TITLE:
Education, Economic Status, and Cultural Contexts of Community Engagement with Immunization Services in Lakes State, South Sudan: A Mixed-Methods Study
AUTHORS:
Dau Deng Abuoi
KEYWORDS:
Immunization Services, Community Engagement, Education, Economic Status, Cultural Context
JOURNAL NAME:
Open Access Library Journal,
Vol.13 No.10,
October
27,
2026
ABSTRACT: Low uptake of routine immunization is still a public health worry where information access, household resources, and community shape health service decisions. This study sought to establish the perspectives of parents or caregivers towards education, socio-economic factors, and cultural context and their relationship with community engagement with immunization. The mixed-methods research was conducted using a questionnaire, key informant interviews, and focus group discussions. Specifically, the study involved 65 participants and 10 key informants and two focus groups. The quantitative analysis involved determining frequencies and percentages of the responses provided by the participants. Similarly, the qualitative data were analyzed thematically. Most of the respondents (63.1%) had no education, while 53.8% were in households with more than five members. Most participants agreed (90.7%) that community engagement with immunization increased with education. In the same way, 92.3% agreed that parents or caregivers with better education had children who were fully immunized. On the issue of economic status, most participants (84.6%) agreed that income levels determined access to immunization services. With regard to cultural context, 87.6% of the respondents said that community engagement with immunization involved health-related taboos and norms. Finally, 92.3% of the participants agreed that cultural beliefs influenced the low levels of engagement with immunization programs. Qualitative findings also revealed limited public knowledge about immunization, financial and cultural barriers, and the influence of access to information and service-related issues. The study finds that community involvement with immunization depends on education, socio-economic status, culture, and service issues.