Factors associated with delayed or non-vaccination among children aged 0–23 months in a rural health district in Guinea: A mixed-methods cross-sectional study

Introduction: Vaccination is a major public health investment and plays an essential role in reducing mortality. This study aimed to explore the factors contributing to delayed or non-vaccination of children aged 0-23 months in the Tougue health district in Guinea. Methods: This mixed-methods, cross-sectional study collected data on vaccination of children aged 0 to 23 months from mothers/caregivers, community and religious leaders, fathers of children, and vaccinators, and observed child vaccination sessions. A questionnaire, interview guides and an observation grid were used. Logistic regression analysis was performed and adjusted odds ratios (aORs) and their 95% confidence intervals (CIs) were reported. The significance level was set at p < 0.05. Results: The proportion of children aged 0-23 months who were delayed or unvaccinated was 46.7% (95% CI: 41.8-51.7). Mothers/caregivers who could not read or write (aOR = 1.78; 95% CI: 1.05-3.01), children aged 12-23 months (aOR = 1.93; 95% CI: 1.23-3.03), mothers/caregivers with a low knowledge of vaccination (aOR = 2.13; 95% CI: 1.34-3.40), mothers/caregivers who had not received vaccination advice from health workers (aOR = 1.64; 95% CI: 1.05-2.57) and those who their peers did not influence (aOR = 2.76; 95% CI: 1.64-4.63) were the factors associated with delayed or non-vaccination of children. Conclusion: This study shows that around half of all children are delayed or unvaccinated. Targeted interventions on these key factors could improve the quality of immunization service provision.