Abstract
INTRODUCTION: Savannah Region witnessed a decline in measles-rubella (MR) vaccination coverage prior to the measles outbreak in 2022. This study aimed to assess contributory factors of the low routine MR vaccination coverage and proffer recommendations to improve vaccination uptake. METHODS: A cross-sectional study was conducted in two districts (Bole and Central Gonja) of Savannah Region from December 2022 to June 2023. Caregivers of children 18-59 months were randomly selected and interviewed using a structured questionnaire. Bivariate and multivariate logistic regression were performed to assess predictors of MR vaccination status. RESULTS: Children of caregivers with inadequate knowledge of MR vaccination (AOR = 0.58, 95 %CI: 0.47-0.72), travelled more than five km to access health services (AOR = 0.48, 95 %CI: 0.39-0.59), described health workers attitude as poor (AOR = 0.44, 95 %CI: 0.26-0.74), and those who sought treatment for adverse events following immunization (AEFI) from the pharmacy (AOR = 0.65, 95 %CI: 0.51-0.84) were less likely to complete MR vaccination. On the contrary, children of female sex (AOR = 1.27, 95 %CI: 1.05-1.53), aged 24-59 month (AOR = 2.56, 95 %CI: 1.05-1.53), caregivers with primary or secondary education (AOR = 1.43, 95 %CI: 1.11-1.84; and AOR = 2.23, 95 %CI: 1.64-3.03 respectively), and those who did not experience rescheduling of vaccination sessions (AOR = 1.61, 95 % CI: 1.25-2.01) were more likely to complete routine MR vaccination schedule. CONCLUSION: Inadequate caregiver knowledge, poor geographical access to health services, poor healthcare worker attitude, and non-institutional management of AEFI significantly contributed to the low MR vaccination uptake in the Savannah Region. Adopting tailored approaches to addressing these factors could improve vaccination coverage.