Abstract

This study investigated the factors influencing the utilization of immunization services among children under 5
years in Lira Municipality, Lira district, Northern Uganda. Utilizing a community-based cross-sectional design with
quantitative data collection methods, 380 mother-infant pairs were randomly selected from residents of Lira
Municipality. Univariate, bivariate, and multivariate logistic regression analyses were conducted using STATA
software version 14.0 to identify significant factors affecting immunization service utilization. The study found that
77.63% (295/380) of children under 5 years utilized immunization services, with the highest utilization observed
among male children (82.71%). Factors significantly influencing utilization included mothers' education level (aOR
7.46, 95%CI 2.17 – 25.65, P=0.001), religion (Muslims vs. Christians: aOR 0.15, 95%CI 0.07 – 0.32, P<0.001),
rudeness of health workers (aOR 3.50, 95%CI 1.73 – 7.06, P<0.001), awareness of subsequent immunization
schedules (aOR 0.38, 95%CI 0.20 – 0.70, P=0.002), possession of a child immunization card (aOR 0.34, 95%CI 0.19
– 0.63, P=0.001), and understaffing at health facilities (aOR 2.87, 95%CI 1.43 – 5.78, P=0.003). The study highlights
the importance of addressing these factors to improve immunization coverage, which currently falls below the global
target recommended by WHO and UNICEF.
Keywords: Immunization services, Children, Under-Vaccinated, Unvaccinated, Mothers, No versus Yes.