Dickson Shey Nsagha^1,, Eunice Kisifen Tatah¹, Alfred Kongnyu Njamnshi², Martyn Sama¹, Vincent Siysi Verla³, Obinchemti Thomas Egbe⁴, William Tantoh Farnyu⁵

Background: Immunization remains one of the most important public health interventions and cost-effective strategies to reduce child mortality and morbidity. In Cameroon, five confirmed cases of the wild polio species were reported in 2014 with one case from the North-West Region. Thus the complete eradication of poliomyelitis remains a major public health concern especially in areas where coverage, knowledge and perceptions about vaccination is low. This study assessed health determinants of caregivers on vaccination activities in the polio eradication process in the Kumbo-East and Nkambe Health Districts. Methods: This was a community-based cross-sectional study. A two-stage cluster sampling method was used to select participants from the study area. Fifteen (68.2%) health areas studied were randomly selected from Kumbo-East and Nkambe Health Districts. Within the health areas (based on probability proportionate to size method), households were randomly selected. Caregivers (15 to 70 years) of children between the ages of 0-59 months who signed a consent form and whose assents were obtained were administered a structured questionnaire through an interview. The questionnaires collected information on knowledge and practices from 1544 caregivers residing in 30 health areas, randomly selected from the Kumbo-East and Nkambe Health Districts. Ethical approval and administrative clearance were obtained for this study. Data was analyzed using stata 13. Descriptive and binary logistic regression was used to analyze the data. A P-value of < 0.05 was set to indicate statistical significance and a 95% confidence interval was considered. Results: The proportion of caregivers with a good knowledge and practices on vaccination activities in the polio eradication process were 53.0%, 49.2% and 74.2% respectively. Independent predictors of good knowledge were being 37 years or older (AOR = 1.3; 95% CI: 1.01 – 2.68) and having an educational level above primary (AOR = 6.42; 95% CI: 3.16 – 13.25). Independent predictors of good practices were being older (≥ 37 years) (AOR = 3.88; 95%CI: 1.44-10.43), being married (AOR = 2.15; 95%CI: 1.34-3.52), having an educational level above primary (AOR = 5.97; 95%CI: 1.69-21.48), antenatal care follow-up (AOR = 7.19; 95%CI: 2.25-22.5), residing less than 5km away from the vaccination site (AOR = 2.01; 95%CI: 1.05 - 4.97), having sufficient knowledge on vaccination (AOR = 3.78; 95%CI: 2.05-6.54) and having positive practices on vaccination (AOR = 2.15; 95%CI: 1.26-3.71). Conclusion: The knowledge and practices of caregivers on vaccination activities in the polio eradication process were not good. Many caregivers and health system-related factors still hinder caregivers from having good knowledge and practices on vaccination activities in the polio eradication process. Our results could help health planners to improve on the perception and coverage rates of immunization services.

caregivers, knowledge, attitudes, practices, predictors, polio vaccination, eradication