Missed opportunities for immunization among children attending a Paediatric Outpatient Clinic at Juba Teaching Hospital

Background: Immunization prevents child morbidity and mortality through the universal access to routinely recommended childhood vaccines. Objectives: To determine the prevalence and factors associated with missed opportunities for immunization (MOI). Method: An out-patient paediatric clinic-based study conducted in May - June 2012 using the standard World Health Organization (WHO), Expanded Programme on Immunization (EPI) protocol for assessing MOI. The study involved client exit interviews with caregivers of children aged less than 2 years, reviews of immunization cards and parental recall of immunization history, and interviews with health workers. Results: Data were collected on 448 children aged 0-23 months and from 18 health workers. The prevalence of MOI was most common among children older than 12 months. As the age of administration of the vaccine increased so did the number of MOI. MOI were more common for DPT3 (22.1%) OPV3 (24.4%), and measles (31.2%) compared to other vaccines. Factors associated with MOI included home births, inadequate antenatal care, lack of information, and, among health workers, poor knowledge of immunization schedules and contraindications. Conclusion: The high prevalence of MOI could be reduced by defaulter tracing, encouraging antenatal visits and hospital deliveries, and education of caregivers and health workers. Keywords: Immunization, missed opportunities, young children, South Sudan