Comparison of vaccination status of children born in health units and those born at home.

BACKGROUND The Expanded Programme of Immunisation schedule starts at birth, yet a significant number of child births in Uganda occur at home, where there are no vaccines. A child born at home may therefore have less chances of being vaccinated than a child born in a health unit. OBJECTIVES To investigate vaccination status of the under-fives and to establish whether vaccination status of children born in health units is better than those born at home. DESIGN Cross-sectional descriptive. SETTING Paediatrics out-patient clinic of Jinja Hospital, a regional referral health facility in Eastern Uganda. METHODS Children under five years were enrolled consecutively as they arrived at the registration desk. The child health card and physical examination for BCG scar were used to establish the vaccination status of each child. A structured questionnaire was used for collecting relevant data. RESULTS Of the 486 children sampled, 79 had been born at home, and 407 had been born in health units. Overall, 68% of the children were fully vaccinated for age. A child born in a health unit was significantly more likely to have a BCG scar (p = 0.0087), and to be up to date with their vaccination (p = 0.0173), compared to a child born at home. Vaccine drop-out rate was similarly high irrespective of whether the children were born at home or in health units. CONCLUSION Being born at home was found to be a risk factor for incomplete or non-vaccination. Continuation of vaccination was similarly poor in children born at home and those born in health units.