Determinants of Spatial Accessibility to Childhood Vaccination Uptake in A Zero-Dose Risk Perspective

Abstract Childhood vaccination is one of the most effective public health strategies for lowering child morbidity and mortality. However, the persistence of poor access and zero-dose continues to pose health challenges in many parts of Nigeria. This study examined the spatial accessibility determinants of childhood vaccination uptake and zero-dose risk perspective in the Plateau Northern zone, Plateau State, Nigeria. A cross-sectional survey design was used. The study focused on women of childbearing age, 15-49 years, who had at least one child under the age of five. Taro Yamane's formula was used to select a sample size of 400 respondents. The study adopted a multistage random sampling technique, selecting sampling units sequentially at different stages to obtain a representative sample of the population, while data were collected through questionnaires and in-depth interviews. Descriptive statistics, Chi-square analysis, and binomial regression were employed for data analysis. The findings revealed that 82.0% of respondents had no vaccination centres within their communities, and 85.0% indicated that outreach teams did not visit their communities. Respondents who had difficulty reaching the vaccination site 68.5% reported long distance as a challenge. The Chi-square Test showed a significant relationship between childhood vaccination uptake and the number of vaccination centres (χ² = 64.83, p < 0.001), outreach visits (χ² = 13.16, p = 0.001), and difficulties in reaching vaccination sites (χ² = 12.19, p = 0.007). Binary logistic regression further showed that the availability of vaccination centres significantly affected uptake (p = 0.023, COR = 2.255, 95% CI: 1.121–4.536), ease of locating vaccination sites was highly significant (p < 0.000, COR = 2.579, 95% CI: 1.786–3.725), and difficult access routes to vaccination centres were also significant (p = 0.017, COR = 1.380, 95% CI: 1.060–1.798). The study showed that spatial accessibility factors have a considerable impact on childhood immunization rates in the Plateau North Senatorial District. It suggests enhancing the spatial distribution of vaccination centres, improving transportation infrastructure, increasing outreach visits, and providing clear directional signposts to increase equitable access to routine childhood vaccination services and reduce low vaccination uptake in the study area.