Drivers of childhood immunization coverage disparities within the district health system boundaries: the case of Tabora municipal and Meru district council

While significant progress in immunization coverage in all countries has been attained under WHO’s expanded Program on Immunization, globally around 19.4 million infants have failed to be immunized in 2015. There is limited understanding of why routine immunization (RI) coverage improves in some settings in Africa and not in others. The general objective of this study is to examine drivers of disparities of childhood immunization coverage within district-health-system boundaries in health facilities by comparing Tabora municipal and Meru district council. This study employed mixed design where cross-sectional and case study designs were used. Bivariate correlation, descriptive analysis and cross tabulation were employed in data analysis. The study findings show that, the immunization coverage in Meru district councils is higher than in Tabora municipal council. The study has found that immunization coverage is statistically significance and correlated by, stock outs of vaccines, HCW training, practice of outreach services strategy and charging user fee on vaccines. The study findings conclude that, stock out of data collection tools has reverse effect in immunization coverage. The study findings show that disparities in immunization rate is significantly influenced by caregiver religion on education. This study finding suggest that religion and education has multiplier effect in other related drivers. The study recommend strengthening of vaccine supply and distribution to ensure constant availability of vaccines at point of care to reduce stock out and resulting impact of low immunization coverage. Investing in health work force trainings, customers’ care and patients’ provider privacy management is highly recommended.