Factors Affecting Vaccination Uptake in Ugbuwangue Community
Chapter One
Study Objectives General Objective
The broad objective of this study was to analyze the factors affecting vaccination uptake in under five children in Delta state, Nigeria.
Specific objectives
The specific objectives of this study were in three folds, that is,
- To determine the proportion of under 5 children with full vaccination uptake in Delta state, Nigeria
- To determine the effect of socio-demographic-economic and vaccination access determinants on vaccination uptake in under five children in Delta state, Nigeria
- To derive policy options from objective two mentioned above
CHAPTER TWO
LITERATURE REVIEW
Introduction
This section/chapter narrates related literature under 3 headings: theoretical literature, empirical literature, and literature overview. Theoretical literature includes various economic hypotheses that explain how socioeconomic, demographic, and health factors influence vaccination coverage. Conversely, empirical literature refers to those researches that looked into determinants that influence vaccine uptake. There is also a brief overview that covers the gaps in the literature.
Theoretical Literature
This section presents the theoretical background of the study.
Health care utilization model
Several theories state that socio-demographic, economic determinants contribute a prominent part in determining individual demand for healthcare services. Phillips, Morrison, Andersen, and Aday (1998) created a healthcare utilization model. Age, geography (rural or urban), provider incentives, stratum in a society, and attitudes and beliefs toward health were critical all variables identified factors that affect utilizing healthcare services. Several studies looking into how people use healthcare have used this model. According to the hypothesis, a person’s decision to access and use healthcare is affected by their location, towns/cities or countryside. People in metropolitan residents have an affinity to use healthiness services more frequently than those in countryside areas.
A person’s socioeconomic standing also influences the uptake of available healthcare services. People who are higher in the social stratum, for example, in attaining higher education and/or employment are more tend to use healthcare facilities relative to those who have less social stratum. A person’s healthiness beliefs influence the coverage and uptake of healthcare services, including vaccination. People who believe health services are valuable are more likely to use them.
Other supportive traits include the availability of resources in the family and in the community. Because they have more purchasing power, those with a higher socioeconomic position tend to receive health amenities relative to the ones with a lower socioeconomic status. Later, he expanded his evaluation to encompass the healthcare system (Andersen & Newman, 1973). The modified model recognizes that utilization is determined by the type of health care and its purpose and the fact that health behavior is a direct determinant of health outcomes. Based on demographic characteristics and health service availability, use and regular uptake of various or individual healthcare services will have various factors in revised model (Andersen & Newman, 2005).
Choice-making model
According to this model, Young (1981) suggested ethnographic research of Mexican healthcare consumption. It comprised four elements that are critical in an individual’s choice to use healthcare services. Perceptions of gravity are the first component, that Young defines personal perception of the extent (severity) of a disease and how their social network views it. This model argues that Individuals are more likely to seek medical help if the sickness is severe; otherwise, they are less likely to do so. The second factor, he noted, is that if an individual knows of an effective home remedy, he/she has more tendency of turning to a health facility (health personnel) for various reasons, including convenience and the desire to save money (Wolinsky & Arnold, 1988). Third, faith in the remedy – refers to the confident a person is that seeking health care for their current condition is effective, and hence whether or not they would use it. The fourth component is treatment access, which includes assessing the cost and availability of health care. He went on to say that getting the needed services would have a significant effect on how much people use it. The cost in terms of economic value for getting medical treatment involves the mechanism of payment for seeking care and lost productivity time and transportation costs, which take into account the time required to access medical care given their geographic location (Garro, 1982).
CHAPTER THREE
RESEARCH METHODOLOGY
Introduction
This chapter describes methodology, framework, description of measurement variables & data source used for the study.
Conceptual Framework
Vaccination coverage is determined by considerable characteristics, including demographic-socio-economic & health institution or structure features. Government capacity to deliver vaccination services is determined by socioeconomic factors such minimum school attended, impoverishment, and remoteness of the HFs, indicating the presence of health institutions. These factors have also been extensively documented as drivers of higher vaccination coverage in the literature. A healthy health system includes an increase in the ration of nurses to clients, prenatal services, delivery in a HF, and the possession of a vaccination record/document. These factors, according to extant literature, influence complete vaccination in a specific district or region.
Moreover, the administration has a responsibility to carry out in ensuring that everyone is fully immunized. In Nigeria, for example, the central government is responsible for giving policy direction and money to county governments to deliver necessary healthcare. In exchange, country government must maintain a competent health system that ensures access to primary healthcare and oversees the maintenance of vaccination clinics. In their jurisdictions, regional governments have the authority to make decisions on how to improve their respective health systems utilizing the resources available to them.
These options could include expanding the building of HFs to lessen remoteness that households must travel to obtain health care or boosting the doctor-to-nurse-to-patient ratio. Furthermore, through various development programs, which the administration play a larger portion of the service in promoting and reducing the magnitude of health illiteracy and impoverishment.
Households, particularly those with under 5 children, should be accountable to warrantee that their kids receive complete vaccination as per WHO requirements. Circumstances that may affect the availability and access of vaccines, on the other hand, have varied effects on households’ capacity to obtain vaccination.
CHAPTER FOUR
DATA ANALYSIS, INTERPRETATION AND DISCUSSION
Introduction
In this section, the study findings on factors affecting vaccination uptake in under five children are presented and interpreted using two approaches. First, the descriptive statistics, which answer objective (1), is presented. Second, the inferential statistics that provide answer for objective (2) on the effect of socio-demographic-economic and vaccination access determinants on vaccination uptake among under 5 children. Descriptive statistics, diagnostic pre-estimation tests, inferential statistics and marginal effects were computed using STATA. Interpretation of the results and discussion in relation to other studies are also presented.
CHAPTER FIVE
SUMMARY, CONCLUSION AND POLICY RECOMMNEDATION
introduction
The current section summarizes the results of this study, conclusion & policy directives according to the findings – and it covers aspects that future studies can focus on.
Summary of the study
Childhood vaccination has proven to be an efficient way in preventing childhood diseases. In Nigeria, vaccination coverage has varied over the years. This study sought to find out characteristics related with uptake of full vaccination in under 5 children. In chapter one, we introduced the study by giving a background to the topic, stating the problem, giving a justification and stating the objectives of the study. Chapter two provides evidence from existing literature on the study topic and identify existing literature gaps. It also covered the theory that this study was framed. Chapter three covered the methodology used to conduct the study, and the conceptual framework for the study. Chapter four covered the results and study findings, as well as the interpretation of the results and discussion sections.
Findings from the study show that the full vaccination uptake was 62.6% among children aged below 5 years in Delta state, Nigeria. Vaccination uptake was high among children with mothers aged between 45-49 (48%), who had more than seven ANC visit (29%). Majority of the women had between 2 to 3 children.
Probit regression model was used to determine maternal, health system and household economic factors associated with full vaccination uptake. Correlation coefficients were interpreted. Mother’s age, and parity were the maternal factors significantly associated with uptake for full vaccination at 5% level of significance. In terms of household economic factors, higher household income (wealth) quintile was a strong determinant of uptake of full vaccination uptake where there is high probability of being fully vaccinated. Place of delivery which is a health system factor was also a factor associated with uptake for full vaccination in under 5 children.
Conclusion
In conclusion, the study sought to investigate factors affecting full vaccination uptake in under 5 children in Delta state of Nigeria. The study found that maternal age, birth order, wealth index, place of delivery, ANC visits and household size were significant factors affecting full vaccine uptake among the children. However, factors such as maternal education, residence and household age did not have any significant effect on vaccination coverage.
Policy recommendations
Increasing demand for full vaccination uptake shall enable regions in Nigeria to attain more vaccination coverage. According to this study findings, full uptake of vaccination was associated with mother’s age, parity, and wealth quintile, ANC visits and household size.
The government should intensify the sensitization of young mothers and women with little or no income on the importance of vaccination. This can be done during antenatal and/or post-natal care visits. Community health workers should increase door-to-door campaigns in order to ensure all children born to a woman has received all vaccines that he/she is eligible for.
Demand for and uptake of full vaccination might be low in the lower wealth quintiles due to indirect costs related to vaccination, including transport to health facility. The government can increase demand for vaccination in the lowest wealth quintile households by offering incentives that will enable mothers to take their children for vaccination. Women from the poorest households should also be economically empowered which will increase their health seeking behavior and therefore increasing demand for vaccination.
The stakeholders, including government, should introduce mobile clinics in remote areas targeting those with low income mother. This will encourage mothers to take their children for vaccination and therefore increasing the demand for and uptake of vaccination.
References
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