Abstract
Vaccination remains one of the most effective and cost-efficient public health interventions for preventing vaccine-preventable diseases and reducing childhood morbidity and mortality. However, vaccination coverage in the Democratic Republic of the Congo (DRC) remains below national and international targets, particularly in remote rural settings. This study aimed to identify the determinants of pentavalent vaccine coverage among children aged 12–59 months in the Katako-Kombe Health Zone, Sankuru Province, DRC. A community-based analytical cross-sectional study was conducted in the 17 health areas of the Katako-Kombe Health Zone. A stratified random sample of 425 households with children aged 12–59 months was selected. Data were collected using a structured questionnaire adapted from the World Health Organization (WHO) vaccination coverage survey tools. Vaccination status was verified using vaccination cards whenever available or through caregiver recall. Bivariate and multivariable logistic regression analyses were performed to identify factors independently associated with complete pentavalent vaccination (Penta3). Adjusted odds ratios (aORs) with 95% confidence intervals (95% CIs) were reported, and statistical significance was set at p < 0.05. Complete pentavalent vaccination coverage was 24%, while 34% of children had received the third dose (Penta3). Multivariable logistic regression showed that secondary education (aOR = 13.90; 95% CI: 5.75–36.50), university education (aOR = 5.02; 95% CI: 1.46–18.90), older parental age (aOR = 1.38; 95% CI: 1.23–1.58), and divorced marital status (aOR = 8.42; 95% CI: 1.44–58.41) were significantly associated with complete vaccination. Conversely, being a trader (aOR = 0.06; 95% CI: 0.02–0.18), being unemployed (aOR = 0.11; 95% CI: 0.04–0.29), and inadequate home visits by community health workers (aOR < 0.001) were associated with a lower likelihood of complete vaccination. Pentavalent vaccination coverage remains critically low in the Katako-Kombe Health Zone. Vaccination uptake is influenced by sociodemographic, socioeconomic, and health system factors. Strengthening community-based outreach strategies, improving caregiver education, enhancing home visits by community health workers, and addressing barriers to access are essential to improve vaccination coverage and promote equitable immunization services in rural areas.
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