The Effects Of Immunization As It Affects Children Health

Medical and Health Science Project and Seminar Material

The Effects Of Immunization As It Affects Children Health


Abstract


This study was carried out on the effects of immunization as it affects children health. A cross-sectional survey was conducted in October 2010, which included the use of interviewer-administered questionnaire to assess knowledge of mothers of children aged 12-23 months on childhood immunization and vaccination coverage of the children. Survey participants were selected using a multistage sampling method. Vaccination coverage was assessed by vaccination card and material history. A child was said to be fully vaccinated if he or she had received all the following vaccines: a dose of BCG, three doses of OPV and DPT, and one dose of measles by the time he or she was enrolled in the survey. Person chi-square (x2) test was performed to identify determinants of full immunization status. 250 mothers and 250 children (each mother had one eligible child) were included in the survey. 80 (32%) of the children were fully immunized while 112 (44.8%) were not immunized from the vaccination cards while with maternal history 86 (34.4%) were fully immunized, though this difference was not statistically significant P = 0.210 45 (26.5%) of 170 children who defaulted had visited a health facility since their last vaccination or since they attained appropriate age.

Majority of the children 109 (43.6%) received their vaccination in Public health facilities. Chi-square test showed that mothers educational status (P = 0.004), religious denomination (P = 0.019) and child’s problem after immunization P = 0.012 were significantly associated with under immunization. It is therefore concluded that despite all the efforts made by the government, the vaccination coverage in this rural suburb is still at a level that does not provide high protection (80%) against DPT/ OPV and even measles. To improve on the low immunization coverage, attention should be paid to female education, health education, capacity building of the immunization service providers and supportive supervision.


Table Of Contents


Preliminary Page(s)

  • Title page
  • Certification page
  • Dedication
  • Acknowledgement
  • Abstract
  • Table of content

Chapter One

Introduction

  • 1.1 Background Of The Study
  • 1.2 Problem Statement
  • 1.3 Study Objectives
  • 1.4 Significance Of The Study
  • 1.5 Study Questions/Hypotheses
  • 1.6 Scope And Limitation Of The Study
  • 1.7 Definition Of Terms

Chapter Two

Review Of Related And Relevant Literature

  • 2.1 Introduction
  • 2.2 Conceptual Clarifications
  • 2.3 Theoretical Studies
  • 2.4 Empirical Studies
  • 2.5 Related Literatures

Chapter Three

Research Methodology

  • 3.1 Research Design
  • 3.2 Study Area
  • 3.3 Sources Of Data
  • 3.4 Population Of The Study
  • 3.5 Sample Size Determination
  • 3.6 Instrumentation
  • 3.7 Reliability And Validity Of Instrument
  • 3.8 Method Of Data Analysis

Chapter Four

Data Presentation, Analysis And Interpretation

  • 4.1 Data Presentation
  • 4.2 Data Analysis
  • 4.3 Data Interpretation

Chapter Five

Summary, Conclusion And Recommendation

  • 5.1 Summary
  • 5.2 Conclusion
  • 5.3 Recommendation
  • References
  • Appendix

Chapter One


Introduction

1.1 Background of the Study

Childhood Immunization is considered one of the greatest public health achievements of all time. According to the World Health Organization (WHO 2011). Immunization rates have increased at a rapid pace in recent years, and more children are immunize than in previous years. Immunizations are estimated to save two to three million lives annually worldwide (WHO, 2013). Diseases which at one point affected million of children worldwide have now been eradicated, as evidenced by the elimination of smallpox in 1977 (Public Health Agency of Nigeria [PHAN], 20009).

Childhood immunization is the initiation of immunity through application of vaccine. it is considered important for improving child survival. This is because more than 10 million children in developing countries die every year because they do not access effective interventions such as immunization that could fight common and preventable childhood illnesses (WHO, 2014).

Although, about three quarters of the world’s child population is reached with the required vaccines, only half of the children in Sub-Saharan Africa get access to basic immunization. Further, in poorer remote areas of developing countries, only one in twenty children have access to vaccination (UNICEF, 2013). Immunization against Vaccination Preventable Disease (VPDs) through the expanded programme of immunization (EPI) is one of the most economical public health interventions available (UNICEF 2012) that contributes extensively to achieving the Millennium Development Goal to reduce the mortality rate of children under five by two-thirds between 1990 and 2015 (UNICEF 2012, World Bank, 2013).

The expanded Programme on Immunization (EPI) was established in 1974 against six vaccine preventable disease. These are diphtheria, polio, tuberculosis, measles, pertussis and tetanus. In 2003, DPT3 global coverage was 78 percent with about 27 million children not covered. South Asia and sub-Sahara African countries accounted for 9.9 million and 9.6 million, respectively of the children that were not covered. In most of these countries poor functioning health service delivery system impedes the efforts to meet immunization targets (WHO, 2015). Therefore, children living in remote location and border areas are difficult to be immunized with booster doses especially of polio and measles during the national or sub-national immunization days.

In Nigeria, vaccination is given on routine and outreach bases. According to the Expanded Programme on Immunization, a routine vaccination schedule for children in Nigeria are given starting from birth, and are being completed before one year life by all children (WHO and UNICEF, 2013). BCG and OPV0 are administered at birth, while three doses of OPV and pentavalent vaccines (which protect against diphtheria, pertussis, tetanus, hepatitis B and Haemophilus influenzae type B disease) are given at interval, of four-week duration; at 6, 10 and 14 weeks and measles vaccine is given at the age of nine months (WHO, 2012). Less than half of children have received each of the recommended vaccinations, with the exclusion of polio 1 (67 per cent) and polio 2 (52 per cent) (NPC, 2013). And more than three times as many urban children as rural children are fully vaccinated (25 per cent and 7 per cent, respectively) (NPC, 2013). It is therefore important to study the factors associated with full child immunization in Nigeria in respect of the parents’ acceptability with a view to improve the quality of life of these children.

Health care professionals have a responsibility to encourage childhood immunization and ensure the information provided to the public is evidence based and accurate, as this is an essential aspect of professional conduct for practice (Plastow, 2012). Socio-economic status (particularly education and wealth status) of parents strongly controls their behaviours and thereby controls health-seeking behaviour and ultimately child survival (Becler et al., 2013).

The above definitions have necessitated the researcher for the choice of perception of parents acceptability on immunization in Government Hospitals and clinics, Gwagwalada Area Council, Abuja, FCT.


1.2 Statement of Problem

One major way to reduce child morbidity and mortality from common vaccine preventable Disease (VPDs) is immunization. From international comparative data, Nigeria’s immunization coverage rates are among the worst in the world (UNICEF, 2007). According to the 2008 National Immunization Schedule, the percentage of fully immunized children to be targeted was less than 1% in Jigawa, 15% in Yobe, 1.6% in Zamfara and 8.3% in Katsina. It was also revealed that only 23% of Nigeria children 12-23 months received all recommended vaccines as at 2008 that is one dose of BCG and measles and three doses each of DPT and polio (NPC, 2008). The same survey showed that 38 per cent of children in Nigeria had not received any vaccinations.

As a result thousands of children are dying as victims of vaccine preventable diseases. In 2009, Nigeria was listed among countries with the highest incidence of poliovirus cases in the world (WHO, 2010). Routine immunization coverage against Polio and other VPDs were below targets at the national level (WHO Nigeria, 2010). There are quite a lot of reasons for such low rates in Nigeria. Given the protective effective of immunization and the observed low immunization coverage in Nigeria, it is important to identify the factors influencing full child immunization among 12-23 months children in Nigeria so that child mortality and morbidity could reduce.


1.3 Objective of the Study

The specific objective of the study is to:

  1. Identify factors associated with full child immunization among children in Jaji community, Igabi Local Government Area.
  2. Determine the perception of parents acceptability on immunization.
  3. Identify the strategies meant to solve the problems of immunization.

1.4 Research Questions

Research questions are very fundamental when research of this magnitude is to be carried out. These include:

  1. What factors are associated with full child immunization among children in Jaji community, Igabi Local Government Area?
  2. What are the perception of parents acceptability on immunization in the study area?
  3. What strategies are meant to solve the problems of immunization?

1.5 Significance of the Study

The findings from this study will be used to develop recommendation for health care professionals to support, respect, and educate parents on immunization this study can inform the education and practice of health care professionals.

The health sectors in Government Hospitals and Clinics, Jaji community, Igabi Local Government Area will benefit because it will form the basis and strengthen immunization programmes.

The households in Government Hospitals and Clinics, Jaji community, Igabi Local Government Area will benefit as their children will be immunized against 6 killer diseases.

Government Hospitals and Clinics, Jaji community, Igabi Local Government Area and the whole country will benefit from this noble objectives.


1.6 Scope and Limitations of the Study

The scope dealt on the effects of immunization as it affects children health in Jaji community, Igabi Local Government Area.

It is delimited to the Nurses and parents within the study areas.

Limitation of the study

Lack of time and financial constrainers were the major problems faced by the researcher in the course of this research work.


Chapter Five


Conclusion / Recommendations

5.1 Conclusion

The need for community- based studies on the immunization status of certain groups of children in our environment cannot be over-emphasized. It is necessary that the immunization status of children living in rural communities are properly documented bearing in mind that due to environmental and social circumstances, they are highly prone to these major childhood diseases.

Immunization coverage in this rural suburb is low when compared to values in this same South East Nigeria. There was also a high dropout rate. Non availability of vaccines in this rural suburb, misconception of the efficacy and safety of immunization, its side effects, sitting of the few health facilities that offer routine immunization far from where the people live and work would have contributed to the low level coverage.

Missed opportunities for immunization, educational status, religious practices and problems after immunization, ignorance and non-acceptance of some orthodox medical health programmes remain a problem in developing countries.

Important correlates of inadequate immunization coverage in this environment include educational status of the mothers, religious practices and problems following immunization while age and occupation of the mothers, number of the children in the family and vaccination card availability are not contributory factors.


5.2 Recommendations

The following recommendations are made to strengthen NPI routine immunization aimed at reducing the incidence of these killer vaccine preventable diseases in our environment.

  1. There is still need to sustain and strengthen regular health education by not only the local government health education/ mobilization officer but all health staff in facilities. This should be aimed at emphasizing the benefits of vaccination and dispelling misconception about the problems of side effects of vaccination. Health education especially for rural dwellers should also address such issues as overcrowding, family planning and environmental sanitation.
  2. Adequate provision of logistics for proper maintenance of cold chain to ensure potency of vaccines should be embarked upon by the state and the local government. This will reduce the incidence of these diseases after immunization in our children.
  3. Regular supply of vaccines should be ensured and logistics for distribution should be ensured in the local government area due to the hard to reach nature of most of its communities.
  4. Members of the community should be mobilized and made to participate, in the programme as their own as an important aspect of health of their children. This will encourage maintenance and sustainability of the immunization programmes even when the country has a government that has no political will, support or commitment to the programme.
  5. There should be supportive supervision which involves embarking on planned regular visits by knowledgeable stakeholders, focusing on identifying problems militating against high immunization coverage at all levels.
  6. More frequent assessment of vaccination coverage
  7. Increased enrolment of girls into secondary schools should be generally encouraged and is likely to have a favourable impact on vaccination rates of their future offsprings.
  8. Adequate motivation of the health workers manning the few health facilities to improve their services and attitudes.
  9. Providing more health facilities and employing more trained health staff.

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