This study was conducted about the knowledge and attitude of nursing mothers towards immunization of children under 2 years in Basic Health Centre, Danjuma Community, Akure. A descriptive study design was adopted for this research. Simple random techniques were used for this research project, which gave everyone equal chance of being selected. One hundred and ten (110) questionnaires were administered but one hundred (100) were retrieved. This study revealed that just 45% of the respondents declared that they got information about immunization during Ante Natal Clinic (ANC). It was also discovered that factors such as distance to immunization centre, harsh attitudes of health care providers, fear of side effects etc. are grossly responsible for apathy for child immunization among mothers. Only 10% of mothers leave very close to the immunization centres, while 67% got to the immunization posts by foot. However, 55% of the participants were happy during the immunization process. It was recommended that government should provide billboards that promote the benefits of immunization for the children and the parents. Also, health workers should always give full detail on the importance of immunization and adverse effect of not adhering to it.
Title Page
Abstract vi
Table of contents vii-ix
List of tables x-xi
Abstract
CHAPTER ONE
1.0 INTRODUCTION
Immunization is the protection of susceptible persons from contacting communicable disease by the administration of living modified agent, a suspension of killed organism or an inactivated toxin (Oladipo, 2021). Immunization today saves more than three million lives a year. However, millions of children still do not have access to basic immunization and die from diseases that can be prevented by available vaccines (WHO, 2013). Certain factors influence the effective utilization of childhood immunization which includes educational background of mothers, age, marital status, socio-economic status and religious background among others. Immunization program is more systemized in developed countries, but the situation is poor in most populous countries. The preventive measure against diseases at childhood stage is basically through immunization which is a complete course of injection that are administered to children soon after birth. Mojoyinola and Olaleye (2012) assert that immunization of children is aimed at providing primary prevention against killer diseases during childhood. These diseases take several precious lives to death all over the world especially in the third world, like Africa and Asia.
Vaccination has been regarded as one of the most important public health achievements and one of the most cost-effective interventions for child health promotion that reduces both the morbidity and the mortality from associated vaccine-preventable diseases (Miller et al., 2004 & Greenwood, 2014). However, despite ample scientific evidence showing the importance of vaccination, parents still have significant concerns about vaccines and their effects (Smailbegovic et al., 2003 & Benin et al., 2006). Parental decisions concerning the vaccination of their children range in various broad categories. Those range from the categorical refusal of any vaccination, intentional delay or selective omission, to full compliance with the entire scheme of routinely recommended vaccinations (Larson et al., 2014). Most notably, vaccine hesitancy has risen in recent decades (Gellin et al., 2010) leading to a steadily decrease of many levels of childhood vaccine coverage in multiple countries, including the United States, which caused the outbreaks of vaccine-preventable diseases (e.g measles, pertussis and mumps) (Napolitano et al., 2018).
Parents are involved in the decision-making process regarding the vaccination of their children; thus, their judgment is crucial. Several studies have examined the knowledge, attitudes, and beliefs of parents of young children with regards to vaccination (Gust et al., 2008, Healy et al., 2014) as considered as a main reason for the parents’ choice to postpone or avoid vaccination (Dannetun et al., 2005). Relatively few studies have focused on mothers, a group that is primarily responsible for childcare and vaccine-related decisions (Baker et al., 2007, Wu et al., 2008). Mothers are often the primary decision makers for healthcare issues of their children, including vaccination ((Baker et al., 2007).
1.1 BACKGROUND OF THE STUDY
Immunization is a global health and development success story, saving millions of lives every year. Vaccines reduce risks of getting a disease by working with the body’s natural defenses to build protection. When you get a vaccine, your immune system responds. We now have vaccines to prevent more than 20 life-threatening diseases, helping people of all ages live longer, healthier lives. Immunization currently prevents 2-3 million deaths every year from diseases like diphtheria, tetanus, pertussis, influenza and measles. Immunization is a key component of primary health care and an indisputable human right (WHO, 2020). It’s also one of the best health investments money can buy. Vaccines are also critical to the prevention and control of infectious-disease outbreaks. They underpin global health security and will be a vital tool in the battle against antimicrobial resistance. Yet despite tremendous progress, far too many people around the world including nearly 20 million infants each year have insufficient access to vaccines. In some countries, progress has stalled or even reversed, and there is a real risk that complacency will undermine past achievements. Global vaccination coverage the proportion of the world’s children who receive recommended vaccines has remained the same over the past few years (WHO, 2020).
In addition to its direct impact on the health of populations, immunization brings added value by reducing the burden of disease on individuals, families and communities, including through savings on medical expenses, as well as productivity and educational gains. The return on investment for immunization has been estimated to be US $44 for every dollar invested, including broader social and economic benefits (Ozawa et al., 2011)
A study was conducted on knowledge, practice and attitude regarding vaccination among mothers in Iran, 2005. The results showed a favorable attitude towards children immunization in 95.5% of respondents. Nearly half (51.4%; 95% confidence interval: 47.6%–55.2%) of mothers knew the name of the diseases against which their children were being vaccinated. More than half (67%) of respondents gave disproportionate importance to mild intercurrent illness as a reason to defer immunization. About half of children (341=51.1%) experienced vaccination delay. Results of logistic regression analysis showed increase in: birth order, number of children in household, and mother's age significantly predicted vaccination schedule non-adherence (P=0.02, P=0.02 and P=0.04 to P=0.001 respectively) and increasing mother's age was the most significant factor for vaccination delay. Educating mothers about the vaccines and vaccine preventable diseases, and improving their performance are recommended (Shahla et al., 2007).
The vision of EPI in Nigeria is to improve the health of Nigerian children by eradicating all the six killer diseases, which are polio, measles, diphtheria, whooping cough, tuberculosis, and yellow fever. Between 1985 and 1990, as outlined in the national health plan for that period, the objectives of EPI were to strengthen immunization, accelerate disease control and introduce new vaccines, relevant technologies and tools. In1995 in line with the above, Nigeria became a signatory to the World Health Assembly, adopted the World Health Assembly Resolution (WHAR) and United Nations General Assembly Special Session (UNGASS) goals for all countries to achieve by 2005 (i) polio eradication, (ii) measles mortality reduction and (iii) maternal and neonatal tetanus elimination (MNTE). Nigeria also adopted the millennium development goals (MDGs) calling for a two-third reduction in child mortality, as compared to 1990, the year 2005.
In addition to the above, the country ratified the United Nations General Assembly Special Session (UNGASS) goals urging Nigeria to achieve by 2010 (i) ensure full immunization of children under one year of age at 90% coverage nationally with at least 80% coverage in every district or equivalent administrative unit, and (ii) vitamin A deficiency elimination. In 1998 following from the above, Nigeria laid out the core activities of EPI policies which included the following: (i) monitoring of the performance, quality and safety of the immunization system through indicators; (ii) assessment of the current burden of vaccine-preventable diseases as well as the “future” burden of vaccine preventable diseases in terms of sickness, death and disability, as well as the economic burden; (iii) assessment of the impact of vaccination strategies, through on-going epidemiological surveillance and reliable laboratory confirmation, as well as impact assessments in Nigeria; (iv) monitoring of the national immunization policies, particularly the vaccines used in the country and the target population for these vaccines (immunization schedules); and (v) monitoring of the overall proportion of children and women who are vaccinated (immunization coverage) and ensuring that all districts of the country are well covered with vaccination (National Population Commission, 2009).
1.2 STATEMENT OF PROBLEM
Despite the fact that those diseases that claimed the lives of those young children can be prevented yet many mothers do not give high significant to immunization. Many mothers hide their children during vaccination programmes, some do not take their children to the health centre for vaccination. Some mothers in Danjuma community did not even bother to come to the health facility to get their child vaccinated for routine immunization, while some comes late. Could it be as a result of lack of education, poor knowledge, wrong perception or wrong attitudes towards immunization? This study aimed to investigate the knowledge attitude and perception of nursing mothers towards the importance of immunization in Basic Health Centre Danjuma Community.
1.3 AIM OF THE STUDY
The aim of this study is to assess the knowledge and disposition of nursing mothers on the importance of immunization for children in Basic Health Centre Danjuma Community, Akure.
1.4 OBJECTIVES OF THE STUDY
The objectives of this study are to;
To determine how knowledge of immunization has affected the response of nursing mothers to immunization of their children in Basic Health Centre Danjuma Community
To examine pertinent factors responsible for poor responses to immunization among nursing mothers in Danjuma.
To identify strategies that may further promote or encourage mothers to bring their children for immunization as and when due
1.5 RESEARCH QUESTION
How does the knowledge of immunization have affected the response of nursing mothers to immunization of their children?
What are the factors responsible for poor responses to immunization among nursing mothers?
Do the mothers bring their children for routine immunization as and when due?
1.7 SIGNIFICANCE OF THE STUDY
The project is expected to be an eye opener to the level of knowledge of nursing mother on importance of immunization to their children. This in turn will add to information needed to reduce morbidity and mortality among the children of Danjuma.
1.8 ASSUMPTIONS
It is believed that vaccines make the child to be sick
It is also believed that it deforms children’s leg
It is also believed that vaccines are not effectives in disease prevention.
1.9 DEFINITION OF TERMS
Cold Chain System: This is a system storage transportation and distribution of vaccine in a potent stage from the manufacturer to the actual vaccinating site.
Death: is the permanent end of the life of a person or animal.
Diseases: a disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury.
Elimination: is the process of getting rid of waste products from your body by going to the bathroom Eradication refers to the complete and permanent worldwide reduction to zero new cases of the disease through deliberate efforts.
Eradication: Refers to the complete and permanent world-wide reduction to zero new cases of the disease through deliberate effort.
Health: This is a state of complete physical, mental and social wellbeing of an individual not merely the absence of disease or infirmity
Injection: is a shot, or a dose of medicine given by way of a syringe and a needle.
Immunity: is the capability of multicellular organisms to resist harmful microorganisms.
Immunization: is the process by which an individual's immune system becomes fortified against an infectious agent (known as the immunogen).
Surveillance: is the monitoring of behavior, many activities, or information for the purpose of information gathering, influencing, managing or directing.
Vaccine: a preparation that is used to stimulate the body's immune response against diseases.
Vaccination: is a simple, safe, and effective way of protecting people against harmful diseases, before they come into contact with them
Vaccine Vial Monitor: This is a detection design in vaccine vial in order to know the potency of the vaccine.
1.10 ABBREVIATION OF TERMS
WHO: World Health Organization
EPI: Expanded Program on Immunization
UNICEF: United Nations Children’s Funds
HIB: Haemophilus Influenza type B
HEPB: Hepatitis B vaccine
DPT: Diphtheria Pertusis Tetanus
IPV: Inactivated Polio Vaccine
TD: Tetanus Diphtheria Toxoid
PCV: Pneumococcal Conjugate Vaccine
BCG: Baccille Calmette Guerine
HBV: Hepatitis B Virus
OPV: Oral Polio Vaccine
GAVC: Global Advisory Committee on Vaccine Safety
PHC: Primary Health Care
CCO: Cold Chain Office
LI: Local Immunization
YF: Yellow Fever Vaccine
AEFI: Adverse Effect Following Immunization
UNESCO: United Nations Education Scientific and Cultural Organization
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