Determinants of measles vaccination dropout among 12 - 23 months aged children in pastoralist community of Afar, Ethiopia.

Background: Measles is a viral disease and a leading vaccine-preventable childhood killer. More than 95% of measles deaths occur in countries with low incomes and weak health infrastructures. In response to this, Ethiopia prepared a measles elimination strategic plan to achieve by 2020. However, based on the Mini-Ethiopian demographic health survey 2019 the full coverage of immunization is 43% at the country level and it is lowest (20%) in the Afar region where this study was conducted. Therefore, this study aimed to identify the determinants of the measles vaccine dropout rate in Afar regional state which is one of the pastoralist communities in Ethiopia.

Methods: Community based unmatched case-control study design was used. The study was conducted in Awash district of Afar regional state, Ethiopia from June 1st -30th 2018. Data were collected from a study unit of 12-23 months old children. For this study, a sample of 166 cases and 331controls were selected by simple random sampling methods and the total sample size was 497. Data were collected using a pretested structured questionnaire by health workers using the local language. Data were entered into Epi-info - 7 and analyzed by SPSS version 20 software and logistic regression was used to assess the determinants measles dropout rate.

Results: A total of 487 children participated in this study with a response rate of 97.9%. More than half of the children were female (53.3%) and 113 (35.2%) children mothers' were not attended formal education. Mother who had antenatal care ≤ 2 visits [AOR:=5.7(3.2-10.14)], being in the birth order of 1 - 3 [AOR = 4.47(1.63-12.29)], long waiting time > 60 min at nearby health facility for vaccine [AOR = 2.37(1.36-4.15)], households visit by health extension workers [AOR = 2.03(1.12-3.66)], pregnant women not participating with women development army [AOR = 3.5(1.94-6.18)], and poor maternal knowledge on vaccination [AOR = 3.30(1.9-5.73)] were significant determinants with measles vaccination dropout rate.

Conclusions: Health facility and mother characteristics were the determinants of the measles vaccine dropout rate. Therefore, tracing and strict follow up by the health extension works using home visits and women development army at the pastoralist community is necessary to reach them.