Factors affecting age-appropriate timeliness of measles vaccination among children aged 9 to 59 months in Rehoboth urban, Hardap region, Namibia
| dc.contributor.advisor | Shilunga, Anna | |
| dc.contributor.author | Burger, Gertruida Fransina | |
| dc.date.accessioned | 2026-03-24T14:04:26Z | |
| dc.date.available | 2026-03-24T14:04:26Z | |
| dc.date.issued | 2025 | |
| dc.description | A thesis submitted in fulfilment of the requirements for the degree of masters of science in applied field epidemiology/ laboratory management | |
| dc.description.abstract | Measles remains a significant public health concern among children, particularly in low- and middle-income countries, where high vaccination coverage may mask delays in vaccine administration. This study aimed to assess the timeliness and determinants of measles-containing vaccine (MR) administration among children aged 9–59 months in Rehoboth Urban, Namibia. A convergent parallel mixed-methods design was employed to provide a comprehensive understanding of the issue. In the quantitative phase, an intervieweradministered questionnaire was used to collect data from caregivers on vaccine timeliness and associated factors. Quantitative data were analyzed using SPSS v.26, with Kaplan-Meier survival analysis, Fisher's exact test, Mann-Whitney U test, and logistic regression. Statistical significance was set at p<0.05, with a 95% confidence interval. In the qualitative phase, key informant interviews were conducted with healthcare workers, and data were analyzed thematically using Atlas.ti version 24. The study revealed high measles vaccination coverage - 99.1% for MR1 and 88.6% for MR2. However, timely administration was suboptimal, with only 69.9% of children receiving MR1 and 31.3% receiving MR2 within the recommended age window. Multivariate analysis identified several significant predictors of delayed vaccination, including being aged 13–24 months (AOR = 4.54; 95% CI: 1.80–11.44; p = 0.001) and residing in blocks B (AOR = 3.85; 95% CI: 1.42–10.42; p = 0.008) and D (AOR = 5.07; 95% CI: 1.49–17.28; p = 0.009). Qualitative findings highlighted key barriers such as long waiting times at health facilities, caregiver forgetfulness, child illness at the time of scheduled vaccination, and geographic inaccessibility. ii These findings underscore a critical gap between vaccination coverage and timeliness. Delayed administration of MR vaccines compromises herd immunity and heightens the risk of measles outbreaks. To address these challenges, the study recommends the implementation of electronic or manual reminder systems, community-based outreach services, and continuous caregiver education to promote timely vaccination and strengthen routine immunization performance | |
| dc.identifier.uri | http://hdl.handle.net/11070/4231 | |
| dc.language.iso | en | |
| dc.publisher | University of Namibia | |
| dc.subject | Measles vaccination | |
| dc.subject | Vaccine timeliness | |
| dc.subject | Immunization coverage | |
| dc.subject | Caregivers | |
| dc.subject | Healthcare workers | |
| dc.subject | Namibia | |
| dc.subject | University of Namibia | |
| dc.title | Factors affecting age-appropriate timeliness of measles vaccination among children aged 9 to 59 months in Rehoboth urban, Hardap region, Namibia | |
| dc.type | Thesis |