with no formal education (31.6%). Awareness of immunization importance was significantly associated with completion (69.4% vs. 44.1%; p = 0.005). Fear of vaccine side effects significantly increased non-completion (49.5% vs. 27.1%; p = 0.001). Healthcare system factors such as distance to health facility (p = 0.011), vaccine stockouts (p = 0.004), unfriendly health worker attitude (p = 0.001), and waiting time exceeding two hours (p = 0.012) were significantly associated with non-completion. Community-related factors, including lack of community support (p = 0.002), presence of anti-vaccine beliefs (p = 0.001), and non-participation in sensitization meetings (p = 0.005), were also significant determinants.

Conclusion: Childhood immunization completion in the FCT, Abuja remains suboptimal, particularly in rural communities. Non-completion is driven by a combination of caregiver-related, healthcare system, and community-level factors. Targeted interventions focusing on caregiver education, health system strengthening, improved service accessibility, and community engagement are essential to improve immunization completion rates.