Abstract
BACKGROUND: Childhood vaccination coverage in Sierra Leone remains unsatisfactory despite multiple efforts made by health authorities to enhance collective immunity of the population, especially for children aged 12 to 23 months. This study aimed at identifying the factors associated with incomplete vaccination or non-vaccination among children aged 12 to 23 months in Sierra Leone in 2019. METHODS: This was a cross-sectional study that used the 2019 Sierra Leone Demographic and Health Survey data. Descriptive statistics was performed to describe the sample, ascending hierarchical classification following a multiple correspondence analysis was employed to establish the profile of children with incomplete vaccination or non-vaccination status, and a binary logistic regression was used to identify the factors associated with incomplete vaccination or non-vaccination. RESULTS: Of the 966 children aged 12 to 23 months involved in the study, 42.9% (95% CI[39.2; 46.6]) were incompletely vaccinated or unvaccinated, of which, 43.5% (95% CI[37.9; 49]) among male children and 42.4% (95% CI[37.3; 47.4]) among their female counterparts. The Northern (AOR 1.683, 95% CI[1.131; 2.503]) and the North Western (AOR 1.847, 95% CI[1.208; 2.825]) survey regions, delivery in a place other than a health facility (AOR 1.404, 95% CI[1.001; 2.042]), the mother's age group 35 to 49 years (AOR 0.437, 95% CI[0.251; 0.762]) and the child's birth order 7th or higher (AOR 2.640, 95% CI[1.452; 4.800]) turned out to be significant factors of incomplete vaccination or non-vaccination. CONCLUSION: Incomplete vaccination or non-vaccination among children was high in Sierra Leone in 2019. In order to increase childhood vaccine uptake, we recommend the development of initiatives geared towards optimizing facility-based service delivery, intensifying health education focusing more on vaccination, enhancing community engagement, addressing barriers to vaccine access, establishing and ensuring proper functioning of immunization defaulter tracking systems.