{"paper_id":"0a244b0d-5bbf-472b-ab5d-d984410e51b7","body_text":"Immunization Status and Challenges During COVID 19 and Associated Factors Among Children Aged 10-23 Months in South Nation Nationality and People Region, Ethiopia 2020 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Immunization Status and Challenges During COVID 19 and Associated Factors Among Children Aged 10-23 Months in South Nation Nationality and People Region, Ethiopia 2020 Alemnew Wale Tegegne, Aychew Kassie Gidafie, Desalegn Girma Mammo, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-130792/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The worldwide COVID-19 pandemic is overstressing health systems and Essential health services and vaccination services are disrupted. Immunization is a confirmed gizmo for governing and even eliminating communicable diseases. An immunization operation carried out by the World Health from 1967 to 1977 exterminated the usual existence of smallpox. When the program instigated, the disease endangered for 60% of the world's population and slayed every fourth victim. Objective This study aims to assess the challenge and status of immunization during Covid 19 and associated factors among children aged 10-23 months south Nation Nationality and People Region Ethiopia. Methods and Materials community-based mixed quantitative and qualitative cross-sectional study was done in southwest Ethiopia. Data was collected using semi-structured questionnaires and in-depth interviews. After that, the data were edited, coded, and move in into Epi info version 7.2 for data management then transported to SPSS version 25 for analysis. The analyzed data were presented by tables, graphs, figures, and text form. Result according to this study the prevalence of incomplete immunization was found to be 809(62.2%) with (95% CI: 59.5, 64.8). in multivariable analysis waiting time at a health facility (AOR=0.04, 95%CI 0.0001,0.004), education (AOR=5.08,95%CI2.31,11.14), place of delivery(AOR=2.34,95%CI 4.96,6.089), fearing of COVID19(AOR=3.62,95%CI 1.72,7.64) and do not understand the separation care of COVID 19 and other health services (AOR=2.85,95%CI1.38,5.9) were significantly associated factors Conclusion The prevalence of incomplete immunization among children aged 10-23 months was very high in this study as compared to the other studies done in a different pocket of Ethiopia. Consecutively, reducing waiting time at a health facility, avoiding unnecessary fear of COVID 19, and promoting immunization in a different area of southwest Ethiopia along with health extension workers are recommended. Health Economics & Outcomes Research Infectious Diseases Health Policy Immunization status challenge Children 12-23-month-old South West Ethiopia Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Background COVID19 is one of the main pathogens that primarily target the human respiratory system. At end of December 2019; a mass of patients were admitted to the health facility with a preliminary diagnosis of pneumonia of an unidentified etiology in Wuhan China. Initial reports forecast the inception of a possible Coronavirus outburst, given the estimate of a reproduction number for the 2019 Novel (New) Coronavirus (COVID-19 , approved by WHO on the day of Feb 11, 2020) (1-3). Ecological factors such as temperature and moisture play an significant role in the advancement and transmission of severe acute respiratory syndrome (SARS)-CoV infection with the virus holding its viability for about 5 days at temperatures of 22 0 Cto 25 0 C and virtual humidity (VH) of 40% to 50%. Higher temperatures and higher RH (38 0 C, and >95% RH) have been found to decrease virus capability (1, 3). From the daily health care services that are being interrupted by coronavirus disease 2019 (COVID-19) in Africa is childhood immunization. Its disruption increases the jeopardy of epidemics of vaccine-preventable diseases, which possibly rise the child mortality(4, 5). Coronavirus disease 2019 is a respiratory disease instigated by a novel virus termed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and it is so-called 2019 Novel (New) Coronavirus by WHO on Feb 11, 2020) The outburst of this disease was initially reported at the end of December 2019 in Wuhan, China and on March 13, 2020, in Ethiopia Addis Ababa who come from Japan. The virus can blowout from person to person via droplets or unclean surfaces and the maturation date is ranged from 2 to 14 days(4, 6). Globally Due to COVID 19, the person unable to get healthcare service for unvarying needs, like antenatal care, newborn immunization etc (7). Today about 3.5 million children are dying annually in developing countries from three of the expanded program of immunization target disease, namely measles pertussis, and neonatal tetanus. There are about 2500 children with lifelong disabilities due to poliomyelitis in the developing world. (5,6) . It is known that children are omitted out on critical vaccines since of COVID 19. Vaccination promotions have been suspended following social separation measures, raising the danger of disease outbreaks. Decrease in routine immunization coverage, particularly if this continues means that many children will be unvaccinated or under-vaccinated, putting their lives at risk of vaccine-preventable diseases. (3, 7, 8) From the routine health services that are being interrupted by coronavirus disease (COVID-19) in Africa is childhood immunization. Its interruption increases the risk of epidemics of vaccine-preventable diseases, which could increase child mortality. Consequently, policymakers must rapidly ascertain vigorous and context-specific tactics to promptly scale-up routine immunization to alleviate the impression of COVID-19 on their national immunization performance. To succeed this, we put forward a archetype transference towards systems thoughtful and the use of execution science in immunization policymaking(4, 9). An estimated 472000 children still pass away each year earlier in their fifth birthday mainly from vaccine-preventable. As a result of 2013 immunization data report, the coverage of vaccine found to be 75%; and Ethiopia has the second-largest number of children having incomplete immunization(9). This incomplete immunization forestalls an estimated of two to three million death each year in all age groups from vaccine preventable disease like diphtheria, tetanus, pertussis, and measles. Furthermore, immunization underwrites a lot to a certain nation by decreasing the risk of incapacity from transmittable diseases such as poliomyelitis. (10). As much as my knowledge is concerned, studies in the area as well as in the country are limited. So this study very helps full for the scaling up of immunization of a child even if there is a fear of COVID 19. Methods A cross-sectional community-based survey supplemented by qualitative Design was conducted in southwest region to assess the incomplete immunization, challenges during COVID 19, and associated factors among children aged 10-23 months from September two to October twenty-one, 2020. All households with children aged 10-23months residing in southwest Ethiopia were the target inhabitants. The household with children in the age range of 10-23 months in the randomly selected zone was the study population. The sampling unit and study units were households and individuals respectively. The children with their mother or caregivers in southwest Ethiopia during the data collection were included in the study and Mother/caregivers unable to communicate verbally in the absence of a translator were left out from the study. The sample size was calculated with both factors and percentage. From all calculated sample sizes the largest one was 1034 but 1300 is taken as the final size due to the final cluster sampling method of the sampling procedure used. From 15 zonal administrations of South Nation Nationality and people region, 7 of them were selected as a cluster. Finally, the eligible household in each zone was traced with the help of health extension workers. In households with more than one eligible child, only one child was included in the study by lottery method. Sample to detailed interview was nominated with the nonprobability purposive sampling method. A total of 10 detailed interviews were accompanied amongst caregiver mothers, fathers, besides priests in South West Ethiopia. The dependent variable of the study was immunization status and the independent variables were Socio-demographic features, obstetric characteristics, and health-related factors. The questionnaire was revised and adjusted from the Ethiopian EPI Survey and EDHS(10, 11), and other interrelated previous studies(12-14). Twenty nurses and midwifery for data collectors and eight public health supervisors were recruited. Finally, the data were collected by head-on and detailed interviews for quantitative and qualitative data respectively. A detailed interview was implanted for collecting qualitative data. The detailed interview contained an unrestricted question about the challenge of EPI. The discussions were documented suitably by participant words, and the participants’ dialogue was recorded by tape. Finally, their dialogue was transcribed into English words Operational and term definition - A fully immunized: -a child aged 10 to 23 months old who received one BCG, at least three doses of PENTA-VALENT, oral poliovirus, pneumococcal conjugated vaccine (PCV); two doses of rotavirus, and 4 doses of polio vaccine and measles. - Partially / incomplete immunized: - child who misses at least one dose of thirteen vaccines. -Antenatal care follow-up: - attending care given during pregnancy at a health facility at least two visits. Results Socio-demographic characteristics of a women or caregivers in southwest Ethiopia The average age of the respondents were 37.5 + SD of 2.5 years with a range of 15 to 45 years and the average number of children per household was 3.5 with SD of 1.2 Regarding occupation, more than 85% of a caregiver were housewife, and Majority of the respondents 1116 (85.8%) were married whereas the remaining 14.2% were widowed, divorced, and single 0. ( Table-1 ) Place of delivery and utilization of health service among the women having children aged 10-23 month during Covid 19 Among the respondents about 753(57.9%) of them were explain that other health service care like immunization, family planning, labor, and delivery, as well other medical cares were given together with the care COVID 19 or they do not understand the separation care of COVID19 and other health services. Near half of the respondents, 450(34.6%) regretted visiting the health facility for the fear of COVID 19 transmission by the health professionals (Figure-1). Health facility and obstetric characteristics of the respondents in South West 2020 Most of the caregivers 953(73.3%) spent time/ waiting after coming to the health facility was less than 10 minutes, The remaining 24%,1.2%, and 1.5% were 10 to 15,15 to 30 and greater than a 30-minute wait for getting immunization respectively (Figure-2). More than 88% of the participants/ caregiver take their child to the health facility when their child was being sick but about 8% and 2% of the caregiver take their child to a traditional place and treat at home respectively (Figure-3). Among the participants, only 905 (69.9%) had antenatal care during their pregnancy, the reaming 395(30.4%) were giving birth without antenatal care (Figure-4). Immunization status of children aged from 10 to 23 months in southwest Ethiopia 2020 The prevalence of incomplete immunization was found to be 809(62.2%) (95% CI: 59.5, 64.8).of the total respondents1110 (85.4%) of them took both BCG and OPV vaccine, from 1110 BCG started children only 798 (71.8%) of the children complete their immunization. Of the total 1300 children, 190 (14.6%) of them were not taking any vaccine at all. Overall 1088(83.7%) of them received both PCV one and Penta one, 1082(83.2%) received rota1 and 798 (61.4%) received measles vaccine. The coverage rate was a decline for the consecutive dose, such as OPV zero (85.4%) to OPV three (73.7%), both Penta and PCV one (83.7%) to Penta and PCV three (71.9%). Dropout rate: the overall dropout rate of immunization in the zone was BCG to measles, and the dropout rate of each subsequent vaccine was 13.6% for OPV0 to OPV3, 12.2% for PCV1 to PCV3 and 14% for pena1 to penta3 for more detail see on ( Figure-5, Figure-6 and figure-7) In-depth/detail interview finding Them 1: fear of COVID 19 transmission during transportation to a health facility. The rural mother of the child complains that during the transportation to the health facility we are asked to wear a face mask without the access of a face mask in the nearby area (20,34, 36, 40, years old rural mothers). Even if we wear a face mask we do not trust that will protect our child from COVID 19 and ourselves (26 and 32 years old mothers). As we hear that the virus stays everywhere such as on clothes, metal, and different surfaces, we fear the surface of the bus for contaminated with COVID 19 (35.37, 40 and 46 years old fathers of the children). Fear of screening by temperature regardless of other cause of raising the temperature and took us to quartile and Isolation areas without evidence of COVID 19 and doubling up of transportation fee because of COVID 19 (30, 42, 45. And 47 years old priests). Theme 2: challenges in the health facility and COVID 19 transmission Considering the health professions as a career of COVID 19 and the may transmit these COVID 19 to our children during immunization (27, 32, 35, 43 years old priests). We understand that the immunization service of the children was given together with the care of COVID 19 in the health facility, so we assume there was a high transmission of COVID 19 during getting the service and as the come up time at the health institution was too long to get the service, person to person transmission is very high at a health facility (this is the idea of all mother of the children). During waiting time at the health facility we fear individual-to-individual transmission of COVID 19 because the waiting area in the health facility was very condensed and not ventilated (30, 29, 34, and 41 years old father of the children). Factors associated with immunization status of Children Aged 10-23 Months during COVID 19. Bivariate logistic regression analysis shows that waiting time, educational status, delivery place, considering COVID 19 and other service is given at the same unit, fear of COVID 19 from health profession and means of transportation were all significantly accompanying with incomplete immunization at p-value 0.05. From all variables on marital status was not significantly associated. However, on multivariable analysis except for marital status and means transportation, all the variables were identified as independently significant associated factors with incomplete immunization. The women waiting time more than 30 minutes at a health facility for immunization were 96% more likely to have incomplete immunization than waiting less than 30 minutes (AOR=04, 95%CI .0001,.004). The odd of incomplete immunization of the children was 2.34 times higher in the women who deliver at home than deliver at a health facility (AOR =2.336, 95%CI 4.96, 6.089). The child who was born from women who cannot read and write were 5.08 times incompletely immunized than the child born from educated women( diploma, degree, and above) ( AOR=5.08,95% CI 2.31,11.14). The women who cannot understand the separation care of CIOVID 19 and other health service had 3.62 times incompletely immunized child than who understand the separation care of COVID 19 and another health service (AOR=3.62,95%CI 1.72,7.64). The odd of incomplete immunization of a child for the women who fear health professions as a source of COVID 19 was 2.85 times higher than did not fear the health profession (AOR=2.85,95%CI 1.38,5.9) (Table-2) Discussion This is a cross-sectional community-based survey supplemented by a qualitative study that has attempted to determine Immunization status and challenges during COVIODN 19 and Accompanying Factors among Children Aged 10-23 Months. The percentage of incomplete immunization among children aged from 10-23 months in this study was found to be 809(62.2%) (95% CI: 59.5, 64.8). This study is in similar with the study done by further analysis of 2016 EDHS (61.7%) (15). This consistency may be the current immunization practice of the women is regretted to the pervious poor immunization intention of the women. Because before 5 years back the immunization thinking of the women is so poor due to miss understanding of the advantage of immunization. The outcome of this study was greater than the study done in a different part of Ethiopia like in Wonago Gedo(47.6.%), Deber Markos (28.3%), northwest Ethiopia(41.6%), Gondar (24.3%), Woldiya (11.3%), Sekota (22.6%), systematic and meta-analysis of immunization from 2003 to 2019 in Ethiopia (41.8%) another systematic and meta-analysis were done in 2020 Ethiopia (53%), at a tertiary-care hospital (University College of Medical Sciences and Guru Tegh Baha-dur Hospital, New Delhi, India (48%) and at Indonesia (2008–2013): a multilevel analysis(38.13%) (12, 14, 16-22). The possible explanation for this can be almost all women have a misunderstanding of about the separation care of COVID 19 and other services like immunization, cost of transportation doubling up and fear of health professionals as a source of COVID 19 was the possible reason to decline the immunization as evidenced by an in-depth interview. In this study, the women waiting more than 30 minutes at a health facility for immunization were 96% more likely to have incomplete immunization as compared with those women waiting less than 30 minutes (AOR=04, 95%CI .0001,.004). The reason may be as the women are busy in their duty; being staying more time in a health facility for immunization encourages discontinuous the immunization program. On the other thing also as waiting times increase in the health facility, overcrowding will increase; this will raise the transmission of COVID 19, finally, there was a drop out of immunization. This is supported by the study done in Sekota zuria district, Gondar city administration, Deber Markos town, and in North West Ethiopia (14, 19-21) The odd of incomplete immunization of the children was 2.34 times higher in the women who deliver at home as compared with the women delivered at a health facility (AOR =2.336, 95%CI 4.96, 6.089). The possible explanation may be the women deliver at health facilities have more information about the importance of immunization than home-delivered women. They also are educated and have a good attitude and knowledge for free utilization of health services. This is supported by a study done in Sekota zuria District, further analysis of EDHS 2016, and Northwest Ethiopia(15, 19, 20).On the other hand not supported by the findings in Wonago Gedo zone, Deber Markos town(18, 21) The child of uneducated women were 5.08 times more incompletely immunized as compared to the child of educated women( diploma, degree, and above) ( AOR=5.08,95% CI 2.31,11.14). The possible reason is as the women are educated; they easily identify the possible vaccine-preventable disease and easy approach to a health facility as well there is no misperception regarding health service utilization. This is supported by the finding further analysis of EDHS 2016 and Sekota District(15, 19) but not supported by the study done in Northwest Ethiopia, Deber Markos Town, Wonago District, Gondar Town(14, 18, 20, 21) The women who cannot understand the separation care of CIOVID 19 and other health service had 3.62 times incompletely immunized their child as compared to the women who understand the separation care of COVID 19 and other health services (AOR=3.62,95%CI 1.72,7.64) and The odd of incomplete immunization of a child for the women who fear health professions as a source of COVID 19 was 2.85 times higher as compared to the women who did not fear the health profession for the source of COVID 19 (AOR=2.85,95%CI 1.38,5.9). This is explained as the women did not understand the separation care of COIVID 19 and other health services as well did not aware about phone service of the health facility, they drop out from the service by fearing transmission of COVID 19 between the client and from health professions. Conclusions Based on the finding obtained in this study the prevalence of incomplete immunization in the South Nation Nationality and People region among children age 10-23 months was very high as compared to other studies. Variables significantly associated with incomplete immunization among children aged10-23 months were time waiting at a health facility, place of delivery, educational status of the women, not understanding the separation care of COVID 19 and other health services, fear of health professionals as a source of COVID 19. Abbreviations ANC Antenatal Care BCG Bacillus Chalmette Guerin DHS Demographic and Health survey DPT Diphtheria, Pertussis, Tetanus EDHS Ethiopian Demographic and Health survey EPI Expanded Program on Immunization HBV Hepatitis B Virus HIB Hemophilic Influenza type B MOH Ministry Of Health OPV Oral Polio Vaccine PCV Pneumococcal Conjugate Vaccine WHO World Health Organization SNNPR South Nation, Nationality and People Region COVID 19 coronavirus disease 2019 Declarations Ethics approval and consent to participate Ethical clearance letter was obtained From the Ethical Review Committee of Midwifery, under the delegation of the institutional review board of Mizan Tepi University and submitted to each zonal administrative to obtained permission letter. Then each zonal administrative given written permission letter to the concerned bodies in the study set up and informed consent was obtained from respondents after giving them evidence about the perseverance of the study, confidential and anonymous Consent for Publication In this study not relevant Availability of Data and martial The data set used and/or investigated during the current study is available from the conforming author on realistic request. Competing of interests There are no competing interests as declared by the authors. Funding Any fund or benefits are not received by the authors from industry or elsewhere to undergo this study. Authors' contributions AT was the principal author; made substantial contributions in the conception of selecting a design, DM , and S data collection as well as analysis and interpretation of data. Finally, AG and ZM were participated in revising and commenting on the paper. All authors read and check the finalize manuscript. Acknowledgment First and foremost, our heartfelt goes to the Mizan Tepi University research committee for their permission letter and the health science staff for their continuous up keeping. Our thanks likewise go to southwest region administrator and different zones and woredas administrators in southwest Ethiopia for their permission and uninterrupted follow-up and health extension workers for their valuable information and are inside us during the data collection period. Finally, we thank you our data collector and participants for their cooperative and time Authors' information Alemnew Wale Tegegne , email: [email protected] Aychew Kassie Gidafie ,email: [email protected] Dessalegn Girma Mammo, email: [email protected] Semahegn Tilahun Wassie , email: [email protected] Zinie Abita Mengie email: [email protected] References Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of autoimmunity. 2020:102433. 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Tables Table 1: Socio-demographic characteristics of mothers or caregivers having children aged 10-23 month in southwest Ethiopia 2020 Variables Category Frequency percentage Age 15-25 475 36.5% 26-35 652 50.2% 36-45 173 13.3% Maternal education unable to read and write 551 42.4 able to read and write 34 2.6 Primary school 328 25.2 Secondary school 329 25.3 Diploma, degree and above 58 4.5 Occupation of the caregiver/mothers housewife 1109 85.3 Merchant 95 7.3 Private and government employee 35 2.7 daily labor and students 17 4.7 Marital status Single 43 3.3 Married 1116 85.8 Windowed 105 8.1 Divorced 36 2.8 Religion Orthodox 811 62.4 Muslim 75 5.8 Protestant 393 30.2 Catholic 21 1.6 Ethnicity Bench 744 57.2 Oromo 282 21.7 Amhara 239 18.4 Sheko 35 2.7 Table 2: Multi-variate logistic regression of factors for incomplete immunization of children in southwest Ethiopia 2020 Status of immunization COR (95%CI) AOR(95%CI) incomplete N% complete N % Waiting time at the health facility less than 30 minute 481(98.0%) 46(5.7%) 1 greater than 30 minute 10(2.0%) 763(94.3%) . 02(.001, .003 ) .04(.0001,.004) Marital status Single 63(12.8%) 51(31.0%) 1 Married 428(87.2%) 558(69.0%) .56(.24, .44) 1.354(.630,2.908) Means of transportation to a health facility On foot 382(77.8%) 515(63.7%) 2 (1.55, 2.59) 2.128(0.065,4.250) By transportation 109(22.2%) 294(36.3%) 1 Place of delivery at Health Facility 83(16.9%) 176(21.8%) 1 at home 408(83.1%) 633(78.2%) 1.37(1.02, 1.83) 2.336(4.96,6.089) Educational status unable to read and write 221(45.0%) 330(40.8%) 1.42(1.08, 1.87) 5.08(2.31,11.14) read and write 26(5.3%) 8(1.0%) 6.9(3.03, 15.66) 3.46(1.31,12.85) primary and secondary school 120(24.4%) 208(25.7%) 1.22(1.20, 1.67) 3.54(1.59,7.89) diploma, degree and above 124(25.3%) 263(32.5%) 1 Do you think that COVID 19 care is given together with other health services Yes 307(62.5%) 446(55.1%) 1.36(1.08, 1.71) 3.62(1.72,7.64 ) No 184(37.5%) 363(44.9%) 1 Do you fear immunization provider health professionals as a source of COVID19 Yes 216(44.0%) 234(28.9%) 1.93(1.53, 2.44) 2.85(1.38,5.9) No 275(56.0%) 575(71.1%) 1 Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-130792\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":true,\"archivedVersions\":[],\"articleType\":\"Research\",\"associatedPublications\":[],\"authors\":[{\"id\":6664600,\"identity\":\"7a768394-6a19-46da-8914-cd6483d1726a\",\"order_by\":0,\"name\":\"Alemnew Wale 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University\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Aychew\",\"middleName\":\"Kassie\",\"lastName\":\"Gidafie\",\"suffix\":\"\"},{\"id\":6664602,\"identity\":\"85cdb46a-653d-4ff2-8f3d-e8c3ff1aa8c9\",\"order_by\":2,\"name\":\"Desalegn Girma Mammo\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Mizan-Tepi University\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Desalegn\",\"middleName\":\"Girma\",\"lastName\":\"Mammo\",\"suffix\":\"\"},{\"id\":6664603,\"identity\":\"c009540a-7778-4e79-9e00-3863f15a6ea8\",\"order_by\":3,\"name\":\"Semahegn Tilahun Wassie\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Mizan-Tepi University\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Semahegn\",\"middleName\":\"Tilahun\",\"lastName\":\"Wassie\",\"suffix\":\"\"},{\"id\":6664604,\"identity\":\"939c802d-3167-4e5b-be1c-6f84dab0248e\",\"order_by\":4,\"name\":\"Zinie Abita Mengie\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Mizan-Tepi University\",\"correspondingAuthor\":false,\"submittingAuthor\":false,\"prefix\":\"\",\"firstName\":\"Zinie\",\"middleName\":\"Abita\",\"lastName\":\"Mengie\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2020-12-17 15:01:57\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-130792/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-130792/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":4455234,\"identity\":\"6358aac1-c450-40f9-b669-be28090a5a64\",\"added_by\":\"auto\",\"created_at\":\"2020-12-22 22:04:41\",\"extension\":\"jpg\",\"order_by\":1,\"title\":\"Figure 1\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":44670,\"visible\":true,\"origin\":\"\",\"legend\":\"a place of delivery of the women having children aged 10-23 month in southwest Ethiopia in 2020\",\"description\":\"\",\"filename\":\"1.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-130792/v1/2b52f4376d5933076c3973ee.jpg\"},{\"id\":4455232,\"identity\":\"3252877d-a973-4a14-9288-05130db4da8d\",\"added_by\":\"auto\",\"created_at\":\"2020-12-22 22:04:41\",\"extension\":\"jpg\",\"order_by\":2,\"title\":\"Figure 2\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":61228,\"visible\":true,\"origin\":\"\",\"legend\":\"The time waiting of the women at a health facility for immunized their child in southwest Ethiopia 2020\",\"description\":\"\",\"filename\":\"2.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-130792/v1/7a8941a971fc232235c1fd9c.jpg\"},{\"id\":4455170,\"identity\":\"ac6c21aa-9b8e-4df1-8ebe-2a124bc4e19d\",\"added_by\":\"auto\",\"created_at\":\"2020-12-22 22:01:41\",\"extension\":\"jpg\",\"order_by\":3,\"title\":\"Figure 3\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":55736,\"visible\":true,\"origin\":\"\",\"legend\":\"a place of health care when the child was being sick in southwest Ethiopia 2020\",\"description\":\"\",\"filename\":\"3.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-130792/v1/29e2bc5c0de8947570b93e7d.jpg\"},{\"id\":4455235,\"identity\":\"eddbad5b-ebbe-4e12-84b3-8522ef4b08ab\",\"added_by\":\"auto\",\"created_at\":\"2020-12-22 22:04:41\",\"extension\":\"jpg\",\"order_by\":4,\"title\":\"Figure 4\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":56259,\"visible\":true,\"origin\":\"\",\"legend\":\"The gravidity of the caregiver having children aged 10-23 month in southwest Ethiopia 2020\",\"description\":\"\",\"filename\":\"4.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-130792/v1/dc92c962af5cb89b81662840.jpg\"},{\"id\":4455173,\"identity\":\"88fd1bdb-b970-4f2d-abc0-95d200362256\",\"added_by\":\"auto\",\"created_at\":\"2020-12-22 22:01:41\",\"extension\":\"jpg\",\"order_by\":5,\"title\":\"Figure 5\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":56508,\"visible\":true,\"origin\":\"\",\"legend\":\"The trends of subsequent immunization of Penta vaccine during COVID 19 in southwest Ethiopia 2020\",\"description\":\"\",\"filename\":\"5.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-130792/v1/69fa816c49a45f6e786ef8c5.jpg\"},{\"id\":4455337,\"identity\":\"0e2caea4-a8b8-43d1-9668-a1b7ba6b21b5\",\"added_by\":\"auto\",\"created_at\":\"2020-12-22 22:07:41\",\"extension\":\"jpg\",\"order_by\":6,\"title\":\"Figure 6\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":56533,\"visible\":true,\"origin\":\"\",\"legend\":\"The subsequent immunization of PCV vaccine during COVID 19 in southwest Ethiopia 2020\",\"description\":\"\",\"filename\":\"6.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-130792/v1/3d2036b3e5584fe52706ad20.jpg\"},{\"id\":4455167,\"identity\":\"c3569c93-3108-497c-b7ef-c6109b057186\",\"added_by\":\"auto\",\"created_at\":\"2020-12-22 22:01:41\",\"extension\":\"jpg\",\"order_by\":7,\"title\":\"Figure 7\",\"display\":\"\",\"copyAsset\":false,\"role\":\"figure\",\"size\":54239,\"visible\":true,\"origin\":\"\",\"legend\":\"The trends of subsequent immunization of OPV vaccine during COVID 19 in southwest Ethiopia 2020\",\"description\":\"\",\"filename\":\"7.jpg\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-130792/v1/07af6cff785cb4cd38469b6f.jpg\"},{\"id\":13639457,\"identity\":\"1ad5fc89-bd8f-4356-8c0a-0c10d3d8e1cd\",\"added_by\":\"auto\",\"created_at\":\"2021-09-17 08:55:55\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":846655,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-130792/v1/31e143ab-2052-4fd5-949f-a20e20f7ca11.pdf\"}],\"financialInterests\":\"\",\"formattedTitle\":\"\\u003cp\\u003eImmunization Status and Challenges During COVID\\u0026nbsp;19 and Associated Factors Among Children Aged 10-23 Months in South Nation Nationality and People Region, Ethiopia 2020\\u003c/p\\u003e\",\"fulltext\":[{\"header\":\"Background\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eCOVID19 \\u003c/strong\\u003eis one of the main pathogens that primarily target the human respiratory system. At end of December 2019; a mass of patients were admitted to the health facility with a preliminary diagnosis of \\u003cstrong\\u003epneumonia\\u003c/strong\\u003e of an unidentified etiology in Wuhan China. Initial reports forecast the inception of a possible Coronavirus outburst, given the estimate of a reproduction number for the \\u003cstrong\\u003e2019 Novel (New) Coronavirus (COVID-19\\u003c/strong\\u003e, approved by WHO on the day of Feb 11, 2020) (1-3).\\u003c/p\\u003e\\n\\u003cp\\u003eEcological factors such as temperature and moisture play an significant role in the advancement and transmission of severe acute respiratory syndrome (SARS)-CoV infection with the virus holding its viability for about 5 days at temperatures of 22\\u003csup\\u003e0\\u003c/sup\\u003eCto 25\\u003csup\\u003e0\\u003c/sup\\u003eC and virtual humidity (VH) of 40% to 50%. Higher temperatures and higher RH (38\\u003csup\\u003e0\\u003c/sup\\u003eC, and \\u0026gt;95% RH) have been found to decrease virus capability (1, 3).\\u003c/p\\u003e\\n\\u003cp\\u003eFrom the daily health care services that are being interrupted by coronavirus disease 2019 (COVID-19) in Africa is childhood immunization. Its disruption increases the jeopardy of epidemics of vaccine-preventable diseases, which possibly rise the child mortality(4, 5).\\u003c/p\\u003e\\n\\u003cp\\u003eCoronavirus disease 2019 is a respiratory disease instigated by a novel virus termed as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and it is so-called 2019\\u003cstrong\\u003e Novel (New) Coronavirus by \\u003c/strong\\u003eWHO on Feb 11, 2020) The outburst of this disease was initially reported at the end of December 2019 in Wuhan, China and on March 13, 2020, in Ethiopia Addis Ababa who come from Japan. The virus can blowout from person to person via droplets or unclean surfaces and the maturation date is ranged from 2 to 14 days(4, 6).\\u003c/p\\u003e\\n\\u003cp\\u003eGlobally Due to COVID 19, the person unable to get healthcare service for unvarying needs, like antenatal care, newborn immunization etc (7).\\u003c/p\\u003e\\n\\u003cp\\u003eToday about 3.5 million children are dying annually in developing countries from three of the expanded program of immunization target disease, namely measles pertussis, and neonatal tetanus. There are about 2500 children with lifelong disabilities due to poliomyelitis in the developing world. (5,6) .\\u003c/p\\u003e\\n\\u003cp\\u003eIt is known that children are omitted out on critical vaccines since of COVID 19. Vaccination promotions have been suspended following social separation measures, raising the danger of disease outbreaks. Decrease in routine immunization coverage, particularly if this continues means that many children will be unvaccinated or under-vaccinated, putting their lives at risk of vaccine-preventable diseases.\\u0026nbsp;(3, 7, 8)\\u003c/p\\u003e\\n\\u003cp\\u003eFrom the routine health services that are being interrupted by coronavirus disease (COVID-19) in Africa is childhood immunization. Its interruption increases the risk of epidemics of vaccine-preventable diseases, which could increase child mortality. Consequently, policymakers must rapidly ascertain vigorous and context-specific tactics to promptly scale-up routine immunization to alleviate the impression of COVID-19 on their national immunization performance. To succeed this, we put forward a archetype transference towards systems thoughtful and the use of execution science in immunization policymaking(4, 9). An estimated 472000 children still pass away each year earlier in their fifth birthday mainly from vaccine-preventable.\\u003c/p\\u003e\\n\\u003cp\\u003eAs a result of 2013 immunization data report, the coverage of vaccine found to be 75%; and Ethiopia has the second-largest number of children having incomplete immunization(9).\\u003c/p\\u003e\\n\\u003cp\\u003eThis incomplete immunization forestalls an estimated of two to three million death each year in all age groups from vaccine preventable disease like diphtheria, tetanus, pertussis, and measles. Furthermore, immunization underwrites a lot to a certain nation by decreasing the risk of incapacity from transmittable diseases such as poliomyelitis. (10). As much as my knowledge is concerned, studies in the area as well as in the country are limited. So this study very helps full for the scaling up of immunization of a child even if there is a fear of COVID 19.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cp\\u003eA cross-sectional community-based survey supplemented by qualitative Design was conducted in southwest region to assess the incomplete immunization, challenges during COVID 19, and associated factors among children aged 10-23 months from September two to October twenty-one, 2020. All households with children aged 10-23months residing in southwest Ethiopia were the target inhabitants. The household with children in the age range of 10-23 months in the randomly selected zone was the study population. The sampling unit and study units were households and individuals respectively. The children with their mother or caregivers in southwest Ethiopia during the data collection were included in the study and Mother/caregivers unable to communicate verbally in the absence of a translator were left out from the study.\\u003c/p\\u003e\\n\\u003cp\\u003eThe sample size was calculated with both factors and percentage. From all calculated sample sizes the largest one was 1034 but 1300 is taken as the final size due to the final cluster sampling method of the sampling procedure used. From 15 zonal administrations of South Nation Nationality and people region, 7 of them were selected as a cluster. Finally, the eligible household in each zone was traced with the help of health extension workers. In households with more than one eligible child, only one child was included in the study by lottery method. Sample to detailed interview was nominated with the nonprobability purposive sampling method. A total of 10 detailed interviews were accompanied amongst caregiver mothers, fathers, besides priests in South West Ethiopia. The dependent variable of the study was immunization status and the independent variables were Socio-demographic features, obstetric characteristics, and health-related factors. The questionnaire was revised and adjusted from the Ethiopian EPI Survey and EDHS(10, 11), and other interrelated previous studies(12-14). Twenty nurses and midwifery for data collectors and eight public health supervisors were recruited. Finally, the data were collected by head-on and detailed interviews for quantitative and qualitative data respectively. A detailed interview was implanted for collecting qualitative data. The detailed interview contained an unrestricted question about the challenge of EPI. The discussions were documented suitably by participant words, and the participants\\u0026rsquo; dialogue was recorded by tape. Finally, their dialogue was transcribed into English words\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eOperational and term definition \\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e-\\u003cstrong\\u003eA fully immunized:\\u003c/strong\\u003e-a child aged 10 to 23 months old who received one BCG, at least three doses of PENTA-VALENT, oral poliovirus, pneumococcal conjugated vaccine (PCV); two doses of rotavirus, and 4 doses of polio vaccine and measles.\\u003c/p\\u003e\\n\\u003cp\\u003e-\\u003cstrong\\u003ePartially / incomplete immunized:\\u003c/strong\\u003e- child who misses at least one dose of thirteen vaccines.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003e-Antenatal care follow-up: -\\u003c/strong\\u003e attending care given during pregnancy at a health facility at least two visits.\\u003c/p\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eSocio-demographic characteristics of a women or caregivers in southwest Ethiopia\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe average age of the respondents were 37.5\\u003cu\\u003e+\\u003c/u\\u003eSD of 2.5 years with a range of 15 to 45 years and the average number of children per household was 3.5 with SD of 1.2\\u003c/p\\u003e\\n\\u003cp\\u003eRegarding occupation, more than 85% of a caregiver were housewife, and Majority of the respondents 1116 (85.8%) were married whereas the remaining 14.2% were widowed, divorced, and single 0. (\\u003cstrong\\u003eTable-1\\u003c/strong\\u003e)\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003ePlace of delivery and utilization of health service among the women having children aged 10-23 month during Covid 19 \\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eAmong the respondents about 753(57.9%) of them were explain that other health service care like immunization, family planning, labor, and delivery, as well other medical cares were given together with the care COVID 19 or they do not understand the separation care of COVID19 and other health services. Near half of the respondents, 450(34.6%) regretted visiting the health facility for the fear of COVID 19 transmission by the health professionals \\u003cstrong\\u003e(Figure-1).\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eHealth facility and obstetric characteristics of the respondents in South West 2020\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eMost of the caregivers 953(73.3%) spent time/ waiting after coming to the health facility was less than 10 minutes, The remaining 24%,1.2%, and 1.5% were 10 to 15,15 to 30 and greater than a 30-minute wait for getting immunization respectively \\u003cstrong\\u003e(Figure-2).\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eMore than 88% of the participants/ caregiver take their child to the health facility when their child was being sick but about 8% and 2% of the caregiver take their child to a traditional place and treat at home respectively \\u003cstrong\\u003e(Figure-3).\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eAmong the participants, only 905 (69.9%) had antenatal care during their pregnancy, the reaming 395(30.4%) were giving birth without antenatal care \\u003cstrong\\u003e(Figure-4).\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eImmunization status of children aged from 10 to 23 months in southwest Ethiopia 2020\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe prevalence of incomplete immunization was found to be 809(62.2%) (95% CI: 59.5, 64.8).of the total respondents1110 (85.4%) of them took both BCG and OPV vaccine, from 1110 BCG started children only 798 (71.8%) of the children complete their immunization. Of the total 1300 children, 190 (14.6%) of them were not taking any vaccine at all. Overall 1088(83.7%) of them received both PCV one and Penta one, 1082(83.2%) received rota1 and 798 (61.4%) received measles vaccine. The coverage rate was a decline for the consecutive dose, such as OPV zero (85.4%) to OPV three (73.7%), both Penta and PCV one (83.7%) to Penta and PCV three (71.9%).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;Dropout rate: the overall dropout rate of immunization in the zone was BCG to measles,\\u0026nbsp;\\u003cimg src=\\\"data:image/png;base64,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\\\" alt=\\\"\\\" /\\u003eand the dropout rate of each subsequent vaccine was 13.6% for OPV0 to OPV3, 12.2% for PCV1 to PCV3 and 14% for pena1 to penta3 for more detail see on\\u003cstrong\\u003e( Figure-5, Figure-6 and figure-7)\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eIn-depth/detail interview finding\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eThem 1:\\u003c/strong\\u003e\\u003cstrong\\u003efear of COVID 19 transmission during transportation to a health facility.\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe rural mother of the child complains that during the transportation to the health facility we are asked to wear a face mask without the access of a face mask in the nearby area (20,34, 36, 40, years old rural mothers). Even if we wear a face mask we do not trust that will protect our child from COVID 19 and ourselves (26 and 32 years old mothers). As we hear that the virus stays everywhere such as on clothes, metal, and different surfaces, we fear the surface of the bus for contaminated with COVID 19 (35.37, 40 and 46 years old fathers of the children).\\u003c/p\\u003e\\n\\u003cp\\u003eFear of screening by temperature regardless of other cause of raising the temperature and took us to quartile and Isolation areas without evidence of COVID 19 and doubling up of transportation fee because of COVID 19 (30, 42, 45. And 47 years old priests).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTheme 2:\\u003c/strong\\u003e\\u003cstrong\\u003echallenges in the health facility and COVID 19 transmission\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eConsidering the health professions as a career of COVID 19 and the may transmit these COVID 19 to our children during immunization (27, 32, 35, 43 years old priests). We understand that the immunization service of the children was given together with the care of COVID 19 in the health facility, so we assume there was a high transmission of COVID 19 during getting the service and as the come up time at the health institution was too long to get the service, person to person transmission is very high at a health facility (this is the idea of all mother of the children). During waiting time at the health facility we fear individual-to-individual transmission of COVID 19 because the waiting area in the health facility was very condensed and not ventilated (30, 29, 34, and 41 years old father of the children).\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFactors associated with immunization status of \\u003c/strong\\u003e\\u003cstrong\\u003eChildren Aged 10-23 Months during COVID 19.\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eBivariate logistic regression analysis shows that waiting time, educational status, delivery place, considering COVID 19 and other service is given at the same unit, fear of COVID 19 from health profession and means of transportation were all significantly accompanying with incomplete immunization at p-value 0.05. From all variables on marital status was not significantly associated. However, on multivariable analysis except for marital status and means transportation, all the variables were identified as independently significant associated factors with incomplete immunization.\\u003c/p\\u003e\\n\\u003cp\\u003eThe women waiting time more than 30 minutes at a health facility for immunization were 96% more likely to have incomplete immunization than waiting less than 30 minutes (AOR=04, 95%CI .0001,.004). The odd of incomplete immunization of the children was 2.34 times higher in the women who deliver at home than deliver at a health facility (AOR =2.336, 95%CI 4.96, 6.089). The child who was born from women who cannot read and write were 5.08 times incompletely immunized than the child born from educated women( diploma, degree, and above) ( AOR=5.08,95% CI 2.31,11.14). The women who cannot understand the separation care of CIOVID 19 and other health service had 3.62 times incompletely immunized child than who understand the separation care of COVID 19 and another health service (AOR=3.62,95%CI 1.72,7.64). The odd of incomplete immunization of a child for the women who fear health professions as a source of COVID 19 was 2.85 times higher than did not fear the health profession (AOR=2.85,95%CI 1.38,5.9) \\u003cstrong\\u003e(Table-2)\\u003c/strong\\u003e\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThis is a cross-sectional community-based survey supplemented by a qualitative study that has attempted to determine Immunization status and challenges during COVIODN 19 and Accompanying Factors among Children Aged 10-23 Months.\\u003c/p\\u003e\\n\\u003cp\\u003eThe percentage of incomplete immunization among children aged from 10-23 months in this study was found to be 809(62.2%) (95% CI: 59.5, 64.8). This study is in similar with the study done by further analysis of 2016 EDHS (61.7%) (15). This consistency may be the current immunization practice of the women is regretted to the pervious poor immunization intention of the women. Because before 5 years back the immunization thinking of the women is so poor due to miss understanding of the advantage of immunization.\\u003c/p\\u003e\\n\\u003cp\\u003eThe outcome of this study was greater than the study done in a different part of Ethiopia like in Wonago Gedo(47.6.%), Deber Markos (28.3%), northwest Ethiopia(41.6%), Gondar (24.3%), Woldiya (11.3%), Sekota (22.6%), systematic and meta-analysis of immunization from 2003 to 2019 in Ethiopia (41.8%) another systematic and meta-analysis were done in 2020 Ethiopia (53%), at a tertiary-care hospital (University College of Medical Sciences and Guru Tegh Baha-dur Hospital, New Delhi, India (48%) and at Indonesia (2008\\u0026ndash;2013): a multilevel analysis(38.13%) (12, 14, 16-22). The possible explanation for this can be almost all women have a misunderstanding of about the separation care of COVID 19 and other services like immunization, cost of transportation doubling up and fear of health professionals as a source of COVID 19 was the possible reason to decline the immunization as evidenced by an in-depth interview.\\u003c/p\\u003e\\n\\u003cp\\u003eIn this study, the women waiting more than 30 minutes at a health facility for immunization were 96% more likely to have incomplete immunization as compared with those women waiting less than 30 minutes (AOR=04, 95%CI .0001,.004). The reason may be as the women are busy in their duty; being staying more time in a health facility for immunization encourages discontinuous the immunization program. On the other thing also as waiting times increase in the health facility, overcrowding will increase; this will raise the transmission of COVID 19, finally, there was a drop out of immunization. This is supported by the study done in Sekota zuria district, Gondar city administration, Deber Markos town, and in North West Ethiopia (14, 19-21)\\u003c/p\\u003e\\n\\u003cp\\u003eThe odd of incomplete immunization of the children was 2.34 times higher in the women who deliver at home as compared with the women delivered at a health facility (AOR =2.336, 95%CI 4.96, 6.089). The possible explanation may be the women deliver at health facilities have more information about the importance of immunization than home-delivered women. They also are educated and have a good attitude and knowledge for free utilization of health services. This is supported by a study done in Sekota zuria District, further analysis of EDHS 2016, and Northwest Ethiopia(15, 19, 20).On the other hand not supported by the findings in Wonago Gedo zone, Deber Markos town(18, 21)\\u003c/p\\u003e\\n\\u003cp\\u003eThe child of uneducated women were 5.08 times more incompletely immunized as compared to the child of educated women( diploma, degree, and above) ( AOR=5.08,95% CI 2.31,11.14). The possible reason is as the women are educated; they easily identify the possible vaccine-preventable disease and easy approach to a health facility as well there is no misperception regarding health service utilization. This is supported by the finding further analysis of EDHS 2016 and Sekota District(15, 19) but not supported by the study done in Northwest Ethiopia, Deber Markos Town, Wonago District, Gondar Town(14, 18, 20, 21)\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;The women who cannot understand the separation care of CIOVID 19 and other health service had 3.62 times incompletely immunized their child as compared to the women who understand the separation care of COVID 19 and other health services (AOR=3.62,95%CI 1.72,7.64) and The odd of incomplete immunization of a child for the women who fear health professions as a source of COVID 19 was 2.85 times higher as compared to the women who did not fear the health profession for the source of COVID 19 (AOR=2.85,95%CI 1.38,5.9). This is explained as the women did not understand the separation care of COIVID 19 and other health services as well did not aware about phone service of the health facility, they drop out from the service by fearing transmission of COVID 19 between the client and from health professions.\\u003c/p\\u003e\"},{\"header\":\"Conclusions\",\"content\":\"\\u003cp\\u003eBased on the finding obtained in this study the prevalence of incomplete immunization in the South Nation Nationality and People region among children age 10-23 months was very high as compared to other studies.\\u003c/p\\u003e\\n\\u003cp\\u003eVariables significantly associated with incomplete immunization among children aged10-23 months were time waiting at a health facility, place of delivery, educational status of the women, not understanding the separation care of COVID 19 and other health services, fear of health professionals as a source of COVID 19.\\u003c/p\\u003e\"},{\"header\":\"Abbreviations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eANC\\u003c/strong\\u003e Antenatal Care\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eBCG\\u003c/strong\\u003e Bacillus Chalmette Guerin\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eDHS\\u003c/strong\\u003e Demographic and Health survey\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eDPT\\u003c/strong\\u003e Diphtheria, Pertussis, Tetanus\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eEDHS\\u003c/strong\\u003e Ethiopian Demographic and Health survey\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eEPI \\u003c/strong\\u003e Expanded Program on Immunization\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eHBV\\u003c/strong\\u003e Hepatitis B Virus\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eHIB\\u003c/strong\\u003e Hemophilic Influenza type B\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eMOH\\u003c/strong\\u003e Ministry Of Health\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eOPV\\u003c/strong\\u003e Oral Polio Vaccine\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003ePCV\\u003c/strong\\u003e Pneumococcal Conjugate Vaccine\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eWHO\\u003c/strong\\u003e World Health Organization\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eSNNPR\\u003c/strong\\u003e South Nation, Nationality and People Region\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCOVID 19\\u003c/strong\\u003e coronavirus disease 2019\\u003c/p\\u003e\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eEthics approval and consent to participate\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eEthical clearance letter was obtained From the Ethical Review Committee of Midwifery, under the delegation of the institutional review board of\\u0026nbsp;\\u0026nbsp; Mizan Tepi University and submitted to each zonal administrative to obtained permission letter. Then each zonal administrative\\u0026nbsp; given written permission letter to the concerned bodies in the study set up and informed consent was obtained from respondents after giving them evidence about the perseverance of the study, confidential and anonymous \\u003ca name=\\\"_Toc484069518\\\"\\u003e\\u003c/a\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent for Publication\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eIn this study not relevant\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAvailability of Data and martial\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe data set used and/or investigated during the current study is available from the conforming author on realistic request.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCompeting of interests\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;There are no competing interests as declared by the authors.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u0026nbsp;Any fund or benefits are not received by the authors from industry or elsewhere to undergo this study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthors' contributions\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAT\\u003c/strong\\u003e was the principal author; made substantial contributions in the conception of selecting a design, \\u003cstrong\\u003eDM\\u003c/strong\\u003e, and \\u003cstrong\\u003eS\\u003c/strong\\u003e data collection as well as analysis and interpretation of data. Finally, \\u003cstrong\\u003eAG and ZM \\u003c/strong\\u003ewere participated in revising and commenting on the paper. All authors read and check the finalize manuscript.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgment\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eFirst and foremost, our heartfelt goes to the Mizan Tepi University research committee for their permission letter and the health science staff for their continuous up keeping. Our thanks likewise go to southwest region administrator and different zones and woredas administrators in southwest Ethiopia for their permission and uninterrupted follow-up and health extension workers for their valuable information and are inside us during the data collection period. Finally, we thank you our data collector and participants for their cooperative and time\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthors' information \\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAlemnew Wale Tegegne\\u003c/strong\\u003e, email:walealemnew@gmail.com\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAychew Kassie Gidafie\\u003c/strong\\u003e,email:aychewkassie055@gmail.com\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eDessalegn Girma Mammo,\\u003c/strong\\u003e email:desegir@gmail.com\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eSemahegn Tilahun Wassie\\u003c/strong\\u003e, email: \\u003ca href=\\\"mailto:semiesmith61@gmail.com\\\"\\u003esemiesmith61@gmail.com\\u003c/a\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eZinie Abita Mengie\\u003c/strong\\u003e email: zinieabita@gmail.com\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\n\\u003cli\\u003eRothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of autoimmunity. 2020:102433.\\u003c/li\\u003e\\n\\u003cli\\u003eZheng Y-Y, Ma Y-T, Zhang J-Y, Xie X. COVID-19, and the cardiovascular system. Nature Reviews Cardiology. 2020;17(5):259-60.\\u003c/li\\u003e\\n\\u003cli\\u003eXu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet respiratory medicine. 2020;8(4):420-2.\\u003c/li\\u003e\\n\\u003cli\\u003eAbdu A. Adamua b, *, Rabiu I. Jaloc, Desire Habonimanad, Charles S. Wiysongea,b,e. COVID-19 and routine childhood immunization in Africa: Leveraging systems thinking and implementation science toimprove immunization system performance. International Journal of Infectious Diseases. 2020;98.\\u003c/li\\u003e\\n\\u003cli\\u003eProgress and Challenges with Achieving Universal Immunization Coverage. 2020.\\u003c/li\\u003e\\n\\u003cli\\u003eAfrica Wf. The Federal Ministry of Health has confirmed a coronavirus disease (COVID-19) case in Addis Ababa, Ethiopia. 2020.\\u003c/li\\u003e\\n\\u003cli\\u003eUNICEF/UNI315081/Yuwei. The impact of COVID-19 on routine vaccinations Reflections during World Immunization Week 2020. 2020.\\u003c/li\\u003e\\n\\u003cli\\u003eKroumpouzos G, Gupta M, Jafferany M. COVID-19: A relationship to climate and environmental conditions? 2020:e13399.\\u003c/li\\u003e\\n\\u003cli\\u003eLiu Y, Gayle AA, Wilder-Smith A, Rockl\\u0026ouml;v J. The reproductive number of COVID-19 is higher compared to SARS coronavirus. Journal of travel medicine. 2020.\\u003c/li\\u003e\\n\\u003cli\\u003eHealth FMo. COMPREHENSIVE MULTI-YEAR PLAN 2016 - 2020. 2015.\\u003c/li\\u003e\\n\\u003cli\\u003ehealth FMo. Immunization Manual for Health Workers. 2012.\\u003c/li\\u003e\\n\\u003cli\\u003eyele Mamo Abebe MWK, 2 Alemu Birara Zemariam,2, Shewangashaw3 aNE. Coverage, Opportunity, and Challenges of Expanded Program on Immunization among 12\\u0026ndash;23-Month-Old Children in Woldia Town, Northeast Ethiopia, 2018. Hindawi. 2018;12.\\u003c/li\\u003e\\n\\u003cli\\u003eKumar D, Aggarwal A, Gomber S. Immunization status of children admitted to a tertiary-care hospital of north India: reasons for partial immunization or non-immunization. J Health Popul Nutr. 2010;28(3):300-4.\\u003c/li\\u003e\\n\\u003cli\\u003eAyenew Engida Yismaw1* NTA, Netsanent Habetie Bayu3, Mekonen4 aSS. Incomplete childhood vaccination and associated factors among children aged12\\u0026ndash;23 months in Gondar city administration, Northwest, Ethiopia 2018. BMC Research Notes. 2019;12.\\u003c/li\\u003e\\n\\u003cli\\u003eTamirat KS, Sisay MM. Full immunization coverage and its associated factors among children aged 12\\u0026ndash;23 months in Ethiopia: further analysis from the 2016 Ethiopia demographic and health survey. BMC Public Health. 2019;19(1):1019.\\u003c/li\\u003e\\n\\u003cli\\u003eEshete A, Shewasinad S, Hailemeskel S. Immunization coverage and its determinant factors among children aged 12\\u0026ndash;23\\u0026thinsp;months in Ethiopia: a systematic review, and Meta-analysis of cross-sectional studies. BMC Pediatrics. 2020;20(1):283.\\u003c/li\\u003e\\n\\u003cli\\u003eNour TY, Farah AM, Ali OM, Abate KH. Immunization coverage in Ethiopia among 12\\u0026ndash;23-month-old children: systematic review and meta-analysis. BMC Public Health. 2020;20(1):1134.\\u003c/li\\u003e\\n\\u003cli\\u003eHailu S, Astatkie A, Johansson KA, Lindtj\\u0026oslash;rn B. Low immunization coverage in Wonago district, southern Ethiopia: A community-based cross-sectional study. PLOS ONE. 2019;14(7):e0220144.\\u003c/li\\u003e\\n\\u003cli\\u003eGirmay A, Dadi AF. Full Immunization Coverage and Associated Factors among Children Aged 12-23 Months in a Hard-to-Reach Areas of Ethiopia. Int J Pediatr. 2019;2019:1924941-.\\u003c/li\\u003e\\n\\u003cli\\u003eTesfaye TD, Temesgen WA, Kasa AS. Vaccination coverage and associated factors among children aged 12 \\u0026ndash; 23 months in Northwest Ethiopia. Human Vaccines \\u0026amp; Immunotherapeutics. 2018;14(10):2348-54.\\u003c/li\\u003e\\n\\u003cli\\u003eGualu T, Dilie A. Vaccination Coverage and Associated Factors among Children Aged 12\\u0026ndash;23 Months in Debre Markos Town, Amhara Regional State, Ethiopia. Advances in Public Health. 2017;2017:5352847.\\u003c/li\\u003e\\n\\u003cli\\u003eHolipah, Maharani A, Kuroda Y. Determinants of immunization status among 12- to 23-month-old children in Indonesia (2008\\u0026ndash;2013): a multilevel analysis. BMC Public Health. 2018;18(1):288.\\u003c/li\\u003e\\n\\u003c/ol\\u003e\"},{\"header\":\"Tables\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eTable 1: Socio-demographic characteristics of mothers or caregivers having children aged 10-23 month in southwest Ethiopia 2020\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" width=\\\"0\\\"\\u003e\\n\\u003ctbody\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"143\\\"\\u003e\\n\\u003cp\\u003eVariables\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eCategory\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003eFrequency\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003epercentage\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd rowspan=\\\"3\\\" width=\\\"143\\\"\\u003e\\n\\u003cp\\u003eAge\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003e15-25\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e475\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e36.5%\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003e26-35\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e652\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e50.2%\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003e36-45\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e173\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e13.3%\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd rowspan=\\\"5\\\" width=\\\"143\\\"\\u003e\\n\\u003cp\\u003eMaternal education\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eunable to read and write\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e551\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e42.4\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eable to read and write\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e34\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e2.6\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003ePrimary school\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e328\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e25.2\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eSecondary school\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e329\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e25.3\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eDiploma, degree and above\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e58\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e4.5\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd rowspan=\\\"4\\\" width=\\\"143\\\"\\u003e\\n\\u003cp\\u003eOccupation of the caregiver/mothers\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003ehousewife\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e1109\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e85.3\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eMerchant\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e95\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e7.3\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003ePrivate and government employee\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e35\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e2.7\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003edaily labor and students\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e17\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e4.7\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd rowspan=\\\"3\\\" width=\\\"143\\\"\\u003e\\n\\u003cp\\u003eMarital status\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eSingle\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e43\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e3.3\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eMarried\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e1116\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e85.8\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eWindowed\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e105\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e8.1\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"143\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eDivorced\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e36\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e2.8\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd rowspan=\\\"4\\\" width=\\\"143\\\"\\u003e\\n\\u003cp\\u003eReligion\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eOrthodox\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e811\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e62.4\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eMuslim\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e75\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e5.8\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eProtestant\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e393\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e30.2\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eCatholic\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e21\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e1.6\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd rowspan=\\\"4\\\" width=\\\"143\\\"\\u003e\\n\\u003cp\\u003eEthnicity\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eBench\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e744\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e57.2\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eOromo\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e282\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e21.7\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eAmhara\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e239\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e18.4\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"253\\\"\\u003e\\n\\u003cp\\u003eSheko\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e35\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"90\\\"\\u003e\\n\\u003cp\\u003e2.7\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eTable 2: Multi-variate logistic regression of factors for incomplete immunization of children in southwest Ethiopia 2020\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003ctable border=\\\"1\\\" width=\\\"0\\\"\\u003e\\n\\u003ctbody\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd colspan=\\\"2\\\" rowspan=\\\"2\\\" width=\\\"324\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n\\u003ctd colspan=\\\"2\\\" width=\\\"192\\\"\\u003e\\n\\u003cp\\u003eStatus of immunization\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd rowspan=\\\"2\\\" width=\\\"102\\\"\\u003e\\n\\u003cp\\u003eCOR (95%CI)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd rowspan=\\\"2\\\" width=\\\"114\\\"\\u003e\\n\\u003cp\\u003eAOR(95%CI)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"96\\\"\\u003e\\n\\u003cp\\u003eincomplete N%\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"96\\\"\\u003e\\n\\u003cp\\u003ecomplete N %\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd rowspan=\\\"2\\\" width=\\\"186\\\"\\u003e\\n\\u003cp\\u003eWaiting time at the health facility\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"138\\\"\\u003e\\n\\u003cp\\u003eless than 30 minute\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"96\\\"\\u003e\\n\\u003cp\\u003e481(98.0%)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"96\\\"\\u003e\\n\\u003cp\\u003e46(5.7%)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"102\\\"\\u003e\\n\\u003cp\\u003e1\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"114\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"138\\\"\\u003e\\n\\u003cp\\u003e\\u0026nbsp;greater than 30 minute\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"96\\\"\\u003e\\n\\u003cp\\u003e10(2.0%)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"96\\\"\\u003e\\n\\u003cp\\u003e763(94.3%)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"102\\\"\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003e.\\u003c/strong\\u003e02(.001, 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width=\\\"114\\\"\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003e3.54(1.59,7.89)\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"138\\\"\\u003e\\n\\u003cp\\u003ediploma, degree and above\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"96\\\"\\u003e\\n\\u003cp\\u003e124(25.3%)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"96\\\"\\u003e\\n\\u003cp\\u003e263(32.5%)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"102\\\"\\u003e\\n\\u003cp\\u003e1\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"114\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd rowspan=\\\"2\\\" width=\\\"186\\\"\\u003e\\n\\u003cp\\u003eDo you think that COVID 19 care is given together with other health services\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"138\\\"\\u003e\\n\\u003cp\\u003eYes\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd 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width=\\\"186\\\"\\u003e\\n\\u003cp\\u003eDo you fear immunization provider health professionals as a source of COVID19\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"138\\\"\\u003e\\n\\u003cp\\u003eYes\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"96\\\"\\u003e\\n\\u003cp\\u003e216(44.0%)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"96\\\"\\u003e\\n\\u003cp\\u003e234(28.9%)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"102\\\"\\u003e\\n\\u003cp\\u003e1.93(1.53, 2.44)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"114\\\"\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003e2.85(1.38,5.9)\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003ctr\\u003e\\n\\u003ctd width=\\\"138\\\"\\u003e\\n\\u003cp\\u003eNo\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd width=\\\"96\\\"\\u003e\\n\\u003cp\\u003e275(56.0%)\\u003c/p\\u003e\\n\\u003c/td\\u003e\\n\\u003ctd 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width=\\\"114\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n\\u003c/tr\\u003e\\n\\u003c/tbody\\u003e\\n\\u003c/table\\u003e\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":true,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true},\"keywords\":\"Immunization status, challenge, Children 12-23-month-old, South West Ethiopia\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-130792/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-130792/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003eBackground\\u003c/p\\u003e\\u003cp\\u003eThe worldwide COVID-19 pandemic is overstressing health systems and Essential health services and vaccination services are disrupted. Immunization is a confirmed gizmo for governing and even eliminating communicable diseases. An immunization operation carried out by the World Health from 1967 to 1977 exterminated the usual existence of smallpox.\\u0026nbsp;When the program instigated, the disease endangered \\u0026nbsp;for 60% of the world's population and slayed every fourth victim.\\u0026nbsp;\\u003c/p\\u003e\\u003cp\\u003eObjective\\u003c/p\\u003e\\u003cp\\u003eThis study aims to assess the challenge and status of immunization during Covid 19 and associated factors among children aged 10-23 months south Nation Nationality and People Region Ethiopia. \\u003c/p\\u003e\\u003cp\\u003eMethods and Materials\\u003c/p\\u003e\\u003cp\\u003ecommunity-based mixed quantitative and qualitative cross-sectional study was done in southwest Ethiopia. Data was collected using semi-structured questionnaires and in-depth interviews.\\u0026nbsp;After that, the data were edited, coded, and move in into Epi info version 7.2 for data management then transported to SPSS version 25 for analysis. The analyzed data were presented by tables, graphs, figures, and text form.\\u0026nbsp;\\u003c/p\\u003e\\u003cp\\u003eResult\\u003c/p\\u003e\\u003cp\\u003eaccording to this study the prevalence of incomplete immunization was found to be 809(62.2%) with (95% CI: 59.5, 64.8). in multivariable analysis waiting time at a health facility (AOR=0.04, 95%CI 0.0001,0.004), education (AOR=5.08,95%CI2.31,11.14), place of delivery(AOR=2.34,95%CI 4.96,6.089), fearing of COVID19(AOR=3.62,95%CI 1.72,7.64) and do not understand the separation care of COVID 19 and other health services (AOR=2.85,95%CI1.38,5.9) were significantly associated factors\\u003c/p\\u003e\\u003cp\\u003eConclusion\\u003c/p\\u003e\\u003cp\\u003eThe prevalence of incomplete immunization among children aged 10-23 months was very high in this study as compared to the other studies done in a different pocket of Ethiopia. Consecutively, reducing waiting time at a health facility, avoiding unnecessary fear of COVID 19, and promoting immunization in a different area of southwest Ethiopia along with health extension workers are recommended.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Immunization Status and Challenges During COVID\\u0026nbsp;19 and Associated Factors Among Children Aged 10-23 Months in South Nation Nationality and People Region, Ethiopia 2020\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2020-12-22 22:01:39\",\"doi\":\"10.21203/rs.3.rs-130792/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"researchsquare\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":true,\"externalIdentity\":\"\",\"sideBox\":\"\",\"snPcode\":\"\",\"submissionUrl\":\"/submission\",\"title\":\"Research Square\",\"twitterHandle\":\"researchsquare\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"\",\"reportingPortfolio\":\"\",\"inReviewEnabled\":false,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"5d5aef87-7dbb-4caa-a416-7384084a8fd5\",\"owner\":[],\"postedDate\":\"December 22nd, 2020\",\"published\":true,\"recentEditorialEvents\":[],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"posted\",\"subjectAreas\":[{\"id\":1591243,\"name\":\"Health Economics \\u0026 Outcomes Research\"},{\"id\":1591244,\"name\":\"Infectious Diseases\"},{\"id\":1591245,\"name\":\"Health Policy\"}],\"tags\":[],\"updatedAt\":\"2021-01-05T21:27:28+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2020-12-22 22:01:39\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-130792\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-130792\",\"identity\":\"rs-130792\",\"version\":[\"v1\"]},\"buildId\":\"cBFmMYwuxLRRLfASyISRj\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}