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Barriers to Uptake of Immunization

BARRIERS TO UPTAKE OF IMMUNIZATION


ABSTRACT

The study was carried out to scrutinize the Barriers to Uptake of Immunization using Polio Immunization in Northern Nigeria as a case study. In achieving this aim, the following specific objectives were laid out to identify the problem of immunization, and understand the attitudes of parents toward immunizing their children in Northern Nigeria. From the findings, it was observed that ignorance and inability of mothers to get their child immunized lead to death of children so government area advised to explain the main importance of immunization to mothers in order to increase the rate of immunization. Immunization is one of the most effective and safest ways to prevent disease and early child mortality rates.

The socio-economically disadvantaged populations are among the most vulnerable groups that are under-vaccinated. Uptake of vaccination services is dependent not only on provision of these services but also on other factors including knowledge and attitude of mothers, density of health workers, accessibility to vaccination clinics and availability of safe needles and syringes. This study underlines a need for an effective counselling tailored to the immunization session, which will maintain a positive relationship between the personnel and the mother.

The findings of this study are of great significance to immunization program managers and policy makers in geographical areas with large rural populations. It provides a basis for rational interventions to improve vaccine delivery in primary healthcare facilities, improve vaccination coverage indices and reduce the burden of childhood infectious diseases. The results are of benefit to the county health management team by providing actionable information relevant for planning and policy making to improve delivery of childhood vaccines in the county.


CHAPTER ONE

1.1 Introduction

Immunization is one of the public health programmers that prevent disease in society. Vaccination is the most common technique used in immunization. It entails the administration of a vaccine into the human body in order to stimulate an individual’s immune system against bacteria, viruses, parasites and fungi. Vaccines are defined as biological preparation intended to produce immunity against a disease by exciting the production of antibodies. Vaccines are safe and effective; however, adverse reactions may develop following a vaccine and the process of immunization itself.

As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the Aim and Objectives of the study. Others are Significance of the study, Scope of work, Research hypothesis and questions, Limitation of the study and Definition of terms.


1.2 Background of Study

Routine immunization coverage among children in developing countries is below the WHO and UNICEF target of 80% which leads to many children suffering from infectious parasitic and immunizablediseases which are by far the leading causes of morbidity and mortality in the developing countries according to Utibeabasi (2018).

The immunization of a new born child is a very important way of preventing illness considering the way common diseases that claimed the life of children. According to Oichl and Datrymple (2009) when more than 50% of a community population are immunized against a disease, the possibility of epidemic is removed.

Supporting this view, Ogbuibe (2005) pointed out that the entry point to be fill introduction of all elements of primary health care system, immunization against diseases in one of the fairly they elements of the child’s survival and development. The national programme of immunization was for certain target groups of the population mainly children within the large group of 0-2 years and pregnant mothers or women. It is target against the six deadly and childhood diseases. These diseases are tuberculosis, measles, poliomyelitis, tetanus, chicken pox and whooping cough. The high rate of mortality from disease preventable by immunization underscores the need for immunization was the most effective programme to reduce these diseases for which satisfactory immunization procedures have been established.

When a disease is peculiar to certain area, health authorities may recommend immunization of all persons in that area particularly those who are likely to be exposed to it. To buttress this view, Anderson (2000) suggested that mass immunization against typhoid fever is not advocated but if an epidemic occurs in a community, health authorities may implore all susceptible persons to be immunized. The success of any immunization programme depends largely on the target population. It is pertinent to note that mothers are the persons in the issues of the children rearing pattern in our society whereby the mothers rather than fathers are the home keepers and know better about their children’s immunization status. Therefore, all children should be protected. All mothers should understand the importance of immunization to ensure this, Sohem (2005) recommended the vaccination of all new born children should be registered at all health clinics for routine immunization. This entails that they should undergo all stages of immunization.

Immunization is the act of protecting someone against a disease by the intake of inoculation of vaccine or other protective agents which stimulate natural body resistance. It could be active or passive. Immunization is the active which involves administering agents which stimulates the receivers’ own immunological mechanism who responds by producing reactions in his resistance to infect by the organisms from which the antigen was derived or obtained. This takes several weeks to produce effective protection hence, it has a prophylactic value but last forever. On the other hand, immunization is said to be passive by the giving of already made anti-bodies formed by another lost in response to natural injection. This has immediate protective and therapeutic value but last for a short period.

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.

Therefore, in Northern Nigeria where the research was carried out, the activities that was conducted is to know the Barriers to Uptake of Immunization in Nigeria.


1.3 Statement of Problems

Investigation revealed that the decision to carry out the study was due to the barriers associated with immunization of children among the illiterate mothers in Nigeria. In the past, many children died before the age of 5 or before the school age due to communicable diseases e.g. tuberculosis, diphtheria, poliomyelitis, whooping cough, measles, tetanus etc. they did not know that these disease could be prevented. These communicable disease were discovered by scientific researcher, clinics are established where the disease can be prevented by treatment.

Low immunization coverage remains a challenge even in a committed country like Nigeria. This study sought to identify intervention targets for improving immunization coverage by investigating Barriers to Uptake of Immunization in Nigeria in Northern Nigeria, Nigeria. The focus was to identify factors contributing to missed immunization and ways to reduce the number of missed opportunities for immunization at the health facilities. Much effort has been made to provide vaccines through the GAVI alliance, enabling states to acquire the recommended vaccines.

Many people are not still making use of the clinic and health center, perhaps due to ignorance, inability of mothers to get the facilities or non availability of vaccine or lack of understanding. Therefore this study is carried out in order to investigate the Barriers to Uptake of Immunization.


1.4 Aim and Objectives of Study

The aim of the study is to scrutinize the Barriers to Uptake of Immunization in Nigeria. In achieving this aim, the following specific objectives were laid out as follows:

  1. To understand the factors affecting the implementation of Polio Immunization in Northern Nigeria;
  2. To know the benefits and challenges of immunization coverage in Nigeria;
  3. To identify the problem of Polio Immunization in Northern Nigeria; and
  4. To understand the attitudes of parents toward immunizing their children in Northern Nigeria.

1.5 Research Questions

The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:

  • What are the factors affecting the implementation of Polio Immunization in Northern Nigeria?
  • What are the benefits and challenges of immunization coverage in Nigeria?
  • What are the problems of Polio Immunization in Northern Nigeria?
  • What are the attitudes of parents toward immunizing their children in Northern Nigeria?

1.6 Significance of Study

This research is expected to be of great importance to parents and the general public in Nigeria who will appreciate the implication of the problem of immunization and know the best way to handle them. The study conducted was done to aid the following group of people.

  1. The mothers
  2. The health center
  3. Ministry of health, Edo State.

The Mothers:

The mother will be advice properly on what they should do. The information gathered will be of great importance which may change mother’s attitudes towards immunization programme.

The health center:

The suggestion made will be used as a source of correction measure to health persons on one way or the other may have contributed to the lukewarm attitude of mothers when they bring their children for immunization through health education and lack of follow up visit to trace defaulters.

Ministry of Health, Edo State:

The findings may serve as a clue for the Ministry of health to make better plan by making of health to make better plan by making adequate provision of vaccine and training more people into the health sector to promote child immunization in Nigeria.


CHAPTER TWO

2.0 Literature Review

2.1 Introduction

The review of relevant literature is the main topic of this chapter. A literature review covers theoretical and methodological contributions to a certain issue in addition to the state of knowledge at the time of writing. It provides information about the state of the art in relation to the subject you are writing about. It examines the body of work on the chosen subject. The literature evaluation in this study comprises the …


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TABLE OF CONTENTS

PRELIMINARY PAGES


CHAPTER ONE

INTRODUCTION

  • 1.1 Introduction
  • 1.2 Background of Study
  • 1.3 Statement of Problems
  • 1.4 Aim and Objectives of Study
  • 1.5 Research Questions
  • 1.6 Research Hypothesis
  • 1.7 Significance of Study
  • 1.8 Scope of Study
  • 1.9 Limitations of the Study
  • 1.10 Definition of Terms

CHAPTER TWO

LITERATURE REVIEW

  • 2.1 Introduction
  • 2.2 History of Immunization
  • 2.3 Conceptual Review of Immunization
  • 2.4 Challenges of Immunization
  • 2.5 Theoretical Framework of Immunization
  • 2.5.1 Vaccination
  • 2.6 Factors Affecting Immunization
  • 2.7 Relevance of Immunization
  • 2.8 Ways to Improve Immunization Coverage and Uptake
  • 2.9 Empirical Studies

CHAPTER THREE

RESEARCH METHODOLOGY

  • 3.1 Methodology
  • 3.2 Ethical Consideration
  • 3.3 Quality Assurance
  • 3.4 Conclusion
  • 3.5 Recommendation

REFERENCES


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