Socio-Cultural Barriers Of Routine Immunisation Uptake: Perspectives Of Health Workers And Mothers In Clinics Within Ebonyi State, Nigeria

Abstract

Routine immunisation is an essential public health intervention for reducing childhood morbidity and mortality. However, uptake remains suboptimal in Ebonyi State, Nigeria. Understanding the barriers from both mothers’ and health workers’ perspectives is essential for designing context-specific interventions. This study explored socio-cultural barriers to routine immunisation uptake in selected clinics within Ebonyi State. A parallel convergent mixed-method design was employed. The qualitative part involved 30 purposively selected participants (15 nursing mothers, 15 vaccinators) using interviews to explore perceived barriers. The quantitative part included 912 respondents selected, but 2 fell off the study. The respondents were selected via cluster random sampling, and a structured questionnaire was used to assess socio-cultural determinants. Data were analysed thematically for qualitative insights and descriptively for quantitative findings. Twelve key themes emerged as barriers, including ignorance and misinformation, belief in traditional and spiritual remedies, male dominance in decision-making, financial constraints, poor health worker attitudes, religious misconceptions, and competing cultural priorities, among others. Quantitative findings corroborated these observations, revealing that community norms, gender dynamics, and economic limitations significantly influenced mothers’ decisions to access immunisation services. In conclusion, routine immunisation uptake is hindered by multifaceted socio-cultural barriers. Addressing these barriers requires community-based education, engagement with traditional and religious leaders, gender-sensitive interventions, and improvements in healthcare service delivery.