Socio-demographic characteristics of a women or caregivers in southwest Ethiopia
The average age of the respondents were 37.5+SD of 2.5 years with a range of 15 to 45 years and the average number of children per household was 3.5 with SD of 1.2
Regarding occupation, more than 85% of a caregiver were housewife, and Majority of the respondents 1116 (85.8%) were married whereas the remaining 14.2% were widowed, divorced, and single 0. (Table-1)
Place of delivery and utilization of health service among the women having children aged 10-23 month during Covid 19
Among the respondents about 753(57.9%) of them were explain that other health service care like immunization, family planning, labor, and delivery, as well other medical cares were given together with the care COVID 19 or they do not understand the separation care of COVID19 and other health services. Near half of the respondents, 450(34.6%) regretted visiting the health facility for the fear of COVID 19 transmission by the health professionals (Figure-1).
Health facility and obstetric characteristics of the respondents in South West 2020
Most of the caregivers 953(73.3%) spent time/ waiting after coming to the health facility was less than 10 minutes, The remaining 24%,1.2%, and 1.5% were 10 to 15,15 to 30 and greater than a 30-minute wait for getting immunization respectively (Figure-2).
More than 88% of the participants/ caregiver take their child to the health facility when their child was being sick but about 8% and 2% of the caregiver take their child to a traditional place and treat at home respectively (Figure-3).
Among the participants, only 905 (69.9%) had antenatal care during their pregnancy, the reaming 395(30.4%) were giving birth without antenatal care (Figure-4).
Immunization status of children aged from 10 to 23 months in southwest Ethiopia 2020
The prevalence of incomplete immunization was found to be 809(62.2%) (95% CI: 59.5, 64.8).of the total respondents1110 (85.4%) of them took both BCG and OPV vaccine, from 1110 BCG started children only 798 (71.8%) of the children complete their immunization. Of the total 1300 children, 190 (14.6%) of them were not taking any vaccine at all. Overall 1088(83.7%) of them received both PCV one and Penta one, 1082(83.2%) received rota1 and 798 (61.4%) received measles vaccine. The coverage rate was a decline for the consecutive dose, such as OPV zero (85.4%) to OPV three (73.7%), both Penta and PCV one (83.7%) to Penta and PCV three (71.9%).
Dropout rate: the overall dropout rate of immunization in the zone was BCG to measles, and the dropout rate of each subsequent vaccine was 13.6% for OPV0 to OPV3, 12.2% for PCV1 to PCV3 and 14% for pena1 to penta3 for more detail see on( Figure-5, Figure-6 and figure-7)
In-depth/detail interview finding
Them 1:fear of COVID 19 transmission during transportation to a health facility.
The rural mother of the child complains that during the transportation to the health facility we are asked to wear a face mask without the access of a face mask in the nearby area (20,34, 36, 40, years old rural mothers). Even if we wear a face mask we do not trust that will protect our child from COVID 19 and ourselves (26 and 32 years old mothers). As we hear that the virus stays everywhere such as on clothes, metal, and different surfaces, we fear the surface of the bus for contaminated with COVID 19 (35.37, 40 and 46 years old fathers of the children).
Fear of screening by temperature regardless of other cause of raising the temperature and took us to quartile and Isolation areas without evidence of COVID 19 and doubling up of transportation fee because of COVID 19 (30, 42, 45. And 47 years old priests).
Theme 2:challenges in the health facility and COVID 19 transmission
Considering the health professions as a career of COVID 19 and the may transmit these COVID 19 to our children during immunization (27, 32, 35, 43 years old priests). We understand that the immunization service of the children was given together with the care of COVID 19 in the health facility, so we assume there was a high transmission of COVID 19 during getting the service and as the come up time at the health institution was too long to get the service, person to person transmission is very high at a health facility (this is the idea of all mother of the children). During waiting time at the health facility we fear individual-to-individual transmission of COVID 19 because the waiting area in the health facility was very condensed and not ventilated (30, 29, 34, and 41 years old father of the children).
Factors associated with immunization status of Children Aged 10-23 Months during COVID 19.
Bivariate logistic regression analysis shows that waiting time, educational status, delivery place, considering COVID 19 and other service is given at the same unit, fear of COVID 19 from health profession and means of transportation were all significantly accompanying with incomplete immunization at p-value 0.05. From all variables on marital status was not significantly associated. However, on multivariable analysis except for marital status and means transportation, all the variables were identified as independently significant associated factors with incomplete immunization.
The women waiting time more than 30 minutes at a health facility for immunization were 96% more likely to have incomplete immunization than waiting less than 30 minutes (AOR=04, 95%CI .0001,.004). The odd of incomplete immunization of the children was 2.34 times higher in the women who deliver at home than deliver at a health facility (AOR =2.336, 95%CI 4.96, 6.089). The child who was born from women who cannot read and write were 5.08 times incompletely immunized than the child born from educated women( diploma, degree, and above) ( AOR=5.08,95% CI 2.31,11.14). The women who cannot understand the separation care of CIOVID 19 and other health service had 3.62 times incompletely immunized child than who understand the separation care of COVID 19 and another health service (AOR=3.62,95%CI 1.72,7.64). The odd of incomplete immunization of a child for the women who fear health professions as a source of COVID 19 was 2.85 times higher than did not fear the health profession (AOR=2.85,95%CI 1.38,5.9) (Table-2)