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Introduction: Despite childhood immunisation services being free in South Africa, Tshwane sub-district 2 continues to have the lowest vaccine coverage rate of all the Tshwane sub-districts in Gauteng province which is below the 90% national target. For measles, the immunisation coverage target is 95% and 90% for other antigens. To understand the factors for low coverage, a caregivers’ knowledge, attitudes and practices (KAP) study regarding the routine immunisation programme was done.
Methods: A cross sectional survey was conducted among caregivers of children <5 years old attending 10 of the 12 clinics in sub-district 2 for any health reason from June to August 2015. An interviewer-administered questionnaire was used and immunisation cards were reviewed. Of 23 questions asked, 18 assessed knowledge, 3 attitudes and 2 practices. Descriptive statistics were used to describe the data using STATA version 13 and Microsoft Excel.
Results: A total of 326 caregivers were enrolled. Mean caregiver age [standard deviation (SD)] was 29.1 (9.61) years. Although 29% (94/326) of the caregivers knew at least three vaccine preventable diseases (VPDs), 13% did not know any. Approximately one third of caregivers, (114/326, 35%) could list at least two VPDs, with polio (70.3%) and measles (57.7%) being mentioned most often. Of the 318 cards reviewed, 82% of children were fully immunised. Mean (SD) score for knowledge was 5.4 (2.7), out of 18; while for attitudes and practices it was 4.4 (1.1), out of 5.
Conclusion: Low knowledge, even among caregivers of infants who were fully immunised, but positive attitudes regarding immunisation were found among caregivers in Tshwane sub-district 2. To attain the 95% immunisation coverage target, health care providers should identify caregivers with infants that are not fully immunised to understand what modifiable risk factors are associated with low immunisation coverage and ways to intervene.
Makgomo R Mphaka, Mpho Moshime, Carl Reddy