Knowledge, Attitude, and Practice of Immunization Among Under-five Children of Mothers/Caregivers in Ado Ekiti, Ekiti State, Nigeria
Chapter One
Abstract
The knowledge, attitudes, and practices of mothers or carers on immunisation for children under five in Ado Ekiti, Nigeria, were investigated in this quantitative survey research using a structured questionnaire. Using a sample of 120 respondents, the study sought to shed light on the variables affecting community immunisation outcomes. SPSS 27 was used throughout the data-gathering process to ensure a thorough and methodical analysis of the research variables, as well as for presentation. The study’s hypotheses were tested using a t-test, revealing significant relationships between the level of knowledge about immunization, attitudes towards immunization, and actual immunization practices. The rejection of null hypotheses indicated that a higher level of knowledge and positive attitudes among mothers or caregivers corresponded with more favourable immunization practices. This statistical validation underlines the importance of educational campaigns and targeted interventions to enhance knowledge and foster positive attitudes within the community. The findings highlighted a commendable level of awareness and adherence to immunization schedules, but the presence of uncertainties and disagreements emphasized the need for nuanced and context-specific strategies. The study also unveiled potential influences of cultural beliefs, accessibility challenges, and socio-economic factors on immunization practices, signalling key areas for focused interventions. The conclusions drawn from the study stress the interconnected nature of knowledge, attitudes, and practices, advocating for tailored approaches that consider local dynamics. In conclusion, the study contributes to the existing body of knowledge by offering insights into the specific challenges faced by mothers or caregivers in Ado Ekiti regarding immunization. The recommendations underscore the importance of community engagement, improved accessibility, and culturally sensitive interventions to enhance immunization outcomes. This research provides a foundation for further studies and informs public health strategies aimed at safeguarding the health of the younger population in similar communities.
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CHAPTER ONE
INTRODUCTION
Background to the Study
Immunization stands as a linchpin in public health, proven to significantly diminish the prevalence of vaccine-preventable diseases and bolster overall population health (Antai, 2020; Frenkel, 2021). This crucial public health intervention is particularly pivotal for vulnerable groups, with a primary emphasis on children under five years old in global immunization programs (Antai, 2020; Shaipuzaman & Rahman, 2022). In Ado Ekiti, Nigeria, the importance of immunization is underscored, placing the health of under-five children inextricably linked to the knowledge, attitudes, and practices of their mothers or caregivers (Antai, 2020).
Research studies, such as Antai’s investigation into migration and child immunization in Nigeria, contribute significantly to understanding the individual and community-level factors influencing immunization uptake, emphasizing the need for targeted interventions to enhance coverage (Antai, 2020). Shaipuzaman and Rahman’s study in Malaysian public universities sheds light on the knowledge and attitudes surrounding infant vaccination, highlighting the multifaceted nature of factors influencing immunization practices (Shaipuzaman & Rahman, 2022).
The relevance of immunization extends to Nigeria, as evidenced by research studies focusing on the impact of water and sanitation on childhood mortality (Ezeh et al., 2022). Studies conducted in specific Nigerian regions, such as Woldia town in northeast Ethiopia and the North Central part of Nigeria, emphasize the coverage, opportunities, and challenges faced in implementing immunization programs (Abebe et al., 2019; Adenike et al., 2017). Additionally, the National Immunization Coverage Survey Report for Nigeria serves as a critical reference point for assessing the current state of immunization efforts (National Immunization Coverage Survey Report, Nigeria, 2023).
Considering the global burden of vaccine-preventable diseases, Frenkel’s exploration of the impact of these diseases on children under five underscores the urgency of effective immunization strategies (Frenkel, 2021). As we focus on the local context of Ado Ekiti, the role of mothers or caregivers becomes paramount. Research on maternal characteristics and immunization status in North Central Nigeria, as well as studies in Enugu, highlight the intricate relationship between maternal knowledge, attitudes, and practices and the immunization status of children (Adenike et al., 2017; Okafor et al., 2022). Therefore, the success of immunization programs in Ado Ekiti hinges on a comprehensive understanding of these factors, as demonstrated by numerous studies, to tailor interventions that address the unique challenges faced by this community (Antai, 2020; Shaipuzaman & Rahman, 2022; Adenike et al., 2017).
Nigeria, the most populous country in Africa, has witnessed commendable strides in bolstering immunization coverage, reflecting the country’s commitment to public health (National Immunization Coverage Survey Report, Nigeria, 2023). Despite these advancements, persistent challenges, particularly at the community level, necessitate a nuanced approach to further strengthen immunization initiatives. It is imperative to delve into the dynamics of knowledge, attitudes, and practices surrounding immunization, especially among mothers and caregivers in Ado Ekiti, to unveil insights crucial for refining existing programs and safeguarding the well-being of the younger population (Antai, 2020; National Immunization Coverage Survey Report, Nigeria, 2023).
Research by Antai (2020) emphasizes the significance of community-level factors in shaping immunization outcomes, reinforcing the need for targeted interventions tailored to the unique challenges faced by specific regions. Ado Ekiti, being a microcosm of the larger Nigerian context, presents an opportunity to investigate localized dynamics influencing immunization practices. By understanding the intricate interplay of knowledge, attitudes, and practices, health authorities can design context-specific strategies that resonate with the community and address barriers to optimal immunization coverage.
The National Immunization Coverage Survey Report for Nigeria serves as a valuable resource for assessing the overall landscape of immunization efforts in the country, offering insights into the areas that require focused attention (National Immunization Coverage Survey Report, Nigeria, 2023). This comprehensive report provides a backdrop against which the specific challenges and opportunities in Ado Ekiti can be contextualized. It serves as a foundation for targeted research and interventions, enabling a more nuanced understanding of the factors influencing immunization practices in this specific community.
At the heart of successful immunization programs are the mothers and caregivers who play a central role in decision-making for the health and well-being of children (Antai, 2020; Adenike et al., 2017). Exploring their knowledge, attitudes, and practices towards immunization in Ado Ekiti is essential for tailoring communication strategies and educational campaigns. By acknowledging the diversity within communities and recognizing the influence of cultural nuances, health authorities can cultivate a more effective and culturally sensitive approach to promote immunization awareness.
In essence, while Nigeria has made substantial progress in immunization coverage, persistent challenges at the community level necessitate a targeted and context-specific approach. Ado Ekiti, as a microcosm, offers valuable insights into the intricate dynamics of knowledge, attitudes, and practices surrounding immunization. By drawing on the existing research landscape and the experiences documented in the National Immunization Coverage Survey Report, health authorities can develop strategies that resonate with the community, address specific challenges, and further elevate the success of immunization programs in safeguarding the health of the younger population (Antai, 2020; National Immunization Coverage Survey Report, Nigeria, 2023).
Statement of Problem
Despite the commendable progress in immunization coverage in Nigeria, especially at the national level (National Immunization Coverage Survey Report, Nigeria, 2023), significant gaps persist, particularly in understanding the localized dynamics influencing immunization practices at the community level in Ado Ekiti. The existing literature emphasizes the importance of community-level factors in shaping immunization outcomes (Antai, 2020), but there is a dearth of specific research focusing on the unique challenges faced by mothers and caregivers in Ado Ekiti.
While national-level data provides a comprehensive overview, it may not capture the nuanced intricacies specific to Ado Ekiti. Localized factors, including cultural beliefs, accessibility to healthcare facilities, and community engagement, play a pivotal role in determining immunization uptake (Antai, 2020; National Immunization Coverage Survey Report, Nigeria, 2023). Understanding these localized factors is crucial for tailoring interventions that address the specific barriers faced by mothers and caregivers in Ado Ekiti, contributing to the overall improvement of immunization programs.
Furthermore, there is a need to explore the socio-economic determinants influencing immunization practices in Ado Ekiti. While studies in Nigeria have touched upon the impact of water and sanitation on childhood mortality (Ezeh et al., 2022), there is limited research specifically investigating how socio-economic factors contribute to immunization disparities in this community. Exploring the financial implications, educational backgrounds, and employment statuses of mothers and caregivers can provide valuable insights into the socio-economic barriers affecting immunization uptake.
Additionally, the existing literature lacks a comprehensive examination of the role of community engagement and health literacy in Ado Ekiti. Research has shown that community involvement is crucial for the success of immunization programs (Antai, 2020), and understanding the level of health literacy and community engagement in Ado Ekiti can highlight areas for targeted interventions. Identifying these gaps and addressing them through research will contribute significantly to refining immunization strategies, fostering community-specific approaches, and ultimately enhancing the well-being of the younger population in Ado Ekiti.
Objectives of the Study
The study aimed to investigate the knowledge, attitudes, and practices of immunisation among mothers or caregivers of under-five children in Ado Ekiti, Ekiti State, Nigeria. The specific objectives were as follows:
- To assess the level of knowledge about immunization among mothers or caregivers of under-five children in Ado Ekiti.
- To explore the attitudes of mothers or caregivers towards immunization in Ado Ekiti.
- To examine the immunization practices adopted by mothers or caregivers for their under-five children in Ado Ekiti.
Research Questions
The research questions guiding this study were as follows:
- What is the level of knowledge about immunization among mothers or caregivers of under-five children in Ado Ekiti?
- What are the attitudes of mothers or caregivers towards immunization in Ado Ekiti?
- What are the immunization practices adopted by mothers or caregivers for their under-five children in Ado Ekiti?
 Research Hypotheses
The study was guided by the following hypotheses:
Null Hypotheses(H0):
- There is no significant relationship between the level of knowledge about immunization and immunization practices among mothers or caregivers of under-five children in Ado Ekiti.
- Attitudes towards immunization do not significantly influence the immunization practices of mothers or caregivers of under-five children in Ado Ekiti.
 Alternative Hypotheses(H1):
- There is a significant relationship between the level of knowledge about immunization and immunization practices among mothers or caregivers of under-five children in Ado Ekiti.
- Attitudes towards immunization significantly influence the immunization practices of mothers or caregivers of under-five children in Ado Ekiti.
 Significance of the Study
This research carries substantial implications for public health not only within the confines of Ado Ekiti but also on a broader scale. The study, which delves into the intricate factors shaping the knowledge, attitudes, and practices of immunisation among mothers or caregivers of under-five children, offers a wealth of valuable insights. These insights have the potential to inform and guide policymakers, healthcare practitioners, and community stakeholders in developing and implementing tailored interventions. The ultimate goal is to address specific challenges and bolster immunization coverage, thereby making a significant contribution to the reduction of vaccine-preventable diseases in the region and potentially serving as a model for similar contexts.
At the heart of the significance lies the potential to influence policy decisions. Policymakers, armed with a nuanced understanding of the local determinants of immunization practices in Ado Ekiti, can craft policies that are not only evidence-based but also context-specific. This research equips them with the knowledge needed to design targeted interventions that resonate with the unique challenges faced by the community. By incorporating these insights into policy frameworks, decision-makers can create initiatives that are more likely to succeed in overcoming barriers to immunization, ultimately leading to improved health outcomes among under-five children.
Healthcare practitioners stand to benefit significantly from the findings of this research. The detailed exploration of knowledge, attitudes, and practices surrounding immunization allows practitioners to tailor their communication strategies. Understanding the community-specific factors that influence decision-making around immunization enables healthcare providers to engage more effectively with mothers and caregivers. By fostering an environment of trust and understanding, healthcare practitioners can contribute to increased acceptance and uptake of immunization, fostering positive health-seeking behaviour within the community.
Community stakeholders, including local leaders and organizations, play a pivotal role in the success of any public health initiative. This research offers them a roadmap for targeted community engagement. By identifying the specific challenges faced by mothers and caregivers in Ado Ekiti, stakeholders can develop community-based programs that directly address these issues. Whether through educational campaigns, outreach programs, or partnerships with local influencers, community stakeholders can leverage this research to create initiatives that resonate with the population, fostering a sense of ownership and participation in immunization efforts.
The broader implications of this research extend beyond the borders of Ado Ekiti. Given Nigeria’s status as the most populous country in Africa, the lessons learned from this study can potentially be applied to similar contexts across the nation. Furthermore, the study’s methodology and approach may serve as a valuable template for researchers and public health professionals grappling with similar challenges globally. The emphasis on localized factors influencing immunization practices underscores the importance of tailoring interventions to the specific needs of communities, irrespective of geographical location.
 Scope of the Study
The study focused on mothers or caregivers of under-five children in Ado Ekiti, Ekiti State, Nigeria. The research delved into their knowledge, attitudes, and practices regarding immunization. Data collection and analysis were conducted within a specific timeframe, ensuring the findings reflect the state of immunization in the region during that period.
Operational Definition of Terms
To maintain clarity and consistency, the following terms were operationally defined:
Knowledge: The understanding and awareness of mothers or caregivers about immunization, including the types of vaccines, their benefits, and the recommended immunization schedule for under-five children.
Attitudes: The feelings and opinions of mothers or caregivers towards immunization, encompassing their beliefs, perceptions, and emotional responses related to the vaccination of under-five children.
Practices: The actions taken by mothers or caregivers in implementing immunization for under-five children, including adherence to the recommended vaccination schedule, attendance at immunization clinics, and compliance with healthcare recommendations.
Immunization Coverage: The extent to which under-five children in Ado Ekiti have received the recommended vaccines based on the national immunization schedule.
Public Health Interventions: Strategies, programs, or policies implemented by healthcare authorities and organizations to improve immunization coverage and prevent vaccine-preventable diseases among the under-five population.
Vulnerable Population: Children under the age of five who are more susceptible to vaccine-preventable diseases due to their developing immune systems.
Comprehensive Understanding: In-depth knowledge and insight into the factors influencing immunization practices, considering cultural, social, and economic determinants.
Targeted Interventions: Specific actions and measures to address identified challenges and improve immunisation coverage among under-five children in Ado Ekiti.
References
- Bolarinwa, O. A. (2020). Sample size estimation for health and social science researchers: The principles and considerations for different study designs. Nigerian Postgraduate Medical Journal, 27, 67.
- Ekwebelem, O. C., Nnorom-Dike, O. V., Aborode, A. T., Ekwebelem, N. C., Aleke, J. C., & Ofielu, E. S. (2021). Eradication of wild poliovirus in Nigeria: Lessons learnt. Public Health in Practice, 2, 100144. doi:10.1016/j.puhip.2021.100144.
- Ezeh, O. K., Agho, K. E., Dibley, M. J., Hall, J., & Page, A. N. (2022). The impact of water and sanitation on childhood mortality in Nigeria: Evidence from demographic and health surveys, 2003–2013. International Journal of Environmental Research and Public Health, 11, 9256–9272.
- Fatiregun, A. A., & Okoro, A. O. (2022). Maternal determinants of complete child immunization among children aged 12–23 months in a southern district of Nigeria. Vaccine, 30, 730–736.
- Frenkel, L. D. (2021). The global burden of vaccine-preventable infectious diseases in children less than 5 years of age: Implications for COVID-19 vaccination. How can we do better? Allergy Asthma Proceedings, 42, 378–385.
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