Factors Contributing to Low Immunization Coverage among Children 0-59 Months in Bolgatanga Municipality: A Study in Upper East Region, Ghana

Introduction: In Ghana, the Expanded Programme on Immunization has reduced infant mortality, with districts striving to meet national immunization targets.However, the Bolgatanga Municipality consistently fell short of these targets for most antigens from 2020 to 2022.This study explored factors behind low immunization rates among children aged 0-59 months in Bolgatanga Municipality, Ghana.Methods: A descriptive cross-sectional quantitative study involved 424 participants, including caregivers of children aged 12-23 months.Quantitative data were collected using pretested structured questionnaires.Data was entered into IBM SPSS statistics software version 23 for analysis.Results: Regression analysis revealed the frequency of immunization services significantly impacted coverage (p = 0.0000, weekly ).Reminder systems varied in effectiveness, with SMS being statistically significant (C.L = 95%, p = 0.0003), alongside verbal and written reminders (C.L = 95%, p = 0.0040; C.L = 95%, p = 0.0000).Conclusion: While accessibility to immunization services is not a major factor, frequency of immunization session and media of reminder systems significantly influenced coverage.More innovative strategies such as establishing formal reminder systems in all health facilities and practicing daily immunization sessions can improve coverage.