Research Article

Determinants of Full Immunization Coverage among Children Aged 12–23 Months in Rural Nigeria

Abstract

Background: Childhood immunization is one of the most effective interventions for preventing vaccine-preventable diseases and reducing childhood morbidity and mortality. However, incomplete vaccination remains a public health concern in Nigeria, particularly in rural communities. This study assessed immunization coverage and factors associated with full immunization among children aged 12 23 months in rural Nigeria. Method: An analytical cross-sectional study was conducted using secondary data from the 2024 Nigeria Demographic and Health Survey (NDHS). The analysis included 3,214 children aged 12–23 months residing in rural Nigeria. Full immunization was defined according to the study’s operational definition, while partially immunized and unimmunized children were classified as not fully immunized. Descriptive statistics and bivariate analyses were performed, followed by multivariable logistic regression. Adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported. Statistical significance was set at p< 0.05. Results: Of the children assessed, 952 (32.99%) were fully immunized, giving a prevalence of 32.99% (95% CI: 30.22–35.89). After adjustment, place of delivery, antenatal care (ANC) attendance, number of children living, and region of residence remained significantly associated with full immunization. Children delivered in health facilities had higher odds of full immunization (AOR=1.37; 95% CI: 1.05–1.79; p=0.021), while those whose mothers attended ANC had substantially higher odds (AOR=4.31; 95% CI: 3.16–5.89; p< 0.001). Having five or more children was also associated with higher odds (AOR=2.09; 95% CI: 1.38–3.16; p=0.001). Regional differences were observed, with higher odds in the North East (AOR=1.51; 95% CI: 1.08–2.12) and lower odds in the North West (AOR=0.61; 95% CI: 0.39–0.94). Conclusion: Full immunization coverage remained low among rural children, with important healthcare and regional differences. Strengthening maternal healthcare and routine immunization services is warranted.

Authors affiliation:

Boma Judith Fubara: Department of Public Health Sciences, College of Medical Sciences, Rivers State University, Port Harcourt, Rivers State, Nigeria.
Clement Kevin Edet: Department of Community Medicine, College of Medical Sciences, Rivers State University, Port Harcourt, Rivers State, Nigeria. 
Oluchi Mildred Ndudim (ORCID): Department of Public Health Sciences, College of Medical Sciences, Rivers State University, Port Harcourt, Rivers State, Nigeria. 
Salome Amarachi Ike-Wegbom (ORCID): Department of Public Health Sciences, College of Medical Sciences, Rivers State University, Port Harcourt, Rivers State, Nigeria.
Rose Ibifaka Blakk: Department of Public Health Sciences, College of Medical Sciences, Rivers State University, Port Harcourt, Rivers State, Nigeria.
Anthony Ike Wegbom (ORCID): Department of Public Health Sciences, College of Medical Sciences, Rivers State University, Port Harcourt, Rivers State, Nigeria.

How To Cite: B.J. Fubara, C.K. Edet, O.M. Ndudim, S.A. Ike-Wegbom, R.I. Blakk, and A.I. Wegbom. Determinants of Full Immunization Coverage among Children Aged 12–23 Months in Rural Nigeria. Healthcare Studies, 4(2):77–91, 2026. https://doi.org/10.58612/hs4211