Vaccination is the most cost-effective, highest-impact health intervention to reduce the
morbidity and mortality of Vaccine Preventable Diseases (VPDs). Globally, it is estimated that
about 2 to 3 million mortalities occur annually due to VPDs with approximately 1.5 million
deaths among under-five children. Most of these deaths due to VPDs occur in developing
countries. The complete vaccination coverage in Kenya in 2014 was 71%; a decline from 77%
in 2008 with huge inequality in pastoral dominated counties. Despite success in Kenya
implementing the Expanded Program on Immunization (EPI), VPDs remain prevalent in
pastoralist communities. Pastoralism was defined as raising any livestock other than fowl;
nomadism was defined by seasonal movement of animals for grazing. The objective of the
study was to determine the vaccination coverage and its associated factors among pastoralists
in Lagdera Sub-county of Garissa County.
A cross-sectional survey was conducted in February 2015, which utilized a cluster survey
methodology to randomly select 25 clusters based on Probability Proportional to Size (PPS)
sampling for settled pastoralist and 25 clusters in nomadic pastoralist using simple random
sampling. Twelve mothers were selected for interview per cluster. The study used a structured
instrument to survey pastoralist mothers with children aged 0–59 months old. For every eligible
mother, vaccination data were collected by record or recall for all her children under five years.
Mobile devices (Tablets) programmed with Open Data Kit (ODK) software was used to collect
and transmit data to an online server. Data was downloaded and then analysed using Statistical
Package for Social Science (SPSS) version 22.0 while the level of significance was set at p <
0.05. Ordinal logistic regression analysis was used to identify independent predictors of
complete vaccination.
A total of 476 eligible mothers were interviewed with 725 children; 241 mothers (50.6%)
belonged to nomadic Households (HHs) while 235 (49.4%) belonged to settled HHs. Forty
percent of nomadic mothers stated that vaccination was “very important” compared to 87.2%
of mothers from settled HHs. Nearly 60% of mothers from nomadic HHs had never vaccinated
their children in comparison to 7.2% of mothers from settled pastoralist. The main reason for
non-vaccination among mothers from nomadic HHs was “hospital or clinic was too far away”
(78.6%). Ordinal logistic regression revealed the following factors as independent predictors of
vaccination coverage in both groups: purpose of vaccination (settled, P=0.001; nomadic,
P<0.0001), importance of vaccination (P<0.0001), age of first vaccination (settled, P=0.015;
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nomadic, P<0.0001), safety of vaccines (P<0.0001), communication indicators like radio
ownership (settled, P=0.02; nomadic, P<0.011) and euclidean distance to health facility
(P=0.018).
In conclusion, nomadic pastoralist exhibited very low vaccination coverage than their settled
counterpart. Improvements in vaccination service delivery, stronger involvement of the
nomadic communities and special outreach services for this population are required to improve
vaccination rates in these remote areas of Kenya.