Trends and Challenges in Immunization Coverage among Children aged 0-11 Months in Nkambe Health District, North-West Region, Cameroon

Trends and Challenges in Immunization Coverage among Children aged 0-11 Months in Nkambe Health District, North-West Region, Cameroon | 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 Article Trends and Challenges in Immunization Coverage among Children aged 0-11 Months in Nkambe Health District, North-West Region, Cameroon Benard Karachu Mbunwe, Samuel Nkengfua, Doreen Mbunwe, Nicholas Tendongfor This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8969648/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: Immunization remains a highly effective and affordable disease-prevention measure, yet sociopolitical unrest in Cameroon’s North West Region hampers vaccine uptake. In Nkambe Health District, limited knowledge persists regarding coverage and challenges to immunization. The objective of this study was to determine the trends in immunization coverage among children aged 0–11 months between 2013 and 2019 and identify the challenges faced by caregivers and healthcare providers in the uptake of immunization in Nkambe Health District, North West Region, Cameroon. Methods: A survey was conducted among caregivers of 385 children aged 0–11 months in the Nkambe Health District to determine the immunization status of children, the coverage, challenges and associated factors using a structured questionnaire. Review of hospital records was done to determine the trend of vaccination coverage. In-depth interviews were conducted among healthcare providers to explore challenges of vaccination coverage. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. Logistic regression analysis was used to identify the predictors of complete immunization and triangulated with thematic analysis results. Results: Among 385 guardians, 68.8% of children had completed vaccination. Coverage peaked at 82.0% in 2017 but fell to 40.0% in 2019. Complete vaccination was significantly associated with living <5 km from a vaccination site (aOR = 3.2, 95% CI: 1.81–5.82, p = 0.001), knowledge of the vaccination schedule (cOR = 2.57, 95% CI: 1.43–4.60, p = 0.001), antenatal care attendance (aOR = 10.5, 95% CI: 3.59–31.05, p = 0.001), and postponed vaccination sessions (aOR = 2.97, 95% CI: 1.66–5.32, p = 0.001). Challenges included staff shortages, lack of cold chain, and socio-political unrest. Conclusion: Vaccination coverage in Nkambe Health District has sharply declined in recent years due to the ongoing crisis and other challenges; improving coverage will require stronger community engagement, sensitization, and expanded outreach services. Vaccination coverage Immunisation challenges Nkambe Health District Full Text Additional Declarations No competing interests reported. Supplementary Files APPENDICESQUESTIONNAIRE.docx 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. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. 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-8969648","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":597201212,"identity":"9dcea6b6-9faa-4480-9a14-4a572da07bac","order_by":0,"name":"Benard Karachu Mbunwe","email":"","orcid":"","institution":"University of Buea","correspondingAuthor":false,"prefix":"","firstName":"Benard","middleName":"Karachu","lastName":"Mbunwe","suffix":""},{"id":597201215,"identity":"7ec66a52-23cc-41aa-9cce-62e0d5d5e226","order_by":1,"name":"Samuel Nkengfua","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5klEQVRIiWNgGAWjYDACHhBhA2YaPgDx+YjTkgZmGhuA+GykaDGTAJEEtZjzHD728EvCYXn5aYe3VX7NsZNhY2B++OgGHi2WvW3pxjIJhw033E4ruy27LRnoMDZj4xw8WgzO85hJS/44zLhBOsfstuQ2ZqAWHjZp/Fr4v0lLJBy2nz87x6xYcls9EVrO9rBJfkg4nNhwO8eM8eO2w0RoOXPMTJohIT0Z6JdiacZtx3nYmAn55UzyM8kfCda282cnb/z4c1u1PT9788PH+LSAADMPCoOZgHIQYPyBzhgFo2AUjIJRgAwAdyZGocNYWaYAAAAASUVORK5CYII=","orcid":"","institution":"University of Buea","correspondingAuthor":true,"prefix":"","firstName":"Samuel","middleName":"","lastName":"Nkengfua","suffix":""},{"id":597201216,"identity":"ed65fbb8-5f79-4ce5-b432-0297b6c2b1fc","order_by":2,"name":"Doreen Mbunwe","email":"","orcid":"","institution":"University of Buea","correspondingAuthor":false,"prefix":"","firstName":"Doreen","middleName":"","lastName":"Mbunwe","suffix":""},{"id":597201217,"identity":"06982843-2e43-43c3-9eda-9b3b7237fdff","order_by":3,"name":"Nicholas Tendongfor","email":"","orcid":"","institution":"University of Buea","correspondingAuthor":false,"prefix":"","firstName":"Nicholas","middleName":"","lastName":"Tendongfor","suffix":""}],"badges":[],"createdAt":"2026-02-25 16:08:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8969648/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8969648/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104397434,"identity":"a59fea00-5ca6-485f-9122-c59767b8a9af","added_by":"auto","created_at":"2026-03-11 11:48:16","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":669600,"visible":true,"origin":"","legend":"","description":"","filename":"FinalManuscriptBen.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8969648/v1_covered_43f8446f-109a-4814-9aff-f0a6a54e1f59.pdf"},{"id":103487390,"identity":"55624ecb-8e9f-4bb1-bcb7-43c78d133fb1","added_by":"auto","created_at":"2026-02-26 09:15:34","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":30294,"visible":true,"origin":"","legend":"","description":"","filename":"APPENDICESQUESTIONNAIRE.docx","url":"https://assets-eu.researchsquare.com/files/rs-8969648/v1/1705ae81f0a6859b7b98aa00.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Trends and Challenges in Immunization Coverage among Children aged 0-11 Months in Nkambe Health District, North-West Region, Cameroon","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","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":"Vaccination coverage, Immunisation challenges, Nkambe Health District","lastPublishedDoi":"10.21203/rs.3.rs-8969648/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8969648/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Immunization remains a highly effective and affordable disease-prevention measure, yet sociopolitical unrest in Cameroon’s North West Region hampers vaccine uptake. In Nkambe Health District, limited knowledge persists regarding coverage and challenges to immunization. The objective of this study was to determine the trends in immunization coverage among children aged 0–11 months between 2013 and 2019 and identify the challenges faced by caregivers and healthcare providers in the uptake of immunization in Nkambe Health District, North West Region, Cameroon.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A survey was conducted among caregivers of 385 children aged 0–11 months in the Nkambe Health District to determine the immunization status of children, the coverage, challenges and associated factors using a structured questionnaire. Review of hospital records was done to determine the trend of vaccination coverage. In-depth interviews were conducted among healthcare providers to explore challenges of vaccination coverage. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. Logistic regression analysis was used to identify the predictors of complete immunization and triangulated with thematic analysis results.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Among 385 guardians, 68.8% of children had completed vaccination. Coverage peaked at 82.0% in 2017 but fell to 40.0% in 2019. Complete vaccination was significantly associated with living \u0026lt;5 km from a vaccination site (aOR = 3.2, 95% CI: 1.81–5.82, p = 0.001), knowledge of the vaccination schedule (cOR = 2.57, 95% CI: 1.43–4.60, p = 0.001), antenatal care attendance (aOR = 10.5, 95% CI: 3.59–31.05, p = 0.001), and postponed vaccination sessions (aOR = 2.97, 95% CI: 1.66–5.32, p = 0.001). Challenges included staff shortages, lack of cold chain, and socio-political unrest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Vaccination coverage in Nkambe Health District has sharply declined in recent years due to the ongoing crisis and other challenges; improving coverage will require stronger community engagement, sensitization, and expanded outreach services.\u003c/p\u003e","manuscriptTitle":"Trends and Challenges in Immunization Coverage among Children aged 0-11 Months in Nkambe Health District, North-West Region, Cameroon","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-26 09:15:29","doi":"10.21203/rs.3.rs-8969648/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","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":"991bd371-df49-4431-bea2-8eeded408eae","owner":[],"postedDate":"February 26th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-29T09:53:53+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-26 09:15:29","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8969648","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8969648","identity":"rs-8969648","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}