Predictors of vaccination card retention in Tamale Metropolis, Ghana

TL;DR

This study identifies factors influencing vaccination card retention among children in Tamale, Ghana, finding that location, child age, and payment for the card are key predictors.

Contribution

The study provides novel insights into predictors of vaccination card retention in a low-income setting in Ghana.

Findings

Vaccination card retention was 91.5% in Tamale Metropolis, higher than national estimates.

Residence in Nyohini and Tamale Central sub-Metro areas and child age 24–59 months were negative predictors of card retention.

Paying for the vaccination card was a strong positive predictor of retention.

Abstract

The home-based vaccination card is an important health record for determining vaccination status of children during surveys, particularly in low- and middle-income countries. However, there are limited evidence on the factors that influence its retention in Ghana. We assessed the predictors of vaccination card retention in Tamale Metropolis, Ghana.

We conducted a cross-sectional study from 21st December 2022 to 10th January 2023 among children aged 0–59 months in the Tamale Metropolis. Multi-stage sampling was used to select caregivers of children aged 0–59 months for enrolment in the study. Data were collected using validated questionnaire through face-to-face interviews of caregivers. A vaccination card was retained if it was presented for physical inspection by research assistants. The factors that influence vaccination card retention were determined in a multivariate logistic regression analysis at p<0.05.

A total of 1,532 eligible children were enrolled in this study. Vaccination card retention was 91.5%. Negative predictors of card retention included: being resident in the Nyohini (AOR = 0.28; 95% CI = 0.15–0.50) and Tamale Central (AOR = 0.51; 95% CI = 0.29–0.90) sub-Metro areas and being caregivers of children aged 24–59 months (AOR = 0.39; 95% CI = 0.22–0.68). On the other hand, paying for the vaccination card (AOR = 5.14; 95% CI = 2.95–8.95) was a positive predictor of vaccination card retention.

In this study, vaccination card retention among children aged 0–59 months was higher than national estimates. Vaccination card retention was mainly influenced by sub-Metro area, age of child and mode of acquisition of the card such as out-of-pocket payment. There is need to design and deliver tailored messages including the importance of vaccination card retention to caregivers of children based on geographic context. Additionally, the policy on sale of vaccination cards should be revised to allow for cost sharing to enhance its retention.

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