Maternal satisfaction with child immunization service, rural tigray after pretoria agreement: A community-based cross-sectional study

Maternal satisfaction with child immunization services is a vital indicator of healthcare quality and heavily influences service utilization. However, evidence regarding maternal satisfaction in the rural districts of Tigray remains scarce following the Pretoria Agreement. This study aimed to assess maternal satisfaction with childhood immunization services and its associated factors in rural districts of Tigray, Ethiopia. A community-based cross-sectional study was conducted among 454 mothers in rural southeastern zone of Tigray from April to May 2025. Maternal satisfaction was evaluated using a five-point Likert scale. Respondents scoring <46 were categorized as ‘dissatisfied’, while those scoring ≥46 were categorized as ‘satisfied’. Data were collected via structured questionnaires and analyzed using SPSS version 27. We used descriptive statistics to summarize the data, and binary logistic regression analysis to identify factors significantly associated with maternal satisfaction. The overall prevalence of maternal satisfaction with child immunization services was 67.2% (95% CI: 62.8–71.6%). Maternal satisfaction was significantly associated with higher maternal education (AOR = 2.32; 95% CI: 1.04–5.18), receiving adequate information about vaccination (AOR = 2.60; 95% CI: 1.42–4.76), cleanliness of the waiting area (AOR = 2.33; 95% CI: 1.32–4.14), shorter distance to the health facility (AOR = 4.21; 95% CI: 2.26–7.84), and shorter waiting times (AOR = 4.58; 95% CI: 2.52–8.32). Approximately two-thirds of mothers were satisfied with childhood immunization services. Interventions aiming to optimize service utilization in rural Tigray should focus on improving facility cleanliness, reducing patient waiting times, enhancing maternal education, and providing comprehensive vaccination counseling.