KNOWLEDGE, PERCEPTION, PRACTICES AND SOURCES OF INFORMATION ON IMMUNIZATION AMONG MOTHERS/CAREGIVERS OF CHILDREN AGED 12-23 MONTHS IN KADUNA STATE, NIGERIA


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TABLE OFCONTENTS

TABLE OFCONTENTS
LIST OF ACRONYMS

CHAPTER ONE
1.1 Background
1.2 Problem Statement
1.3 Justification for the Research
1.4 Research Questions
1.5 Objectives
1.6 Scope of the study
1.7 Definition of Terms

CHAPTER TWO: LITERATURE REVIEW
2.1 History of Immunization
2.2 Benefits of Immunization
2.3 National Program on Immunization (NPI) in Nigeria
2.5 Factors Affecting Full Child Immunization
2.6 Access to Health Facilities
2.7 Concept of Compliance
2.8 Vaccine Coverage and Drop-Out Rate
2.9 Sources of Information to Mothers/Caregivers on Routine Immunization in Nigeria
2.10 Community Involvement and Communication of Information on Immunization

CHAPTHER THREE: METHODOLOGY
3.1 Background of the Study Area
3.2 Study Design
3.3 Study Population
3.4 Sample Size Determination
3.5 Sampling Technique
3.6 Grading of Mothers Knowledge, Perception and Practices
3.7 Data Collection Techniques and Tools
3.8 Training
3.9 Pre-Testing
3.10 Data Management
3.11 Ethical Considerations
3.12   Limitations of the Study


CHAPTER FOUR: RESULTS
4.0 Results

CHAPTER FIVE: DISCUSSION

CHAPTER SIX: CONCLUSION AND RECOMMENDATIONS
6.1 Conclusion
6.2 Recommendation
REFERENCES
APPENDICES



SUMMARY


Immunization is one of the safest and most effective interventions to prevent disease and early child death. 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. In Nigeria, only 10% of children in the North West geographical region are fully immunized compared to 52% in the South East and South West regions. Immunity gap created by this low immunization coverage in Northern Nigeria favors the emergence and transmission of some vaccine preventable diseases (VPDs) especially measles and polio. Knowledge and perception of mothers/caregivers regarding VPDs favour demand and utilization of immunization services. This study was thus, carried out to assess the knowledge, perception and practices of mothers/caregivers on routine immunization in children aged 12-23 months in Kaduna State, determine the sources of information on routine immunization and other factors associated with uptake of routine immunization among mothers/caregivers of children aged 12-23 months in Kaduna State.

A cross-sectional descriptive study was conducted using multistage sampling technique; 379 eligible mothers/caregivers were recruited. Data collection was done using semi structured interviewer-administered questionnaire to obtain information on socio-demographics, knowledge, perception and practices of mothers/caregivers towards routine immunization and sources of information on routine immunization. Data were analyzed using Epi infoTM version 7. A total of 379 respondents were interviewed. Of these, majority (64.67%) practiced Islam , less than half (41.95%) completed Secondary school while about one-quarter (25.07%) were aged 30-34 years. . In addition, most (64.91%) were unemployed, 92.25% were married while 52.82% were from rural settlements. Among the children whose mothers/caregivers were interviewed,



majority (43.01%) were between aged 16-19months old, 53.30% were females while most (62.80%) fell within the birth order of 2nd -5th child . Only 59 (15.6%) of these children were found to be fully immunized, evidenced by vaccination card history. Furthermore, among the respondents, majority (64.4%) had unsatisfactory knowledge while 55.36% and 54.0% exhibited poor perception and bad practices respectively, regarding routine immunization. Commonest source of information was radio (61.61%). Educational status and good perception of mothers were found to be associated with getting information on routine immunization within 12months prior to this study while Polygamous family setting, unsatisfactory knowledge and bad practices of mothers were independently associated with lack of information on routine immunization.

In conclusion the research showed that mother‘s educational status, family setting, knowledge, perception and practices about immunization are important factors that influence access to routine immunization information which are ultimately predictors of full child immunization. It is therefore recommended that Kaduna state government should create convenient adult education classes to improve educational status of mothers and be committed to girl-child education. The state should intensify sensitization of mothers/caregivers on routine immunization using radio and television jingles through the Ministry of information to improve their knowledge and utilization of routine immunization service.




CHAPTER ONE: INTRODUCTION


1.1 Background

Immunization is one of the safest and most effective interventions to prevent disease and early child death. 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. In recent years, many countries have employed a growing range of strategies to increase both the provision and utilization of immunization services. These experiences are in consonant with the Global Immunization Vision and Strategy (GIVS) of ―using a combination of approaches to reach everyone targeted for immunization‖.1

A substantial number of children worldwide do not complete immunization schedules because neither health services nor conventional communication mechanisms regularly reach their communities. In some communities, low immunization rates are associated with families living a long distance from health services, having little access or exposure to large-scale or local media, and low doctor- and nurse-patient ratios (e.g. slum-dwellers in the Philippines and South Africa, nomadic populations in Sub-Saharan Africa, and internal migrants in Brazil, Cameroon, and Mozambique). Underserved communities have consistently shown low immunization coverage.6Innovative outreach strategies are needed to particularly target children who are excluded or beyond the reach of immunization services.

Similarly, anti-vaccination information and/or refusal to get children immunized is not new in the world. Historically, populations have rejected immunization due to concerns about vaccine safety as well as political, cultural, and religious reasons.7Today, trust and acceptance of immunization faces two new formidable challenges. Firstly, a global, fast-paced communication environment makes it possible for negative publicity and anti-immunization positions to be disseminated quickly worldwide. Localized opposition (e.g., polio campaigns in India and Nigeria), negative publicity surrounding vaccine safety (e.g., MMR vaccination.....

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