Factors Influencing the Attitude of Mothers Towards Immunization

Factors Influencing the Attitude of Mothers Towards Immunization

Chapter One

Purpose of the Study

The purpose of the present study was to investigate the immunization attitude and practice among Mothers in Lapai LGA of Niger State. Specifically, the study was designed to find out the:

1. the attitude of mothers towards immunization against childhood killer diseases.
2. the immunization practice of mothers against childhood killer diseases.
3. the extent to which the mothers’ age influence their attitudes towards immunization of their children against childhood killer diseases.
4. the extent to which the mothers’ educational levels influence their attitudes towards immunization of their children against childhood killer diseases.
5. the extent to which the mothers’ age influence the practices of immunization against childhood killer diseases.
6. the extent to which the mothers’ educational level influence the practices of immunization against childhood killer diseases.

CHAPTER TWO

Review of Related Literature

Following the facts that there are numerous literature on immunization, literature for this study were reviewed based on Nigeria and other countries of the world. Literature for the present study is therefore presented under the following heading.

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 Review

Conceptual Framework

Concepts of immunization, attitude, and practice.

The advent of immunization worldwide is a landmark toward the prevention of children against being infected with the six killer diseases vis-à-vis tuberculosis, polio, measles, diphtheria, pertussis (whooping cough), and hepatitis B. It is an age long practice that date several decades ago.

Goodman and Gutteridge (1979); Bland and Clement (1988) traced the theory of immunization-expanded programme on immunization (EPI) to Edward Jenna in England in 1796. According these authors, Jenna was familiar with the common belief held in the countryside that people who worked with cows were less likely to catch smallpox, because they have caught similar disease called cow pox from the animals. On this basis, he set to work out whether this belief was true. They further reported that Jenna kept records patiently and accurately for a long period.He was led to believe that cowpox did confer immunity for smallpox. He experimented this by making two small cuts on a boy’s arm, and rubbed into the cuts germ-carrying pus from the sores on a woman suffering from cowpox, the boy developed cowpox. Jenna then waited for two months and conducted second part of experiment. From a patient suffering from a serious smallpox, he again obtained pus which he rubbed in the cuts made on the boy’s skin, and argued that if his theory was right the boy would not fall ill with smallpox; if he was wrong the boy would catch the disease and might even die from it. But he was relieved to find out that the boy did not develop smallpox.

Based on Jenna’s discovery of vaccine,the expanded programme on immunization (EPI) was lunched by the WHO on October 26^th, 1974 (Bland & Clement, 1998). The aim was to take vaccination against the six killer disease: – measles, diphtheria, tetanus, poliomyelitis, pertussis, tuberculosis to the women and children of the world. They referred to the word “Expanded” as denoting the addition of measles and poliomyelitis to the vaccines then being in use in immunization programme and that many developing countries did not include measles and polio vaccine in their routine immunization until 1985.

It is also against this background that the FMOH (2000) and Felden Battersby Analyst [FBA] (2005) reported that Nigeria’s Expanded Programme on Immunization (EPI) was initiated and lunched in Nigeria, in 1979 and was placed within the Department of Public Health and Communicable Disease Control within the FMOH. It was re-launched in 1984 due to poor coverage ranging from 9-29 per cent and consequently minimal impact on the target diseases. In order to extend EPI to the grassroots, the programme was transferred to the local Government Areas in the country in 1990. In 1996, it became the National Programme on Immunization (NPI) lunched by the then First Lady, Mrs. Maryam Abacha. Following a review of EPI, Decree 12 of 1997 created NPI as a parastatal.

The Federal Ministry of Health (FMOH) continues to place high priority on immunization. In 1999, a new drive to sustain ably re-vitalizes the immunization system commenced in synergy with the accelerated strategy on polio eradication. Consequently, the Federal Government established the NPI to demonstrate national consciousness and ownership for immunization charged with the mandate to effectively control vaccine preventable disease through immunization and the provision of vaccines. Key focus was to provide support to the implementation of state and LGA immunization programmes (WHO, 2010). In order to eradicate these targeted diseases, the development of 10 years strategic plan has been carried out by WHO from 1995 – 2004 to achieve the following:

1. routine immunization coverage for all NPI target disease in all LAGAS by 80%;
2. reduction of measles morbidity by 90% and mortality by 95%;
3. control of yellow fever;
4. control of hepatitis B;
5. control of cerebrospinal meningitis (CSM);
6. elimination of neonatal tetanus (NNT) and vitamin A deficiency; and
7. eradication of poliomyelitis.

Based on Jenna’s theory various vaccines were developed by other scientists and prescribed for various ages especially for children and women all over the universe (world). Werner, Thuman, Pearson and Maxwell (1993) classified and recommended the following vaccine schedule for children and adults:

1. Poliomyelitis (OPV): for infantile paralysis: A child needs a drop or two in the months but once each month for 3 months but currently four doses are given. These are usually given with D.P.T injection.

• Bacillus Calmette Guerin (BCG): For tuberculosis. A single dose of injection is given into the skin of the right scheduler. This is given at birth.
• Measles: One injection only given at the age of 9 months.
• Tetanus Toxoid (TT): For lock jaw. For both adults, and children, especially pregnant women and women of child bearing age.
• Yellow Fever (YF): For yellow fever is given at the age of 9 months and above.
• Ceretrospinal Miningitis (CSM): This is also given at the age of 9 month and above.
• Hepatitis B (HB): This is also given at the age of 9 month and above.

2. Diphtheria, Pertussis and Tetanus (DPT): For diphtheria-pertussis-tetanus. This is for full protection, children needs three injections. These are usually at 3 months, 4 months and 5 months of age.

More so, Werner et al., (1993) stressed and emphasized inoculation of children, pregnant mothers and women of reproductive age, because according to them, they are the most vulnerable groups to the target diseases, namely: Measles, tetanus, tuberculosis, poliomyelitis, yellow fever, diphtheria, pertussis, cerebrospinal meningitis and hepatitis B. Similar inoculation of children, women of child bearing age and pregnant mothers is being carried out in Lapai Local Government in Niger State and thus the need for the present research work.

John, Sutton and Webster (1986) described immunization as the most effective and protection measure for the susceptible host is increasing resistance through the body defense mechanism and changes a susceptible host into an immune person. Osakwe (1988) described immunization as one of the major ways employed in preventing disease. He stressed that high survival of children these days is due to immunization.

Ama (1993) defined immunization as the process of making a person immune to a particular disease. Onwzulike (1998) described immunization as a deliberate stimulation of the body’s defense against a specific harmful germ or bacterium or virus.

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CHAPTER THREE

Methods

This chapter describes the research design, area of the study, population for the study and sample and sampling techniques. It also presents the instrument for data collection, validation of the instrument, reliability of the instrument, method of data collection as well as method of data analysis.

Research Design

The cross-sectional survey research design was used for the study. Best (1981) and Nworgu (1991) observed that the design permits the description of phenomenon as they exist in their natural settings. Kerlinger (1992) referred to cross-sectional design as a design permitting a simultaneous study of different categories of subjects in a setting. Okpukpara (2007) used the cross-sectional survey research design in her study of the level of health knowledge and six childhood killer diseases possessed by mothers in Nawfija, Onumba south LGA, Anambra. The design was therefore considered appropriate for use in the present study.

Area of the Study

Lapai LGA is located in the southern part of the Niger state headquarter, Minna,  in the North by Paikoro LGA, in the South West by Agaie LGA, and in the East by Gurara LGA. Lapai LGA populace are mostly farmers and fishermen that lives in rural settings because of the nature of their environment. Their accessibility to health centres during immunization exercise as observed by the researcher was very low. Lapai LGA was selected for the study because the researcher has also observed from experience that a sizeable number of mothers in this area used to be fearful to immunization programme whenever officers in charge of this area embarked on the conduct of this exercise. Consequently, the health of the children in the local government could adversely be affected by the preventable diseases.

Population of the Study

The population for the study consisted of 10, 637 mothers from households who were of Lapai LGAorigin in the 22 district areas,(National Population Commission, 2011) (See Appendix C-E). Household in this regard refers to individuals who comprised a family unit and who lived together under the same roof either as mothers or fathers (Merriam Webster, 2012).

CHAPTER FOUR

Results and Discussion

This chapter presents the results of the data analysis for the study. The presentation is in accordance with the research questions and hypotheses formulated to guide the study.

Research Question 1

What are the attitudes of mothers towards immunization against child killer diseases?

CHAPTER FIVE

Summary, Conclusion and Recommendation

Summary

The study was carried out to investigate the attitude and practice of the mothers toward immunization against the childhood killer diseases in Lapai local Government Area of Niger state. The descriptive survey research design was used for the study and instrument for data collection was structured questionnaire for the respondents. The population consisted of 323 mothers of the estimated of 10, 637 of the total population of the mothers in LGA of mothers 15-45 years. The data generated were analyzed using mean and standard deviation to answer the six research questions, and t-test to verify the null hypothesis. The following major results were obtained.

Summary of the Findings

The following are the major finding of the study:

1. The overall attitude of mothers towards immunization of their children was positive. This result was however shown in table 1 where the mean and the standard deviation SD of the response of the mothers on attitude towards immunization against childhood killer diseases ( = 2.53) and (SD = 0.55).
2. The mothers regularly practiced immunization of their children against childhood killer diseases. This was shown on the table 2 in which the and standard deviation SD of the response of the mothers towards immunization practices was (= 2.52) and (SD = 0.80).
3. The mothers differs in their attitude towards immunization of their children based on age (Younger = (2.60); Older = (2.45). The difference was significant at .05 level (t-cal = 2.33; t-crit = 1.96).
4. The mothers differed in their attitude towards immunization of their children based on level of education (Educated = (2.60); Not Educated =  (2.44)). The difference was significant at .05 level (t-cal 2.60; t-crit = 196).
5. The mothers were not different in their practice of immunization against childhood killer diseases based on their age (Younger mothers (2.45); Older mothers  (2.38)). The difference was not significant at .05 level (t-cal 0.76; t-crit = 1.96).
6. The mothers differed in their practice of immunization of the children against childhood killer diseases based on level of education (Educated mothers = (2.56); Not – Educated mothers = (2.22)). The difference was significant at .05 level (tcal = 3.81; t-crit = 1.96).

Conclusion

On the basis of the major findings and discussions, the following conclusions were made:

1. Mothers have positive attitudes towards immunization of their children against childhood killer diseases.
2. Mothers have regularly practiced immunization of their children against childhood killer diseases.
3. Mothers differed in the attitude towards immunization of their children against childhood killer diseases based on their age.
4. Mothers differed in their attitude towards immunization of their children based on level of education.
5. The mothers were not different in their practice of immunization of their children against childhood killer diseases based on their age.
6. The mothers differed on their practice of immunization of their children against childhood killer diseases based on level of education.

Recommendations

Based on the findings of the present study, the discussion and conclusions thereof, the following recommendations were made:

1. Although mothers have better attitudes and practices towards immunization of their children against childhood killer diseases, there should still be an organized programme for the education of the public vaccine preventable diseases using appropriate channels of communication.
2. Public health education messages should include the causes, risk factor, transmission/spread, preventative strategies, side effects and contraindications to immunization.
3. All components of immunization should be free, including the cost of syringes.
4. The NPI should conduct period health systems research to identify hindrance to effective delivery of routine immunization at household and community levels especially for mothers.
5. The NPI should hold special dialogue on a periodic basis with minority and highly resistant groups with a view to mobilizing them to accept immunization services.
6. The Federal Government needs to workout plan for more regular supply of vaccines, materials and equipment to all the local government areas of the country to ensure effective and efficient delivery of the immunization services and activities.

Suggestions for Further Study

This study was limited to investigate the factors influencing the attitude of mothers towards immunization in Lapai Local Government Area of Niger State. Similarly study should be carried out to investigate the achievements of the programme in the whole state as well as to find out the level of immunization coverage in the state.

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