AN INVESTIGATION ON THE IMPORTANCE AND THE EFFECTIVENESS OF ROUTINE IMMUNIZATION AMONG CHILDREN 0 TO 5 YEARS

AN INVESTIGATION ON THE IMPORTANCE AND THE EFFECTIVENESS OF ROUTINE IMMUNIZATION AMONG CHILDREN 0 TO 5 YEARS

​​​​​​​Background of the study

It is obvious that immunization is one of the most cost-effective public health interventions for reducing global child morbidity, mortality and life time disabilities (Lee, 2003) (Chen et al, 2004). Worldwide, immunization prevents more than 2.5 million child deaths each year (WHO/UNICEF and World Bank, 2009, WHO 2009). Global public health has greatly improved through the widespread use of vaccines, preventing millions of childhood hospitalizations and deaths each year rating immunization as a number one public health intervention (CDC, 2010 CDC 2009). Before the advent of immunization programs, infectious diseases such as measles, diphtheria, smallpox and pertussis were leading causes of child mortality (Stern et al., 2005). Tetanus toxoid vaccine is given to pregnant women to prevent against neonatal tetanus, which can be a major cause of infant deaths (KDHS 2014).

In the United States there has been a remarkable achievement in the control of vaccine preventable diseases resulting in decline in morbidity and mortality associated with vaccine preventable diseases (CDC 2010). In Africa, there has been tremendous improvement in the overall immunization coverage, though at a relatively slower rate (WHO 2004, WHO 2014). However, some African countries like Ghana, Morocco and Gambia have registered success in reaching coverage of over 90% (Ghana News Agency 2012, WHO 2014, UNICEF, 2014). The introduction of the immunization programme has led to continual reduction of vaccine preventable disease incidence.

Despite the remarkable achievements and improvements in immunization services, the agenda remains largely unfinished with large numbers of children (24 million) remaining unreached, unvaccinated or under-vaccinated (WHO, UNICEF & World Bank 2009). One-fifth of the world’s children which is about 22.4 million infants, are not immunized against VPD and 70 percent of these children come from 10 countries, Nigeria being one of them (WHO/UNICEF 2014), (UNICEF/WHO 2011), (UNICEF Australia 2013). One of the causes of high mortality rates in Nigeria are vaccine-preventable diseases. Previous studies have explored factors associated with implementation of childhood immunization programs, however most of these studies focused on the demand side factors. Some of the most cited demand-side factors that have been shown to influence functioning of immunization programs include parity, household income, ethnicity, place of delivery, mother’s level of education, distance to health facility, culture, religion, age and forgetfulness of guardian due to preoccupation with other activities, (Abdulraheem et al 2011.,Bbaale, 2013,Barman et al, 2009)(Bates, 1994)(Calhoun et al., 2014)(Kariuki, 2004) Mutua et al., 2011, Maina et al,. 2013, Ndiritu et al. 2007, Njeru, 2011, Ophori et al, 2014, Odusanya, et al 2003). There are relatively few studies examining supply-side factors affecting implementation of childhood immunization programs in the Nigerian context, particularly in predominantly rural areas. This study aims to fill this gap. The relatively poor health indices and large size of the county makes it a reasonable choice for understanding the factors affecting implementation of immunization programs in primary healthcare facilities in Nigeria.

​​​​​​​Statement of the problem

Immunization program is a key strategy for prevention of child and neonatal deaths and lifetime disabilities. Immunization prevents 2.5 million child deaths each year (WHO, 2009). Despite the global improvement in vaccine coverage that has seen 84% of children around the world receiving this life-saving intervention, 10 million children in low and middle level countries die before reaching age of five (Arevshatia et al, 2007). Full immunization potential has not yet been realized in many countries where 22.4 million Children around the globe are not fully immunized. Majority of not fully immunized children 70% are from 10 countries, Nigeria being one of them (WHO/UNICEF 2014). Low immunization coverage remains a challenge even in a committed country like Nigeria. This study sought to identify the importance and the effectiveness of routine immunization among children 0 to 5 years. 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. In Nigeria for instance, vaccines are made freely available to the public, yet over 20 percent of Nigerian children are not immunized each year. There is a need to identify strategies for improving implementation of vaccination programs in the country, particularly at primary health care level in predominantly rural areas and this study aimed to fill this gap. Therefore, the study seeks to investigate the importance and the effectiveness of routine immunization among children 0 to 5 years.

​​​​​​​Objective of the study

The broad objective of the study is to investigate the importance and the effectiveness of routine immunization among children 0 to 5 years. The specific objectives is as follows:

1. To find out whether parents are aware of the need to immunize their babies.
2. To examine whether routine immunization of children reduces the child mortality rate.
3. To assess the challenges parents have in immunizing their children.
4. To investigate the importance and effectiveness of routine immunization of children of 0 to 5 years.

Research Questions

The following questions has been prepared as a guide for the study:

1. Are parents aware of the need to immunize their babies?
2. Does  routine immunization of children reduces the child mortality rate?
3. What are  the challenges parents have in immunizing their children?
4. What is the importance and effectiveness of routine immunization of children of 0 to 5 years?

Research hypotheses

The following hypothesis have been formulated for the study:

H01: Parents are not aware of the need to immunize their babies.

H02:  Routine immunization of children does not reduces the child mortality rate.

​​​​​​​Significance of the study

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. This study contributes to the broader literature addressing how to improve implementation of childhood immunization programs in rural areas by providing an empirical analysis of challenges faced by program implementers. Specifically, this study seeks to contribute to the literature related to the identification of intervention targets for increasing the effectiveness of immunization programs in primary healthcare facilities in  Nigeria.

1.7 Scope of the study

The study will find out whether parents are aware of the need to immunize their babies. The study will also examine whether routine immunization of children reduces the child mortality rate. The study will further assess the challenges parents have in immunizing their children. Finally, the study will  investigate the importance and effectiveness of routine immunization of children of 0 to 5 years. Hence, the study is delimited to mother and child general hospital Akure, Ondo State.

1.8 Limitation of the study

Like in every human endeavour, the researchers encountered slight constraints while carrying out the study. Insufficient funds tend to impede the efficiency of the researcher in sourcing for the relevant materials, literature, or information and in the process of data collection (internet, questionnaire, and interview), which is why the researcher resorted to a moderate choice of sample size. More so, the researcher will simultaneously engage in this study with other academic work. As a result, the amount of time spent on research will be reduced.

1.9 Definition of terms

Immunization: is the process by which an individual's immune system is stimulated through exposure to an immunogenic agent known as vaccine (a substance that stimulates the immune system is said to be immunogenic)

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