Factors associated with tetanus toxoid vaccine utilization among reproductive-age women in Debre Markos town, Ethiopia, 2021: a cross-sectional study.

Background: The risk of neonatal tetanus infection will be reduced when the pregnant woman takes two doses of the maternal tetanus toxoid vaccine. In Ethiopia, however, low immunization coverage levels, mostly due to missed opportunities, are a concern. The study's main objective of the study was to assess tetanus toxoid immunization utilization coverage and associated factors among postnatal mothers in Debre Markos town, Ethiopia.

Materials and methods: A community-based cross-sectional study was conducted among 505 mothers who had given birth in the last 12 months. A two-stage stratified sampling technique was applied, and the The participants were selected using a systematic random sampling technique. Data were entered into EpiData manager version 4.6.0 and analyzed using Statistical Package for Social Science (SPSS) version 25 software. Bivariable and multivariable logistic regression analysis was performed. Adjusted odds ratios (AORs) at 95% CIs were used to identify factors associated with tetanus toxoid immunization utilization.

Results: The total tetanus vaccine intake (TT+2) doses were 71.2% (95% CI: 67.4-76.2). Mothers who attended primary school (AOR: 0.07, 95% CI: (0.01-0.6)), mothers whose husbands had secondary education (AOR: 0.26, 95% CI: (0.08-0.84)), mothers who attended 2-3 times antenatal care (ANC) visit (AOR: 0.05, 95% CI: (0.01-0.3)), good quality service (AOR: 2.8, 95% CI: (1.05-7.5)), appropriate behavior of health workers (AOR: 6.2, 95% CI: (2.2-18.7)), and who visited health extension workers (AOR: 7.6, 95% CI: (2.3-25.3)) were significantly associated with TT vaccine utilization.

Conclusion: Only three out of four pregnant women received the current TT vaccine during their previous pregnancy. The most influencing factors in TT vaccine utilization were the mother and her husband's low educational level, 2-3 times ANC visits during pregnancy, the standard of healthcare service, the healthcare provider's behavior, and the mother's visits with health extension staff.