Parental, Health System, and Environmental Factors Associated with Measles Immunization Coverage

Abstract

ABSTRACT

Background: Measles remains a vaccine-preventable disease with significant public health implications, yet immunization coverage in many settings continues to fall below global targets. Parental behavior, health service delivery, and the school environment may collectively influence the completeness of measles immunization among children. This study aimed to analyze parental, health system, and environmental factors associated with measles immunization coverage.

Methods: An analytical cross-sectional study was conducted among 120 parents of first-grade students participating in a school-based immunization program. The dependent variable was measles immunization coverage, classified as complete or incomplete based on immunization records. Independent variables included parental knowledge, attitudes, practices, and exposure to immunization-related information. Data were collected using structured questionnaires and secondary records. Bivariate analysis using the Chi-square test and multivariate logistic regression were performed to identify factors associated with immunization coverage.

Results: Measles immunization coverage was 56.7%, indicating that coverage had not yet reached the recommended target. Significant associations were found between complete immunization and parental knowledge (p = 0.001), attitudes (p = 0.003), practices (p = 0.010), and exposure to immunization information (p = 0.002). Children whose parents demonstrated good knowledge, positive attitudes, appropriate practices, and access to immunization information were more likely to receive complete measles immunization.

Conclusion: Measles immunization coverage is influenced by the interaction of parental behavior, health service support, and the information environment within school-based programs. Strengthening parental education, improving communication strategies, and enhancing collaboration between health services and schools are essential to improving immunization coverage and supporting effective measles prevention..