Satisfaction with immunization services and factors associated with satisfaction among guardians of 0–6-year-old children in China: A cross-sectional study

Guardians' satisfaction is an important quality indicator of vaccination services. However, there is insufficient contemporary, post-pandemic research on parent/guardian satisfaction with immunization services in China. In this study, we explore satisfaction of guardians of young children with vaccination services, and factors associated with satisfaction. During December 2022 to March 2023, we conducted a cross-sectional, questionnaire-based satisfaction survey of guardians of 0-6-y-old children attending any of 180 vaccination clinics in 10 provinces selected through a multi-stage stratified random sampling method. The primary outcome was guardian satisfaction with eight aspects of routine immunization services. Among 3,099 guardians, 84.6% were very satisfied or satisfied with all eight aspects of immunization services. Individual item satisfaction ranged from 85.8% (clinic queuing time) to 97.9% (staff service attitude). Multivariate logistic regression showed that medical-worker guardians were 2.13 times more likely to be satisfied than non-medical worker guardians (OR: 2.13; 95% CI: 1.32-3.44); satisfaction was positively associated travel time to clinic ≤10 min (OR: 1.78; 95% CI: 1.45-2.19); making an appointment (OR: 2.58; 95% CI: 2.10-3.16); having confidence in vaccine effectiveness (OR: 2.10; 95% CI: 1.33-3.29) and waiting times ≤10 min (OR: 1.29; 95% CI: 1.05-1.59). Guardians with an annual family income >100,000 yuan had a lower satisfaction level (OR: 0.61; 95% CI: 0.49-0.76). Guardians' satisfaction with vaccination services was high overall, but can be improved. Satisfaction is influenced by guardians' occupation, income, service accessibility, and knowledge. Optimizing appointment systems, shortening waiting times, and enhancing education about vaccination may improve the quality of immunization services and guardians' satisfaction.