Factors Associated with Incomplete Childhood Immunisation among Children Attending Maternal and Child Health Clinics in Narok County: A Systematic Review
Liban Bagajo Bilala *
Department of Clinical Medicine, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
Ali Said Zeid
Department of Clinical Medicine, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
James Ngari Maina
Department of Clinical Medicine, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
Muhajj Khalifa Muhaji
Department of Clinical Medicine, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
Oduor Jacob Otieno
Department of Clinical Medicine, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
Boen Kelvin Kipkorir
Department of Clinical Medicine, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
Kulei Alex Kipkosgei
Department of Clinical Medicine, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
Kibet Sharon Jepkorir
Department of Clinical Medicine, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
Innocent Levy Ogendo
Department of Clinical Medicine, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
Daniel Peterson Mumo
Department of Clinical Medicine, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
Clifford Nyakundi Mocha
Department of Clinical Medicine, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
Alice Wangui Ongera
Department of Nursing, Kenya Medical Training College, P.O. Box 76 – 20402, Longisa, Bomet, Kenya.
*Author to whom correspondence should be addressed.
Abstract
Background: Completion of childhood immunisation depends on timely return visits and reliable services. Evidence for children attending maternal and child health clinics in Narok County is dispersed across facility and community studies.
Objective: To synthesise factors associated with incomplete routine childhood immunisation in Narok County and assess their applicability to clinic attendees.
Methods: A completed open-source verification search, executed on 1 September 2026, covered publications from 1 January 2000 to 31 August 2026. Europe PMC, targeted publisher and institutional-repository searches, and reference checking were used. Screening, extraction and appraisal followed a single reviewer workflow. Revised JBI tools informed appraisal. Clinic evidence and supporting Narok community evidence were synthesised separately without meta-analysis.
Results: Of 210 captured records, 208 remained after deduplication; 27 reports were sought and 25 assessed. Seven reports representing five study groups were included. Two groups supplied clinic-linked evidence: a survey of 100 mother–child pairs and a registry analysis of 8,487 child records. Three community studies supplied contextual evidence. Reported associations concerned maternal education and employment, antenatal care, delivery setting, geographical access and failure to vaccinate during service contact. One household study reported adjusted odds ratios for full vaccination of 5.68 (95% confidence interval 2.44–13.21) for secondary versus primary education and 3.01 (1.37–6.64) for no previous facility failure to vaccinate. These estimates require caution because the composite outcome was inconsistently reported. Other reports contained conflicting models, age-ineligible completion classifications or unclear denominators. Confidence in factor magnitudes and their transfer to clinic attendees was very low.
Conclusions: Service continuity, caregiver resources and access warrant local attention, but the evidence does not establish a reliable causal ranking. Age-appropriate assessment at each contact and prospective evaluation of missed doses are priorities. No pooled estimate was calculated. The review was unregistered; no funding was declared.
Keywords: Childhood immunisation, vaccination completion, missed opportunities, maternal and child health, Narok County, Kenya, systematic review