WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

*Mariya Salih Jaloo, Dr. Anmar B. Al-Dewachi

ABSTRACT

Background: Immunization remains the most effective and cost-effective public health tool against vaccine-preventable diseases in children, yet regional disparities in coverage persist worldwide because of funding gaps and health-system weaknesses. Aim: To assess the barriers to routine immunizations among children under six years of age in Mosul city. Methods: A cross-sectional study was conducted on 500 caregivers of children under six years, selected by convenience sampling from six primary healthcare centers in Mosul city between February and July 2025. Barriers were grouped into three domains—child-level, individual-level, and healthcare-system-level—and data were collected by direct interview after oral and written consent. Results: The study showed that caregivers over 50 years old were more likely to have children who weren't fully vaccinated compared to those with fully vaccinated children. Higher education among caregivers acted as a shield, reducing the chances of incomplete immunization, while those with only primary schooling faced greater risks. Employed caregivers showed better outcomes in ensuring full vaccination for their children, whereas unemployment heightened the likelihood of gaps in immunization. Children aged 12 to 17 months were particularly prone to incomplete vaccination (OR 2.07, 95% CI 1.15–3.75, P=0.015). Additionally, barriers related to the child itself significantly raised the risk of not being fully vaccinated (OR 2.07, 95% CI 1.15–3.75, P=0.015), with distance to healthcare facilities emerging as the top system-level obstacle, impacting nearly half of those affected. Conclusion: Recombinant growth hormone therapy was most effective in children with GHD, with modest benefits in ISS and limited effects in TS, emphasizing the need for early diagnosis and individualized treatment.

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