Factors Influencing Childhood Immunization Coverage in Juba County, South Sudan: A Cross-Sectional Survey

Abstract Introduction: The study aimed to investigate the immunization status of children aged 1 to 2 years in Juba County, South Sudan, and to identify factors associated with their immunization coverage. Methods: A cross-sectional survey design was employed, with Juba being purposively sampled and the Payams in Juba being stratified, followed by the random sampling of villages within these Payams. Data was collected through structured interviews and analyzed using SPSS v22, incorporating descriptive and inferential statistics. Findings: The study revealed that more than three-quarters of the children had received all the recommended vaccines, with the BCG vaccine being the most commonly received, while the measles vaccine was the least received. The study identified several factors associated with immunization coverage, including parental age, religious affiliation, knowledge of the benefits of immunization, maternal economic activity, and perceived flexibility of immunization services provided at healthcare facilities. Notably, the prevalence of reception of all vaccines was lower among children whose parents were aged 18–25 years and born-again Christians, while it was higher among children whose parents recognized the benefits of immunization. Additionally, children whose mothers were engaged in economic activities were less likely to receive all primary vaccines. Furthermore, the study found that the flexibility of immunization services at healthcare facilities was associated with lower immunization coverage. Conclusion: The study highlighted that while the proportion of children in Juba receiving all vaccines is relatively high, it still falls below the global standard of 90%. The immunization status of children in Juba was found to be primarily influenced by parental characteristics, with institutional characteristics playing a smaller role. These findings underscore the importance of targeted interventions to address specific parental and institutional factors that may hinder optimal immunization coverage in Juba County, South Sudan.