A Review of Determinants of Low Measles Immunization and FeasibleInterventions to Increase Uptake among Children Aged 9-59 months inthe Lawra District, Ghana

Vaccine preventable diseases contribute to about 20% of all under-five deaths globally. Annually, about 10% of un-immunized children die of measles globally. Developing countries continue to experience frequent Measles outbreaks despite numerous preventive measures. Measles is one of the vaccine preventable diseases targeted by the World Health Organization for elimination by 2020. Measles remains the top killer among children in SubSaharan Africa despite global progress to eliminate the disease through vaccination. Even though there is a vaccine against this disease, most countries still report low measles immunization coverages. The main aim of this review is to analyse the determinants of low measles uptake in Lawra district and recommend appropriate measures to solve this problem. An in-depth review was conducted using literature, both peer-reviewed and grey literature from 2000. The literature was retrieved from databases (PubMed, Global health, Popline) and also through the Google scholar search engine. A conceptual framework was adapted to guide the analysis of the factors affecting measles immunization coverage in Lawra district. Inadequate data from the district for comparison was a major limitation and thus further research is recommended. Out of the ninety five studies (95) that met the inclusion criteria, 85 (89%) were peer reviewed. The main factors influencing low measles immunization coverage in Lawra include the quality of immunization services, attitude of health workers, inaccessibility to services and the social class of the caregivers. Feasible intervention strategies recommended include mass media, home visits, effective supervision and partnership between the health system and the communities.