Determinants and Barriers to the Actual Timing of Early Neonatal Immunization Services After Delivery Among Mothers in Kuje, Abuja

Abstract

Introduction: Despite global initiatives such as the Expanded Programme on Immunization (EPI), sub-Saharan Africa continues to experience substantial gaps in routine immunization coverage. Nigeria’s Federal Capital Territory (FCT), including Kuje Area Council, demonstrates persistent inequalities in the timeliness of early neonatal immunization. This study investigates the determinants and barriers to the actual timing of early neonatal immunization services after delivery among mothers in Kuje, Abuja.

Methodology: This study employed a descriptive cross-sectional design and was conducted at Kuje General Hospital, Abuja, Nigeria, a peri-urban setting. The study population comprised 217 mothers with children aged 0–23 months who were accessing neonatal care at the hospital.

Results: The study revealed that mothers whose spouses were in formal employment were 3.13 times more likely to have good knowledge of early neonatal immunization than those whose spouses were not. Joint household decision-making also showed a significant positive influence on maternal knowledge. However, only 46.5% of newborns received their first vaccine dose within 24 hours of delivery, reflecting suboptimal timeliness. The major barriers to timely immunization included: inadequate information provided at discharge (54.4%), long waiting times at clinics (34.6%), inconvenient clinic schedules (82.5%). These findings demonstrate that health-system constraints and poor communication remain major contributors to delayed immunization despite moderate maternal awareness.

Conclusion: The study revealed that the key determinants of maternal knowledge on early neonatal immunization in Kuje were the spouse’s occupation and joint decision-making on child health. Mothers whose spouses were in formal employment were 3.13 times more likely to have good knowledge of early neonatal immunization than those whose spouses were not, while shared household decision-making significantly enhanced awareness. However, several barriers continue to hinder the timely uptake of immunization services. The most notable include inadequate information provided at discharge (54.4%), long waiting times (34.6%), and inconvenient clinic schedules (82.5%). These systemic and service-related factors, rather than maternal unwillingness, largely account for the missed opportunities observed in the area. Consequently, the timeliness of early neonatal immunization remains suboptimal, with less than half (46.5%) of newborns receiving their first vaccine dose within 24 hours after delivery. The determinants and barriers identified in this study highlight the need for targeted interventions that combine male partner engagement, effective health worker communication, and improved service delivery systems. Strengthening these areas is essential for achieving timely vaccine administration, reducing missed opportunities, and improving neonatal health outcomes in Kuje and similar peri-urban communities across Nigeria.