Understanding the Drivers of Non-Compliance to Polio Vaccination Programs: A Nigeria Multi-State Comparative Study

Nigeria's polio eradication efforts continue to face significant setbacks due to persistent noncompliance with vaccination programs in several regions.This study examines the socio-cultural, economic, institutional, and communication-related drivers of non-compliance across four diverse Nigerian states, Kano, Taraba, Edo, and Abia using a cross-sectional quantitative design.Data were collected exclusively through the administration of structured questionnaires to 1,600 households with children under five years old (400 per state).The questionnaire explored caregiver knowledge, attitudes, accessibility challenges, socio-demographic characteristics, and sources of vaccine-related information.Analysis using SPSS revealed five key findings.First, a large proportion of respondents (68.3%) had poor knowledge of polio and the vaccination program, indicating widespread information gaps.Second, socio-cultural factors, such as fear of infertility (35.4%) and religious influence (33.8%), were prominent reasons for non-compliance.Third, poor access to vaccination centers and long distances were major institutional barriers, with 46.2% reporting transport difficulties.Fourth, sociodemographic characteristics, especially low maternal education and income levels, were significantly associated with lower compliance.Finally, most respondents (59.7%) relied on informal sources such as community rumors and unverified social media content for information, limiting the effectiveness of official health messages.These findings highlight the urgent need for context-specific communication strategies, community engagement, and strengthened healthcare access to address vaccine hesitancy and improve polio immunization coverage in Nigeria.