Factors Affecting the Reporting of Adverse Event Following Immunization in Ahafo Region of Ghana.

BackgroundAdverse Events Following Immunization (AEFI) remain a significant concern for immunization programs, as underreporting can undermine public confidence and compromise vaccine safety monitoring. Despite significant efforts to address challenges associated with AEFI reporting globally, the AEFI reporting rate in the Ahafo Region of Ghana still remains a challenge. This study investigated healthcare workers knowledge and practices regarding AEFI reporting in the Ahafo Region of Ghana, aiming to identify key factors influencing reporting behavior and suggest strategies for improvements for the immunization surveillance system. MethodsA cross-sectional quantitative study was employed in this study to collect data from 1300 frontline health workers who engage in Adverse Events Following immunization surveillance activities. However, the Sample size was determined using Yamanes formula to obtain a final sample size of 312 with confidence interval of 95% and margin of error being 5%. Multistage sampling approach was employed to ensure that respondents from all six districts in the Ahafo region were proportionately represented. In each district, health facilities were stratified by facility level mainly hospitals, health centers and Community Based Health Planning and Services (CHPS). Descriptive statistics and Poisson regression analysis were used to examine relationships between variables and AEFI reporting practices. ResultsThe study found that age 26-35 years shows a markedly higher incidence rate ratio (IRR) in all models compared to 18-25 years. Community health nurses and midwives report higher AEFI rates than clinicians; IRR=2.730(1.326-5.228). Respondents with advanced years of work experience reported significantly more AEFI; Model III IRR = 7.938 (95% CI: 2.097-13.008). Only 45.2% of facilities had AEFI reporting forms available, and 40.1% of staff reported no access to reporting guidelines. Training on AEFI significantly increased reporting rate (IRR = 0.485), and lack of access to guidelines reduced it (IRR = 0.814). ConclusionThe study concludes that systemic and individual-level gaps hinder effective AEFI reporting rate. Enhancing access to standard tools, providing regular training, and improving electronic reporting systems are essential. Strengthening caregiver communication and district-level supervision will further improve surveillance and vaccine safety.