Socio-Cultural Predictors Toward Non-Compliance Of Immunization Schedules Among Mothers Of Children Aged 0-59 Months

Socio-Cultural Predictors Toward Non-Compliance Of Immunization Schedules Among Mothers Of Children Aged 0-59 Months

CHAPTER ONE

INTRODUCTION

Background of the Study

Immunization is one of the most preventive measures organized to prevent childhood illnesses among children aged 0-59 months. It is a process of introducing an approved certified potent and recommended antigens or vaccines into the body system to prevent deadly childhood illness and other diseases. According to World Health Organization-WHO and United Nation International Children’s Fund – UNICEF, (2002). These childhood Vaccines Preventable Diseases (VPD) includes Poliomyelitis, Diphthera, Pertusis, Whooping Cough, Hepatitis, Measles, Yellow fever, Tuberculosis, Meningitis.

According to the National Primary Health Care Development Agency – NPHCDA (2014), opined that Immunization became a core component of preventive packages in primary health care delivery service, and VPD is the most cost effective clinical service among others. The adverse of these VPD on the health of children cannot be over emphasized.

Childhood illness are reported to be the major causes of brain damage, intellectual disabilities and death among children of under 5 years. This situation constitute a serious concern globally.

WHO  and UNICEF (2002) noted that the childhood illness account for 17 percent of global total under (5) mortality per year, and 22 percent of child mortality in Nigeria. Thus, (VPD) through immunization became a key method to reduce childhood morbidity when administered at the right time and right age. According to the authors, immunization prevented about 2 to 3 million death, annually that could have resulted from (VPDs) and additional 1.5 million deaths was prevented through global vaccination.

In 2014, about 115 million (86 percent) of infant Worldwide received Diphtheria Pertusis – Tetanus (DPT3) vaccine. The world estimated percentage in WHO, (2015) were at least 90 percent though there was a decline under 5 mortality rate globally, Sub Sahara Africa and South Asia come up with 82 percent of under – 5 death in 2011 (UNICEF. 2012).

Despite these efforts carried out by government, individuals, non-governmental organization, partners, UNICEF towards child immunization package, non-compliance among mothers of children 0-59 months remain a serious issue. WHO (2015) noted that about 18.7 million infant Worldwide have not been reached even on routine immunization services including Nigeria. This increase in non-vaccination of children leads to 2.7 million children death annually from vaccine preventable diseases.

Interestingly, the Expanded Program on Immunization (EPI) which focused initially on six major vaccine preventable diseases such as Measles, Diphtheria, Tetanus, Polio, Tuberculosis and Pertusis for children immunization less than 1 year of age was later expanded to include hepatitis B, pentavalent, pneumococcal conjugate, inactivated polio vaccination, meningitis, rotavirus up to the 12-24 months of life (The Health Team, 2012).

In 2014, (PCV) Pneumococcal Conjugate Vaccine was added in Nigeria as part of the routine immunization schedule (WHO, 2015). Sadly with all these efforts on programs, protocols, policies and reorganization of vaccine delivery system in Nigeria, children are still missed out on immunization. The compliance on immunization schedule has been noted by several agencies to be lower than expected in Nigeria National Population Commission (NPC) and NPHCDA- National Primary Heath Care Development Agency (2013).

Though many publications have observed actual factors that hinder children’s immunization globally. There are several other factors that may also hinder immunization among children. These include age of mothers, educational level, marital status, financial status and religious belief and non-accessibility of health facilities to mention a few  within Nigeria. Hence this study is designed to look at the sociocultural predictors toward non-compliance of immunization schedule among mothers of children aged 0-59 months in Ibesikpo Asutan I Local Government Area Akwa Ibom State, Nigeria.

1.2       Statement of the Problem

Non-compliance among mothers toward children immunization schedule aged 0-59 months is a serious concern with regards to their wellbeing and survival. This non-compliance has health implications on childhood development within the age bracket in most developing countries including Nigeria. This situation has been noted by most projections towards causes of morbidity and mortality among children of under 5 years (WHO, 2014).

Notably, the global vaccination target of 2015 was not realized as 1 out of every 5 children were still missed out on immunization. (WHO, UNICEF 2017), and its partners aim at providing routine immunization of 90 percent to children under the age of 1 and achieve at least 90 percent coverage for every country district by the year 2020, including Nigeria, which is one of the six countries in the world with India, Chiana, Pakistian, the Democratic Republic of the Congo and Ethiopai that accounts for half of worldwide childhood deaths and has the 10th worst infant mortality rate in the world Central Intelligence Agency (CIA) 2016.

Sadly, Nigeria has one of the world’s poorest immunization schedule status, resulting in infants and under – 5’s morbidity and mortality from easily vaccine preventable disease (WHO, 2015). This is due to more than half of the 22.4 million children not immunized.

It is also observed that despite strategies and programs conducted by organizational bodies and NPHCDA- National Primary Healthcare Development Agency, mother still showed negative attitude towards accessing the services rendered to their children either missing immunization appointments or refuses to access the service thus a dropout rates in DPT 3, PCV3 respectively. Therefore this study is carried out to investigate the sociocultural predictors toward non-compliance among mothers of children aged 0-59 months in Ibesikpo Asutan.

1.3       Objectives of the Study

The general objective of this study is to investigate the sociocultural predictors toward noncompliance of immunization schedule among mothers of children aged 0-59 months in Ibesikpo Asutan Local Government Area, Akwa Ibom State.

Specifically, the objectives of the study are;

1. To access the influence of age on non-compliance of immunization schedule among mothers of children aged 0-59 months
2. To determine the influence of educational level on non-compliance of immunization schedule among mothers of children aged 0-59 months
3. To determine the influence of religious belief on non-compliance of immunization schedule among mothers of children aged 0-59 months in Ibesikpo.
4. To determine the influence of marital status on non-compliance of immunization schedule among mothers of children aged 0-59 months in Ibesikpo.

1.4       Research Questions    

The following research questions were generated to guide the study thus,

1. What is the influence of age on non-compliance of immunization schedule among mothers of children aged 0-59 months?
2. What is the influence of educational level on non-compliance of immunization schedule among mothers of children aged 0-59 months?
3. What is the influence of religious belief on non-compliance of immunization schedule among mothers of children aged 0-59 months in Ibesikpo?
4. What is the influence of marital status on non-compliance of immunization schedule among mothers of children aged 0-59 months in Ibesikpo Asutan I Local Government Area in Akwa Ibom State?

1.5       Hypothesis

1. There is no significant influence of age on non-compliance on immunization schedules among mothers of children aged 0-59month of age in Ibesikpo Asutan 1 Local Government Area in Akwa Ibom State.
2. There is no significant influence of educational level on non-compliance on immunization schedules among mothers of children aged 0-59month of age in Ibesikpo Asutan 1 Local Government Area in Akwa Ibom State.
3. There is no significant influence of religion belief on non-compliance on immunization schedules among mothers of children aged 0-59month of age in Ibesikpo Asutan 1 Local Government Area in Akwa Ibom State.
4. There is no significant influence of marital status on non-compliance on immunization schedules among mothers of children aged 0-59month of age in Ibesikpo Asutan 1 Local Government Area in Akwa Ibom State.

1.6       Significance of the Study

The result of this study will reveal the factors that contribute to non-compliance of immunization schedule among mothers of children of 0-59 months in the community.

The findings of the study be great value to community Health officers as areas that need to be emphasized during immunization programmes will be exposed for adequate sensitization.

The findings of the study will also help government, NGO and concerned health agencies on areas that need to be monitored and conceised during immunization programmes.

The result of this study will provide exposed areas that need health education in order to reduce high morbidity and mortality rates among children age 0-59 months.

Findings of this work will enable health workers in the study area to appreciate and quantify the level of patronage and immunization service by the recipients.

The result of this investigation will serve as reference material to future researchers who may be interested on this study area.

The result of this work will serve as a reliable source of data to health professionals and the general public on health programmes.

1.7      Scope of the Study

This study will focus only on socio-cultural predictors of non-compliance of immunization schedule among mothers of children aged 0-59 months in Ibesikpo Asutan I Local Government Area, Akwa Ibom State.

1.8       Operational Definition of Terms

The operational terms used in this write up are explained below:

Non-compliance: The practice of not obeying rules or request made by people or authority that must be followed to ensure full usage of safety measures that are to be performed or carried out.

Immunization: Is an act of introducing an approved certified antigen vaccines into the body system to stimulate a protective, or a waken effect toward certain childhood disease, example polio vaccine against poliomyelitis disease among others.

Socio-cultural Predictors: These may include some cultural status like income status, level of education, marital status, culture, beliefs, tabos and poor topographic status of the community that may hinder access to obtain health service delivery.

Schedule: A plan that list all the work that you have to do when you must do each thing

Utilization: Utilization is the action of making practical and effective use of something.

BCG- Bacillus Calmette Guerin.

EU.Prime – European Union Partnership to reinforce immunization efficiency