Prevalence and Associated Factors of Full Immunization Coverage among children aged 12–23 months in Kenya: A multi-level logistic regression analysis

BACKGROUND: Full immunization coverage remains suboptimal in Kenya, despite the availability of effective vaccines. Understanding the multilevel factors influencing immunization uptake is essential for strengthening child health interventions. This study examines individual and community-level determinants of full immunization coverage among children aged 12-23 months in Kenya. OBJECTIVE: To assess the individual and community-level factors associated with full immunization coverage among children aged from 12-23 months in Kenya using a multilevel analytical approach. METHODS: A cross-sectional study was conducted using nationally representative survey data from Kenya. A two-level binary logistic regression model was used to identify individual- and community-level factors associated with full immunization coverage in Kenya. Adjusted odds ratios (AOR) with 95% confidence intervals (CI) were reported. RESULTS: The prevalence of full immunization coverage among children aged from 12-23 months in Kenya was 79.4% (95% CI: 78.13-81.25). A total of 3790 weighted children aged from 12-23 months were included. Children whose mothers were exposed to media (AOR = 1.16, 95% CI: 1.01-1.34), delivered in health facilities (AOR = 2.88, 95% CI: 2.43-3.42), and attended antenatal care (AOR = 3.15, 95% CI: 2.10-4.73) had higher odds of full immunization. Children of average birth size (AOR = 1.68, 95% CI: 1.40-2.01) and those from rural areas (AOR = 1.44, 95% CI: 1.22-1.69) were also more likely to be fully immunized. Higher maternal education showed a strong positive association: primary (AOR = 1.60), secondary (AOR = 2.14), and higher education (AOR = 1.74). Older maternal age increased immunization odds: 25-34 years (AOR = 1.49), 35-49 years (AOR = 2.15). Conversely, households with more than two under-five children (AOR = 0.72) and higher parity (2-5 children AOR = 0.78; 6 + AOR = 0.67) had lower odds. Community-level low maternal education also reduced the odds (AOR = 0.79). CONCLUSION AND RECOMMENDATION: Maternal age, education, parity, media exposure, antenatal care, place of delivery, place of residence, and community education levels were associated with full immunization coverage in Kenya. Interventions should focus on improving maternal education, strengthening ANC services, promoting institutional deliveries, and enhancing outreach through media and community engagement.