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Barriers to and Facilitators of Childhood Immunization in Central Ethiopia Region: A Qualitative Study

Year: 2026

Type: article

Abstract: Background: Childhood vaccination remains one of the most successful and cost-effective public health interventions, preventing millions of illnesses and deaths each year. Ethiopia is one of the countries with a high number of zero-dose children and under-immunization. However, there is limited evidence about the barriers to and facilitators of immunization. Therefore, this study aimed to explore the barriers and facilitators of immunization in central Ethiopian region. Methods: An exploratory qualitative study was employed to collect data from October 15, 2025, to December 14, 2025. A total of 109 participants were involved in the qualitative study. We employed a purposive sampling method to select study participants. Data were collected through focus group discussions (FGDs), in-depth interviews (IDIs), and key informant interviews (KIIs) guided by a semi-structured topic guide. Data were analyzed using thematic analysis approach. Results: Three themes emerged from the data. The themes included awareness of child immunization and facilitators and barriers of child immunization. Positive attitude and beliefs toward immunization, family and social support, and mothers'/caregivers' motivation and responsibility were found to be the facilitators of immunization, whereas fear and misconceptions related to vaccines, lack of awareness and misinformation, health-system and access barriers, and competing priorities and workload were mentioned as the barriers to immunization. Conclusions: This study highlights that childhood immunization uptake in central Ethiopia is shaped by a complex interaction of individual, social, and health-system factors. Positive maternal attitudes and beliefs, strong family and community support, and caregivers' sense of responsibility emerged as key facilitators of immunization. In contrast, fear and misconceptions about vaccines, inadequate awareness and misinformation, health-system and access constraints, and competing household responsibilities were major barriers. Interventions that strengthen community awareness, counter misinformation, enhance family and social support, and improve the accessibility and responsiveness of immunization services are helpful to improve the immunization uptake.

Source: Public Health Challenges

DOI: 10.1002/puh2.70456