Immunisation has been an important strategy
for disease prevention globally. Despite
proven successes in other settings, child
immunisation has continued to be problematic
in developing countries including Nigeria. In
addressing the problems, policy in Nigeria is
largely directed at overcoming socio cultural
issues surrounding parents’ rejection of vaccines.
However, determinants of immunisation
have geographical implications as well. A cross
sectional survey was used to select 484 mothers/caregivers
through a multi stage cluster
sampling technique from the three senatorial
districts of Borno State, Nigeria. Mothers or
caregivers of children 12–23 months were
interviewed using a structured questionnaire
adapted from the Nigeria Demographic and
Health Survey (2008). Socio cultural factors
measured include mother’s education, religion,
husband’s permission and sex of child
while spatial variables include location i.e.
whether rural or urban, and distance measured
in terms of physical distance, cost and
perception of physical distance. Descriptive
statistics, univariate and multivariate logistic
regressions were used to analyse the results.
Data indicate that only 10.5% of children were
fully immunised. Though immunisation
uptake differed between the senatorial districts,
this was not significant (P=0.1). In the
bivariate analysis, mothers living in urban
areas, <1 km to immunisation centre, their
perception of travel distance and travel cost
were the spatial predictors of immunisation
while literacy and husband’s permission were
the socio-cultural factors of significance.
However, in the multivariate regression only
two geographical factors i.e. living in an urban
area [odds ratio (OR) 3.42, confidence interval
(CI) 1.40–8.33] and mothers’ perception of
distance (OR 4.52, CI 2.14–9.55) were protective
against under immunisation while mother’s
education was the only socio cultural variable
of significance (OR 0.10, CI 0.03–0.41). It
was concluded that while it is important to
address socio cultural issues, policies directed
at overcoming the friction of distance especially
mobile clinics in rural areas are required to
significantly improve immunisation uptake in
the state.