IMMUNIZATION ATTITUDE AND PRACTICE OF MOTHERS IN LAPAI LOCAL GOVERNMENT AREA OF NIGER STATE

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ABSTRACT
The study was conducted to investigate immunization Attitude and Practice of Mothers in Lapai Local Government Area of Niger State. The cross sectional design survey was used for the study. The population for the study consisted of 10,637 mothers from households who were of Lapai LGA in Niger State. Three hundred and Thirty (330) mothers were drawn using multi
– stage sampling procedure involving three stages. The instrument for data collection was self structured questionnaire which comprised of 15 items that investigated immunization attitude and practice of mothers. Six research questions were posed and four hypotheses tested. Data were analyzed using mean score, standard deviation and t-test. The findings revealed that:

1.                The overall attitude of mothers towards immunization of their children was positive (X=2.55).

2.                The mothers regularly practiced immunization of their children (X=2.55).

3.                The mothers differed in their attitude towards immunization of their children based on age (Younger = X of 2.60; Older = X of 2.45). The different was significant at .05 level (t-cal = 2.3; t-crit=1.96).

4.                The mothers differs in their attitude toward immunization of their children based on level of education (Educated = X of 2.60; Not – educated = X of 2.44). The different was significant at .05 level (t-cal 2.60; t-crit = 1.96).

5.                The mothers were not different in their practice of immunization of their children based on their age (Younger = X of 2.45; Older = X of 2.38). The different was not significant at .05 level (t-cal 0.76; t-crit =

1.96).

6.                 The mother differed in their practice of immunization of their children

based on level of education (Educated = X of 2.56; Not – educated = X of 2.22). The difference was significant at .05 level (t-cal = 3.81; t-crit=1.96).


Based on the findings of the present study, it was recommended that public health education messages should include the causes, risk factor, transmission/spread, preventative strategies, side effects and contraindications to immunization.

TABLE OF CONTENTS

Title Page
Abstract
Table of Contents
List Tables

CHAPTER ONE: Introduction
Background to the Study
Statement of the Problem
Purpose of the Study
Research Questions
Hypotheses
Significance of the Study
Scope of the Study

CHAPTER TWO: Review of Related Literature
Conceptual Framework
Immunization, attitude, and practice
Demographic factors associated with immunization attitude and practice
Methods of improving immunization coverage
Theoretical Framework
Theory of reasoned action (TRA)
Self-efficacy theory (SET)
Empirical Studies on Immunization Attitude and Practice
Summary of the Literature

CHAPTER THREE: Methods
Research Design
Area of the Study
Population of the Study
Sample and Sampling Techniques
Instrument for Data Collection
Validity of the instrument
Reliability of the instrument
Method of Data Collection
Method of Data Analysis

CHAPTER FOUR: Results and Discussion
Summary of the Findings
Discussion of the Findings

CHAPTER FIVE: Summary, Conclusion and Recommendation
Summary
Summary of the Findings
Conclusion
Recommendations
Suggestions for Further Study
References
Appendices

CHAPTER ONE
Introduction

Background to the Study

Care about the optimal well-being of children and women are global. Wright (1992) stressed that United Nations Children’s Emergency Fund (UNICEF) initiated the programme on child survival and protection in 1947. This was because of the suffering of children as a result of the World War II in 1939. Wright pointed out that the programme was restricted to the developed countries and further emphasized that in recognition of the relevance this organization has to the survival and protection of children, the United Nation’s (UN) General Assembly in an interim decision in 1950 extended UNICEF mandate to concentrate on the needs of children in the developing countries.

UNICEF (1992) revealed that Nigeria and UNICEF have been working together since 1951 on the programme to improve the well-being of children and women in the country. The early thrust of UNICEF cooperation centered on cash grants and technical support to primary education, health and social development. According to UNICEF, special allocation of US $100 million was made in 1980 for a phase restructuring of Primary Health Care(PHC) to reflect the new national policy of decentralization of health care services. The emphasis then was more on the Expanded Programme on Immunization (EPI) at the grassroots. The EPI in Nigeria is currently referred to as National Programme on Immunization (NPI).


Bland and Clement (1998) traced the idea of immunization to Edward Jenner who in 1796 demonstrated that scratching cowpox virus on the skin produced immunity. Based on this discovery immunization programme was developed andtoday it is accepted worldwide. World Health Organization – WHO (1980) attested that following the discovery of this vaccine by Edward Jenner, mankind was saved from dreaded diseases.
Jenner’s effort was a challenge to other scientist to produce vaccines which led to the eradication of small pox globally, elimination of polio from western hemisphere and major reduction in the incidence of other preventable diseases in the United States (Bland & Clement, 1998). Based on this, WHO developed its plans for world-wide immunization programme which include the eradication of poliomyelitis (paralysis of one or more of the limbs by the polio virus) from the world by the year 2000. In order to attain the desired result, the Federal Ministry of Health – FMOH (2000) adopted EPI in 1978 and launched it in 1979, with the target of achieving 60 per cent immunization coverage by the year 1984. A national survey to determine the achievement was conducted by the FMOH at the end of 1984, but the results showed a very low coverage ranging from 20-29 per cent at the end of the period. The low coverage was attributed to poor management and implementation strategies.

Following the low coverage, the programme was revised in 1984, with the target of achieving 80 per cent by 1990, but the coverage remained low (FMOH, 2000). In 1988, the FMOH supported by the WHO, UNICEF, Polioplus and Non-Governmental Organizations (NGOs) introduced the idea of mass campaign as a means of boosting and sustaining EPI coverage nationwide. The strategy, according to FMOH (2000), accelerated the immunization coverage to about 60 per cent by 1989, and this became the spring board for the attainment of Universal Child Immunization (UCI) target coverage of 80 per cent by 1996.

Tarfa (1992) indicated that the findings of national survey to assess the coverage of EPI carried out in February 1991 indicated that 96 per cent of Nigerian children had received national immunization services at least once. In attempt to extend and improve health care services to the grassroots, the Federal Government transferred Primary Health Care (PHC) programme to the Local Government Authorities in 1990 (Tarfa, 1992). In the same year the nomenclature, EPI,was changed to NPI which implied the adoption and owning of the programme by the Federal Government thus making it a national programme. To implement the programme, the FMOH (2002) set up the following objectives to be achieved by the year 2003: eradicate polio, control measles, eliminate neonatal tetanus (NNT), and sustain routine immunization of at least 80 per cent of children under two years and women of child-bearing age.

Odusanya, Alufoha, Meurice and Ahonkhai (2008), stressed that immunization remains one of the most important public health interventions and a cost effective strategy to reduce both the morbidity and mortality associated with infections diseases. They asserted that over two million deaths are delayed through immunization each year world wide. The researchers further explained that despite the above assertion, vaccine preventable diseases remain the worst common cause of childhood mortality within an estimated three million deaths each year. They reiterated that the uptake of vaccination services is dependent not only on provision of these services but also of mothers, density of health workers accessibility to vaccination clinics and availability of safe needles and syringes.

The Nigerian National Programme on Immunization (NPI) schedule is Bacillus Calmette Guerin (BCG), Oral Polio Vaccine (OPV0), Hepatitis B1 (HB1) (first dose) at 6 weeks, Diphteria Pertussis and Tetanus (DPT2), OPV2 at 10 weeks; DPT3, OPV3, HB3 (third dose) at 14 weeks; measles and yellow fever at 9 months.
Following from the above, the question arises as to what immunization is and what it is intended for. John, Sutton and Webster (1986) described immunization as the most effective measure for protecting the susceptible host against a particular disease. Osakwe (1988) viewed immunization as one of the major ways employed in preventing diseases. He further indicated that high survival rate of children these days is largely attributed to immunization. Onuzulike (1998) sees immunization as a deliberate stimulation of the body’s....

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