Factors Associated with Low Vaccination Coverage among Children Under 2 Years of Age in the Kolaboui Subprefecture, Boké Health District (Guinea)

Introduction- Vaccination is one of the most effective interventions for reducing infant mortality. However, in the subprefecture of Kolaboui (Boké health district), vaccination coverage among children under two years of age remains insufficient, exposing this vulnerable population to preventable diseases. This study aims to analyze the factors associated with this low vaccination coverage, using the Health Belief Model. Methods- A cross-sectional analytical study was conducted among 404 parents/guardians of children under two years of age. Data were collected using standardized questionnaires and analyzed using SPSS (multivariate logistic regression). The variables studied included sociodemographic characteristics, parental perceptions (susceptibility and perceived benefits), as well as structural and organizational barriers. Results- The proportion of fully vaccinated children remains low. The main factors associated with DTP1 vaccination were the number of vaccinated children in the household (OR = 16.58; p < 0.001). For DTP3, the significant determinants were the number of fully vaccinated children under five years of age (OR = 6; p < 0.001) and the child’s age (1–6 months) (OR = 1.07; p = 0.02). Parental perceptions (susceptibility and perceived benefits) did not show a statistically significant association, but neglect and lack of follow-up were frequently reported as reasons for non-vaccination. Conclusion- Low vaccination coverage in Kolaboui is multifactorial, influenced by family dynamics, structural barriers, and parental behaviors. Strengthening community awareness, improving access to services, and actively involving mothers appear to be key strategies for increasing vaccination coverage and reducing infant mortality.