The Effect of War on Expaned Program on Immunization in North East Ethiopia, 2022

Abstract Background Population affected by war experience severe public health consequences like displacement, food scarcity, collapse of infrastructure and basic health services. Furthermore, war greatly hinders health programs to be implemented by governmental and non-governmental organizations. One of the programs which face great challenge is the expanded program of immunization which has become crucial due to the emergence of different communicable diseases. Objective To assess the dropout rate of immunization after the war, identify associated factors for the dropout and explore the reasons behind for the dropout among under two children in North Wollo zone, Northeast Ethiopia 2022. Method A cross-sectional study mixed with phenomenological study design was utilized and the study was conducted in North Wollo zone, Northeast Ethiopia from April to June 2022. Results A total of 449 mothers with their children were included in the final analysis which made a response rate of 97%. Only half (50.3%) of the mothers heard about catch-up vaccine. Lost family member due to the war triples the risk of drop out of immunization (AOR: 3.11, 95%CI: 1.63, 5.93) and mothers who never heard about catch-up vaccine are two times more likely to drop out of immunization (AOR: 2.18, 95% CI: 1.39, 3.43). Conclusions The dropout rate from immunization is above the WHO cut point. Place of childbirth, hearing about catch-up vaccine, residence, length of the war in the area, and loss of family member due to war were predictors of drop out of immunization.