ABSTRACT
Introduction: Legally, parents decide for their minors the acceptance or rejection of health services including immunizations. Ill or misinformation often results in controversies resulting in rejection and even resistance of child immunization services. Viewed globally, vaccines are the most cost-effective medical intervention to prevent death and disease. This study described parent’s perceptions of the benefits of child immunization, risks of lack of immunization and sources of information on child immunization in Oghede Community Ovia North East Local Government Area.
Method: In the House-hold descriptive survey, the researcher as coordinator worked with a research supervisor and four (4) assistants in each of the wards chosen. Total of two hundred (200) parents (male and female) were administered the survey questionnaire. All the questionnaires were filled and returned.
Results: The responses of 200 parents were analyzed. The generated Socio- demographic data is presented on simple tables and of frequency and percentage, while other variables were tested using X2 and presented as same. All the X2 values computed for awareness of benefits of child immunizations, risks of lack of child immunizations and sources of information on immunization were greater than critical value of X2(7.512) at 3df at 0.05 level of significance. Most parents strongly, suggested that; Demand for full immunization certificate as personal documents will increase acceptance of child immunization.
Conclusion: Parents are significantly aware of benefits of immunization and risks of its lack or refusal as well as access to local information sources on child immunization activities. Parents suggested ways of improving acceptance of immunization needs to be harnessed and other determinants of acceptance of child health services needs to be explored in further studies.
CHAPTER ONE
INTRODUCTION
1.1 Background to the study
Immunization is one of the most effective and safest ways to prevent disease and early child mortality rates. Although, about three quarters of the world’s child population is reached with the required vaccines, only half of the children in Sub-Sahara Africa (WHO/IVB, 2009) get access to basic immunization. Recently, many countries have employed a growing range of means 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 (WHO/IVB, 2009).
A substantial number of children worldwide do not complete immunization schedules because neither health services nor conventional communication mechanisms regularly reach their communities (Waisbord, S. et al, 2015). 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 among others) (Waisbord, S. et al, 2015). Anti-vaccination information and/or refusal to get children immunized is a new phenomenon in the world. Historically, people have rejected immunization due to concerns about vaccine safety as well as political, cultural, and religious reasons (Greenough, P., 2015). Today, 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 in the UK), and suspected or real adverse events following immunization are more likely to attract wide media coverage, and spread through the Internet (Offit P.A., 2013; Clement, C.J., 2013). Secondly, increased democratization promotes debates about individual and community rights and choice. Today, democratization offers an environment more conducive to the emergence of challenges to government-mandated programs such as immunization (Waisbord, S., 2015).
More vaccines have become available, but most developing countries cannot afford the newer vaccines, lack well-functioning systems to deliver them, and have inadequate surveillance systems or study data to determine the burden of disease to motivate decision-makers to adequately fund them. A number of vaccines such as hepatitis B, yellow fever, and haemophilus influenza type B (Hib) are under-utilized due to inadequate funding from Ministries of Health, overstretched health systems, and weak demand from health providers and caregivers (Waisbord, S., 2015) (who lack sufficient knowledge about the efficacy of specific vaccines and are unaware of the burden of vaccine-preventable diseases or the availability of vaccines).
The induction of immunity by applying vaccine in children is among the most cost-effective health interventions and awareness creation programs to reduce child mortality, morbidity, and disability in the world (WHO/AFRO, 2009-2012). This is achieved through a routine vaccination schedule for children in Nigeria which are given starting from birth, and are being completed before one year of life by all children as it obtained elsewhere (WHO, 2012). Nigerian government introduced pentavalent vaccine into her immunization schedule recently (2012).
Nigeria like many countries in Africa is making efforts to strengthen its health system especially immunization so as to reduce disease burden from vaccine preventable diseases (VPDs). Such efforts include creating awareness of the importance of health education, provision of the vaccines and personnel through the NPHCDA, private or NGO providers’s, community based participation and the media.
1.2 Statement of problem
Do parents in Maiduguri have correct understanding of the benefits of child immunization? “Although most parents believe they are safe, up to 25% have serious misconception about vaccine safety that may lead them to refuse some or all immunizations” (AAP, 2015). In Nigeria, immunization activities are it routine, supplemental and emergency or outbreak use of vaccine for the prevention of vaccine preventable diseases have been fraught with problems. In recent times ‘‘polio controversy’’ referring to community or family block rejection, resistance and even outright opposition of immunizations are common incidents in Nigeria, particularly in the North. “According to an AAP Periodic Survey of Fellows, 79% of pediatricians have had one or more instances of parents refusing to allow their child or children to be vaccinated” (AAP, 2015).
There are signs of improvements in some health services, particularly in child immunization. The Government has taken many measures to improve immunization and to eradicate polio. In the case of polio, 2007 was the year with the lowest polio incidence since 2002 and the lowest incidence ever of type 1polio, the most virulent of all polio viruses. Despite these recent improvements, Nigeria is not likely to achieve the health related Millennium Development Goals (The world bank group, 2014). It is well known that, immunization or vaccination is the cheapest and most effective remedy against vaccine preventable infections (VPI). Parents in Oghede Community Ovia North East Local Government Area often reject or handle immunization activities with skepticism this might ensue from low understanding of its benefits or risks of its lack.
According to the WHO, the persistence of vaccine-preventable diseases in Nigeria can largely be attributed to the under-utilization of available vaccines (National Population Commission (NPC), 2013), and health education knowledge gaps by the mothers/caregivers which underscores low compliance with vaccination schedules; [many parents are not fully aware of the benefits of vaccination and as a result do not immunize their children against vaccine preventable diseases] (WHO, 2012). It is against this background that this study was carried out to evaluate the importance of immunization in children in Edo in Edo State.
1.3 Objectives of the study
The general objective of this study is to evaluate the importance of immunization in children in Oghede Community Ovia North East Local Government Area of Edo State. Specifically, the study seeks to;
1. To determine parents understanding and identify sources of information on benefits of child immunization in Oghede Community Ovia North East Local Government Area of Edo State
2. To assess the knowledge and perception of parents on vaccine preventable diseases and its effect on their acceptance of immunization in Oghede Community Ovia North East Local Government Area of Edo State.
3. To determine implications of parents knowledge on immunization practices, health planning and management based on available health information on immunization in Oghede Community Ovia North East Local Government Area of Edo State
4. To determine effects of parents understanding on the compliance with immunization in Oghede Community Ovia North East Local Government Area of Edo State.
1.4 Research questions/Hypothesis
The following questions guided the research in order to achieve the objectives of the study.
1. What is the level of parents understanding and sources of information on benefits of child immunization in Oghede Community Ovia North East Local Government Area of Edo State?
2. What is the knowledge and perception of parents on vaccine preventable diseases and its effect on their acceptance of immunization in Oghede Community Ovia North East Local Government Area of Edo State?
3. What are the implications of parents’ knowledge on immunization practices, health planning and management based on available health information on immunization in Oghede Community Ovia North East Local Government Area of Edo State?
4. What are the effects of parents understanding on the compliance with immunization in Oghede Community Ovia North East Local Government Area of Edo State?
1.5 Significance of the study
This study will be helpful to ascertain the level of parents understanding or knowledge of the value of child immunization. Determined level of parents understanding could be a valuable tool for redesigning strategy for increasing the acceptance, utilization and coverage with immunization. In essence, when the findings are implemented it could lead to increase in the benefits of and decrease in the dangers associated with lack of child immunization. Findings of this study can also be useful for general public health and child health care planning and delivery. The incredible success of immunizations in dramatically reducing the incidence of vaccine preventable diseases has led to increased public focus on vaccine safety.
Furthermore, it is hoped that data and findings from this study would be used by health agencies, professionals, experts and providers, academics, scientists and other concerned stakeholders for the development of policies that would be used for control and prevention of vaccine preventable diseases in the country. The recommendations based on the findings would contribute to improving the uptake of immunization by parents in Edo and also go a long way in educating the public in effective health management for children and families.
1.6 Scope of study
The main focus of this study is to assess the knowledge practice and factors influencing proper immunization in Oghede Community Ovia North East Local Government Area of Edo State. The population used is parents and caregivers in Oghede Community Ovia North East Local Government Area of Edo State. This would provide a basis for scientific based inference and decision making. Variables covered the level of parents understanding and sources of information on benefits of child immunization, the knowledge and perception of parents on vaccine preventable diseases and its effect on their acceptance of immunization, the implications of parents’ knowledge on immunization practices, health planning and management based on available health information on immunization, and the effects of parents understanding on the compliance with immunization in Oghede Community Ovia North East Local Government Area of Edo State.
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