Barriers to reaching the Zero-Dose and Under Immunized Children in Uganda: a qualitative rapid assessment
Bibliographic record
Abstract
ABSTRACT Background Despite great strides made in improving immunization coverage in Uganda, the burden of under-immunized (UI) and zero-dose (ZD) children remains high, increasing the risk of Vaccine Preventable Disease outbreaks. This study explored the barriers to reaching ZD and UI children in selected high-burden communities in Uganda. Methods This cross sectional qualitative rapid assessment study was conducted in three high-burden districts—Kasese, Mubende, and Wakiso in Uganda The study received ethical approval, and all participants were consented before interview. Data were collected through key informant interviews with local leaders, district health team members, health workers and village health team members, as well as in-depth interviews with caregivers of children aged 18 weeks to 23 months. The collected data were analyzed thematically with the aid of NVIVO 14 (QSR International). Results are presented in themes and subthemes and supported by verbatim quotations where necessary. Results The study identified a range of demand and supply-side barriers hindering access to immunization for ZD and UI children in Uganda. These barriers are reported under seven themes namely: limited physical access to immunization services; inadequate client-centered immunization services (Long waiting time at health facilities, poor health worker attitudes, immunization-related costs); vaccine stockouts; fear of adverse events following Immunization; limited spousal support; myths and misconceptions related to immunization; and persistent home-based births or deliveries. Conclusion Understanding the barriers to immunization uptake among zero-dose and under-immunized children is a critical foundation for strengthening vaccination coverage and reducing the incidence of VPDs in Uganda. This rapid assessment conducted in Kasese, Mubende, and Wakiso districts highlights both demand and supply side challenges that hinder access and utilization of immunization services. Addressing these barriers requires coordinated, multi-sectoral approaches that are both comprehensive and contextually grounded.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.008 | 0.008 |
| Scholarly communication | 0.003 | 0.004 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".