Background: Measles is a severe and highly infectious illness that significantly affects humans, causing substantial death and illness in children, especially in developing nations. The infection's pattern has shifted from irregular outbreaks involving all age groups to a consistent presence mainly impacting children under five years old. This study aims to evaluate the elements that contribute to the low coverage of the second dose of the measles vaccine among children aged 0-59 months in the Sefwi Wiawso Municipality of Ghana's Western North Region.”.

Methods: The study used quantitative cross-sectional study design. The data from 321 caregivers at Sefwi Wiawso Municipality were collected through questionnaire and analyzed with SPSS version 23.0. The data included information on the knowledge level of caregivers on measles II immunization, health and community factors that affected measles II immunisation and the data were thereafter interpreted at 95% confidence interval.

Results: the knowledge level on measles II immunization was high as all the respondents had heard and attended CWC. More than half of the respondents had their information from the health workers. Majority of the caregivers knew measles II protected against measles. On reasons why caregivers failed to go for measles II, most of them said it was due to their busy schedule. On the association between the caregivers’ sociodemographic characteristics and knowledge on measles II, age was statistically significant as a factor associated with mothers’ knowledge on measles II. Majority of the respondents said they paid GH₵1.00 for immunization of their babies.

Conclusion: the study concludes that money paid at the CWC was the main contributing factor for the low measles II coverage in the municipality. If immunisation is given free of charge it will go a long way to improve the coverage of measles II in the municipality.