Quality of Counselling, Exposure to Vaccination Messages and Caregivers’ Knowledge on the Uptake of Penta Vaccine in Six Northern Nigerian States

Background Pentavalent 3 (Penta-3) coverage for children aged 12-23 months is used as the prime substitute for determining vaccination coverage and monitoring the performance of the national immunization programme. However, the coverage for Penta 3 in Nigeria remains low. Quality interaction between caregivers and providers and access to appropriate information are associated with healthcare utilization and acceptance of recommended health behaviours. This study examines the quality of counselling (QOC), caregivers’ exposure to vaccination messages and child’s uptake of the Penta vaccine.

This was a cross-sectional study that utilized quantitative data obtained through a survey. Caregivers (n=561) of children aged 2-24 months accessing child vaccination services who received Penta vaccines at randomly selected health facilities (n=163) offering routine immunization (RI) services were surveyed. Penta uptake was coded as binary; hence, binary logistic regression was performed using Stata 14.

We found that 56% of the caregivers received quality counselling. Although awareness of child vaccination was high (70%), two-thirds had poor exposure. The uptake of all three doses of Penta vaccine was 43%. Contextual factors associated with Penta uptake include caregivers’ knowledge of when a child should receive their first vaccination (aOR=2.08; 95% CI=1.01-4.29), sources of child vaccination messages, namely, place of worship (aOR=2.78; 95% CI=1.15-6.67), Community Health Workers CHW (aOR=1.95; 95% CI=1.14-3.34), community leader (aOR=2.21; 95% CI=1.11-4.41) and residence in the northwest region (aOR=2.60; 95% CI=1.51-4.48).

Given the low quality of counselling and the positive influence of religious and traditional leaders, interventions that prioritize strengthening patient-provider interaction and community structure are crucial for increasing child vaccination coverage in Nigeria. Competing Interest Statement The authors have declared no competing interest. Funding Statement This research article is based on research supported by the Gates Foundation with funding code [INV-033024]. Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the Population Council Institutional Review Board (Protocol number 992). In Nigeria, the National Health Research Ethics Committee (approval number NHREC/01/01/2007-17/01/2022) and the States Health and Research Ethics Board also approved the study. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes