نبذة مختصرة : Abstract Background Routine childhood vaccination (RCV) has demonstrated its effectiveness, saving millions of lives globally and reducing childhood mortality. However, several factors impede mothers from completing their children’s vaccination schedule. The purpose of this study was to determine factors influencing RCV among children aged 12–23 months in the Adansi South District (ASD) of Ghana. Methods A cross-sectional community-based survey with a census approach was conducted involving 3,312 mothers with children aged 12–23 months. Frequency and percentage, bivariate, and hierarchical binary logistic regression analyses were used to identify the factors related to RCV. Results The number of fully vaccinated children was 56.8% with partially vaccinated being 43.2%, indicating a low full RCV. The factors that influenced RCV included the child’s birth order (AOR = 0.653, [0.452-–0.945], p = 0.024), maternal religious affiliation (AOR = 1.315, [1.098–1.575], p = 0.003), Antenatal care (ANC) contacts (AOR = 2.045, [1.315–3.179], p = 0.001), number of times ANC contacted (AOR = 0.597, [0.502–0.710], p = 0.000), and child (AOR = 1.842, [1.566–2.166], p = 0.000) and mother’s age (AOR = 2.346, [1.369–4.019], p = 0.002). Maternal (AOR = 1.461, [1.143–1.866], p = 0.002) and spousal income adequacy (AOR = 1.590, [1.081–2.337], p = 0.018), spouse’s income irregularity (AOR = 2.292, [1.757–2.987], p = 0.000), and if spouse’s income is the sole source of livelihood (AOR = 1.751, [1.271–2.414], p = 0.001), type of material used for house construction (AOR = 1.459, [1.046–2.033], p = 0.026), and the type of housing for dwelling (AOR = 1.570, [1.310–1.881], p = 0.000), as well as mothers’ perception of vaccines, and vaccination activities (AOR = 1.333, [1.137–1.562], p = 0.000) influence RCV in the district. Conclusions The relatively low uptake of RCV is indicative of low herd immunity among these children and posing a potential risk of causing vaccine-preventable diseases (VPD) outbreaks and subsequent health issues among children. The Ghana Health Service should offer flexible scheduling and reminder systems for vaccination appointments in the district. The GHS should prioritise targeted interventions during child welfare clinics (CWC), ANC contacts, and community gatherings to educate mothers on the importance of childhood vaccinations.
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