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