Table 4.
Multilevel multivariate logistics regression models to identify the predisposing factors that affected children between 0 and 23 months old living in South Sudan from being on track with their routine immunisation schedule
| Variable | Crude Estimate | Model 1a | Model 2b | Model 3c |
| cOR (CI) | aOR (CI) | aOR (CI) | aOR (CI) | |
| Individual-level factors | ||||
| Maternal and Child Characteristics | ||||
| Parity | ||||
| 1 child | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| 2–5 children | 0.82 (0.40, 1.68) | 0.55 (0.23, 1.28)# | 0.58 (0.18, 1.85)# | 1.01 (0.45, 2.23)# |
| 6 and above | 0.43 (0.19, 0.93) | 0.28 (0.09, 0.83) | 0.32 (0.08, 1.12)# | 0.40 (0.16, 0.96) |
| Community Characteristics | ||||
| Immunization benefits | ||||
| Protection against diseases | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| Child Growth | 3.96 (1.35,11.53) | 5.94 (1.70, 20.71) | 23.05 (2.81,188.68) | 7.45 (2.06, 26.87) |
| Churches discussed immunization importance | ||||
| Yes | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| No | 7.42 (4.28,12.82) | 5.75 (2.79, 11.80) | 1.62 (0.60, 4.37)# | 7.62 (3.90, 14.87) |
| Community discussed immunization importance | ||||
| Yes | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| No | 7.76 (4.50,13.36) | 5.62 (2.6, 11.86) | 1.77 (0.58, 5.34)# | 8.01 (4.02, 15.92) |
| State (health system) related factors | ||||
| Frequent provision of immunization at health facility on daily bases | ||||
| Yes | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| No | 1.80 (1.11, 2.90) | 1.93 (1.04, 3.57) | 1.59 (0.80, 3.14)# | 1.01 (0.53, 1.89)# |
| Vaccinator conduct outreach immunization | ||||
| Yes | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| No | 2.32 (1.45,3.71) | 2.27 (1.29, 3.98) | 4.12 (1.91, 8.88) | 7.21 (3.82, 13.5) |
| Vaccinator visit during family livelihood business | ||||
| Yes | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| No | 0.40 (0.21,0.68) | 0.56 (0.29,1.09) | 0.32 (0.13, 0.73) | 0.43 (0.23, 0.80) |
| Health facility too far and no transportation to going for immunization | ||||
| Yes | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| No | 0.20 (0.10,0.37) | 0.26 (0.12, 0.54) | 0.19 (0.07, 0.48) | 0.17 (0.08, 0.35) |
| Inadequate notice about immunization outreach visit to community | ||||
| Yes | 1 (reference) | 1 (reference) | 1 (reference) | 1 (reference) |
| No | 0.23 (0.12, 0.42) | 0.15 (0.05, 0.39) | 0.39 (0.16, 0.91) | 0.68 (0.29, 1.55)# |
| Multivariable logistic regression models to control for them using forward selection stepwise regression | ||||
| Crude Estimates | Adjusted Estimates | |||
| Variables | Crude Odd Ratio (95% CI) | P -value | Adj Odd Ratio (95% CI) | P -value |
| Immunization benefits: Association: | ||||
| Immunisation benefit adjusted for Frequent provision of immunization at health facility on daily bases | 3.96 (1.35,11.53) | 0.012 | 3.53 (1.199, 10.36) | 0.022 |
| Immunisation benefit adjusted for (Frequent provision of immunization at health facility on daily bases + Maternal Age (25–34 years)) | 3.36 (1.12, 10.05) | 0.03 | ||
| Immunisation benefit adjusted for (Frequent provision of immunization at health facility on daily bases + Maternal Age (25–34 years) + Health facility too far and no transportation to going for immunization) | 4.34 (1.23, 15.24) | 0.022 | ||
| vaccinator conduct outreach immunization | ||||
| vaccinator conduct outreach immunization adjusted for immunisation benefit | 2.32 (1.45,3.71) | < 0.001 | 2.05 (1.24, 3.39) | 0.005 |
| vaccinator conduct outreach immunization adjusted for (immunisation benefit + Maternal age (25–34 years old)) | 2.18 (1.25, 3.78) | 0.005 | ||
| vaccinator conduct outreach immunization adjusted for (immunisation benefit + Maternal age (25–34 years old) + Vaccinator visit during family livelihood business) | 2.27 (1.29, 3.96) | 0.004 | ||
| vaccinator conduct outreach immunization adjusted for (immunisation benefit + Maternal age (25–34 years old) + Vaccinator visit during family livelihood business + Not completed all the immunization for my child, not informed to come back) | 2.26 (1.29, 3.94) | 0.004 | ||
| vaccinator conduct outreach immunization adjusted for (immunisation benefit + Maternal age (25–34 years old) + Vaccinator visit during family livelihood business + Not completed all the immunization for my child, not informed to come back + Health facility too far and no transportation to going for immunization) | 1.81 (1.00, 3.25) | 0.046 | ||
| Vaccinator visit during family livelihood business: | ||||
| Vaccinator visit during family livelihood business adjusted for Availability of children immunization card | 0.40 (0.21,0.68) | 0.001 | 0.35 (0.19, 0.64) | 0.001 |
| Vaccinator visit during family livelihood business adjusted for Availability of children immunization card + Functional facility type in the area) | 0.32 (0.17, 0.59) | < 0.001 | ||
| Vaccinator visit during family livelihood business adjusted for Availability of children immunization card + Functional facility type in the area + Health facility conduct routine immunization outreach services | 0.33 (0.17, 0.62) | 0.001 | ||
| Health facility too far and no transportation to going for immunization: | ||||
| Health facility too far and no transportation to going for immunization adjusted for Functional facility type in the area | 0.20 (0.10,0.37) | < 0.001 | 0.14 (0.07, 0 .26) | < 0.001 |
| Health facility too far and no transportation to going for immunization adjusted for Functional facility type in the area + Inadequate notice about immunization outreach visit to community) | 0.15 (0.07, 0.28) | < 0.001 | ||
| Inadequate notice about immunization outreach visit to community: | ||||
| Inadequate notice about immunization outreach visit to community adjusted for Maternal Age | 0.23 (0.12, 0.42) | < 0.001 | 0.11 (0.04, 0.28) | < 0.001 |
| Inadequate notice about immunization outreach visit to community adjusted for Maternal Age + vaccinator conduct outreach immunisation | 0.10 (0.03, 0.25) | < 0.001 | ||
| Inadequate notice about immunization outreach visit to community adjusted for Maternal Age + vaccinator conduct outreach immunisation + Parity (above 6 children) | 0.10 (0.03, 0.25) | < 0.001 | ||
| Inadequate notice about immunization outreach visit to community adjusted for Maternal Age + vaccinator conduct outreach immunisation + Parity (above 6 children) + Health facility too far and no transportation to going for immunization | 0.11 (0.04, 0.27) | < 0.001 | ||
| Inadequate notice about immunization outreach visit to community adjusted for Maternal Age + vaccinator conduct outreach immunisation + Parity (above 6 children) + Health facility too far and no transportation to going for immunization +child card availability | 0.12 (0.04, 0.31) | < 0.001 | ||
| Inadequate notice about immunization outreach visit to community adjusted for Maternal Age + vaccinator conduct outreach immunisation + Parity (above 6 children) + Health facility too far and no transportation to going for immunization +child card availability +Vaccinator not happy for coming regularly to the community | 0.14 (0.05, 0.37) | < 0.001 | ||
| Churches discussed immunization importance: | ||||
| Churches discussed immunization importance adjusted for county | 7.42 (4.28,12.82) | < 0.001 | 2.42 (1.16, 5.01) | 0.018 |
| Churches discussed immunization importance adjusted for county + Health facility too far and no transportation to go for immunisation | 1.95 (0.92, 4.13) | 0.081 | ||
| Churches discussed immunization importance adjusted for county + Health facility too far and no transportation to go for immunisation + Are you parent or guardian | 2.02 (0.87, 4.65) | 0.099 | ||
| Churches discussed immunization importance adjusted for county + Health facility too far and no transportation to go for immunisation + Are you parent or guardian + Vaccinator visit during family livelihood business | 1.82 (0.77, 4.24) | 0.169 | ||
| Churches discussed immunization importance adjusted for county + Health facility too far and no transportation to go for immunisation + Are you parent or guardian + Vaccinator visit during family livelihood business + Not completed all the immunization for my child, not informed to come back | 1.77 (0.75, 4.18) | 0.191 | ||
| Churches discussed immunization importance adjusted for county + Health facility too far and no transportation to go for immunisation + Are you parent or guardian + Vaccinator visit during family livelihood business + Not completed all the immunization for my child, not informed to come back + Functional facility type in the area | 1.93 (0.80, 4.63) | 0.139 | ||
| Churches discussed immunization importance adjusted for county + Health facility too far and no transportation to go for immunisation + Are you parent or guardian + Vaccinator visit during family livelihood business + Availability of children immunization card | 2.19 (0.87, 5.47) | 0.094 | ||
| Churches discussed immunization importance adjusted for county + Health facility too far and no transportation to go for immunisation + Are you parent or guardian + Vaccinator visit during family livelihood business + Availability of children immunization card + Frequent provision of immunisation at health facility | 2.26 (0.89, 5.72) | 0.085 | ||
| Churches discussed immunization importance adjusted for county + Health facility too far and no transportation to go for immunisation + Are you parent or guardian + Vaccinator visit during family livelihood business + Availability of children immunization card + Frequent provision of immunisation at health facility + Inadequate notice about immunization outreach visit to community | 2.19 (0.82, 5.82) | 0.115 | ||
| Churches discussed immunization importance adjusted for county + Health facility too far and no transportation to go for immunisation + Are you parent or guardian + Vaccinator visit during family livelihood business + Availability of children immunization card + Frequent provision of immunisation at health facility + Inadequate notice about immunization outreach visit to community + Health Facility conduct routine immunisation outreach | 2.09 (0.78, 5.59) | 0.141 | ||
| Community discussed immunization importance: | ||||
| Community discussed immunization importance: adjusted for Churches discussed immunization importance | 7.76 (4.50,13.36) | < 0.001 | 3.62 (1.42, 9.18) | 0.007 |
| Community discussed immunization importance: adjusted for Churches discussed immunization importance + Availability of children immunization card | 2.22 (0.85, 5.80) | 0.103 | ||
| Community discussed immunization importance: adjusted for Churches discussed immunization importance + Availability of children immunization card + Health facility too far and no transportation to going for immunization | 2.22 (0.85, 5.74) | 0.099 | ||
| Community discussed immunization importance: adjusted for Churches discussed immunization importance + Availability of children immunization card + Health facility too far and no transportation to going for immunization + Are you Parent/guardian of the child | 1.94 (0.74, 5.07) | 0.178 | ||
| Community discussed immunization importance: adjusted for Churches discussed immunization importance + Availability of children immunization card + Health facility too far and no transportation to going for immunization + Are you Parent/guardian of the child + Functional health facility types | 1.38 (0.47, 3.97) | 0.551 | ||
| Community discussed immunization importance: adjusted for Churches discussed immunization importance + Availability of children immunization card + Health facility too far and no transportation to going for immunization + Are you Parent/guardian of the child + Functional health facility types + Inadequate notice about immunization outreach visit to community | 1.13 (0.36, 3.43) | 0.836 | ||
| Community discussed immunization importance: adjusted for Churches discussed immunization importance + Availability of children immunization card + Health facility too far and no transportation to going for immunization + Are you Parent/guardian of the child + Functional health facility types + Inadequate notice about immunization outreach visit to community + Vaccinator visit during family livelihood business | 1.13 (0.37, 3.364) | 0.829 | ||
| Community discussed immunization importance: adjusted for Churches discussed immunization importance + Availability of children immunization card + Health facility too far and no transportation to going for immunization + Are you Parent/guardian of the child + Functional health facility types + Inadequate notice about immunization outreach visit to community + Vaccinator visit during family livelihood business + Not completed all the immunization for my child, not informed to come back | 1.23 (0.40, 3.71) | 0.711 | ||
| Community discussed immunization importance: adjusted for Churches discussed immunization importance + Availability of children immunization card + Health facility too far and no transportation to going for immunization + Are you Parent/guardian of the child + Functional health facility types + Inadequate notice about immunization outreach visit to community + Vaccinator visit during family livelihood business + Not completed all the immunization for my child, not informed to come back + Parity (above 6 children) | 1.18 (0.38, 3.59) | 0.777 | ||
| Community discussed immunization importance: adjusted for Churches discussed immunization importance + Availability of children immunization card + Health facility too far and no transportation to going for immunization + Are you Parent/guardian of the child + Functional health facility types + Inadequate notice about immunization outreach visit to community + Vaccinator visit during family livelihood business + Not completed all the immunization for my child, not informed to come back + Parity (above 6 children) + Frequent provision of immunisation at health facility | 1.24 (0.39, 3.84) | 0.713 | ||
| Community discussed immunization importance: adjusted for Churches discussed immunization importance + Availability of children immunization card + Health facility too far and no transportation to going for immunization + Are you Parent/guardian of the child + Functional health facility types + Inadequate notice about immunization outreach visit to community + Vaccinator visit during family livelihood business + Not completed all the immunization for my child, not informed to come back + Parity (above 6 children) + Frequent provision of immunisation at health facility + Health facility conduct routine immunisation outreaches | 1.29 (0.40, 4.05) | 0.665 | ||
Model 1: Association is adjusted for Maternal Age + parity + parent/guardian + child availability card
Model 2: Association is adjusted for immunisation benefit + community discussed + church discussed + Vaccinator visit during family livelihood business + BHWs + Health facility too far and no transportation to go for immunization
Model 3: Association is adjusted for Functional facility type in the area + Health facility conduct routine immunization outreach services + vaccinator not happy + did not inform to come back + frequent provision of immunisation at the health facilities + inadequate notice + health facility conduct routine immunisation
#means it is not statistically significant (p value > 0.05)