Factors influencing the attitude of mothers towards immunization

 

Abstract

 

The study was conducted to investigate factors influencing the attitude of mothers towards immunization in Lapai Local Government Area of Niger State. The cross sectional design survey was used for the study. The population for the study consisted of 10,637 mothers from households who were of Lapai LGA in Niger State. Three hundred and Thirty (330) mothers were drawn using multi – stage sampling procedure involving three stages. The instrument for data collection was self structured questionnaire which comprised of 15 items that investigated factors influencing the attitude of mothers towards immunization. Six research questions were posed and four hypotheses tested. Data were analyzed using mean score, standard deviation and t-test. The findings revealed that: The overall attitude of mothers towards immunization of their children was positive (X=2.55). The mothers regularly practiced immunization of their children (X=2.55). The mothers differed in their attitude towards immunization of their children based on age (Younger = X of 2.60; Older = X of 2.45). The different was significant at .05 level (t-cal = 2.3; t-crit=1.96). The mothers differs in their attitude toward immunization of their children based on level of education (Educated = X of 2.60; Not – educated = X of 2.44). The different was significant at .05 level (t-cal 2.60; t-crit = 1.96). The mothers were not different in their practice of immunization of their children based on their age (Younger = X of 2.45; Older = X of 2.38). The different was not significant at .05 level (t-cal 0.76; t-crit = 1.96). The mother differed in their practice of immunization of their children based on level of education (Educated = X of 2.56; Not – educated = X of 2.22). The difference was significant at .05 level (t-cal = 3.81; t-crit=1.96). Based on the findings of the present study, it was recommended that public health education messages should include the causes, risk factor, transmission/spread, preventative strategies, side effects and contraindications to immunization.

 

 

CHAPTER ONE

Introduction

Background to the Study

Routine immunization coverage among children in developing countries is below the WHO and UNICEF target of 80% which leads to many children suffering from infectious parasitic and immunizable diseases which are by far the leading causes of morbidity and mortality in the developing countries according to Utibeabasi (2018).

The immunization of a new born child is a very important way of preventing illness considering the way common diseases that claimed the life of children. According to Oichl and Datrymple (2009) when more than 50% of a community population are immunized against a disease, the possibility of epidemic is removed. Supporting this view, Ogbuibe (2005) pointed out that the entry point to be fill introduction of all elements of primary health care system, immunization against diseases in one of the fairly they elements of the child’s survival and development.

The national programme of immunization was for certain target groups of the population mainly children within the large group of 0-2 years and pregnant mothers or women. It is target against the six deadly and childhood diseases. These diseases are tuberculosis, measles, poliomyelitis, tetanus, chicken pox and whooping cough. The high rate of mortality from disease preventable by immunization underscores the need for immunization was the most effective programme to reduce these diseases for which satisfactory immunization procedures have been established.

Odusanya, Alufoha, Meurice and Ahonkhai (2008), stressed that immunization remains one of the most important public health interventions and a cost effective strategy to reduce both the morbidity and mortality associated with infections diseases. They asserted that over two million deaths are delayed through immunization each year world wide. The researchers further explained that despite the above assertion, vaccine preventable diseases remain the worst common cause of childhood mortality within an estimated three million deaths each year. They reiterated that the uptake of vaccination services is dependent not only on provision of these services but also of mothers, density of health workers accessibility to vaccination clinics and availability of safe needles and syringes.

The Nigerian National Programme on Immunization (NPI) schedule is Bacillus Calmette Guerin (BCG), Oral Polio Vaccine (OPV0), Hepatitis B1 (HB1) (first dose) at 6 weeks, Diphteria Pertussis and Tetanus (DPT2), OPV2 at 10 weeks; DPT3, OPV3, HB3 (third dose) at 14  weeks; measles and yellow fever at 9 months.

Following from the above, the question arises as to what immunization is and what it is intended for. John, Sutton and Webster (1986) described immunization as the most effective measure for protecting the susceptible host against a particular disease. Osakwe (1988) viewed immunization as one of the major ways employed in preventing diseases. He further indicated that high survival rate of children these days is largely attributed to immunization. Onuzulike (1998) sees immunization as a deliberate stimulation of the body’s defence against specific harmful germs. Furthermore, Akubue (2000) perceived immunization as a process which confers immunity against a specific disease.

The process of administering special medicine into a person’s body in order to make the person’s body resistant to diseases stronger so that he/she may not become sick or die from disease is known as immunization (WHO, 2001). UNICEF (1989) warned that without immunization, an average of three out of every hundred children born will die from measles, two will die from whooping cough, one or more will die from tetanus. UNICEF further warned that out of every two hundred children not immunized one will be disabled by polio.

Mukherjee (1978) defined attitude as one’s feelings, thoughts, and predisposition to behave in some particular manner towards some aspect of one’s environment. According to him, attitudes are best expressed when individuals make statements about their feelings or opinions about certain objects, issues, or things. Park (2007) explained that attitude is a relatively enduring organization of beliefs around an object, subject or concept, which predispose one to respond in some preferential manner. Attitude in the context of this present study refers to the way and manner mothers feel, think and behave toward the immunization of their children.

Some of the dimensions of the attitude could be acceptance or rejection of immunization programme by mothers. Some mothers often preach to other mothers to reject immunization because of predetermined belief that such programme is meant to reduce/control the population of the society by tactical poisoning of children. Some mothers often take their children for immunization reluctantly because they are not fully convinced that the programme is meant to be a preventive measure for safeguarding and protecting the health of their children. Moreover, some mothers use religion as an excuse for the rejection of immunization because of certain negative pronouncement by some religious leaders against immunization programme (Felden Battersby Analyst [FBA], 2005).

Prior to recent period when orthodox form of medication came in to being, immunization was not being practiced and therefore some cultures do not believe in it and did not see the need to accept it even in this modern age of technological advancement. Similarly, this present study will like to identify the highlighted attitude and practice of mothers toward immunization programme in Lapai LGA.

Antai (2009) stressed that immunization coverage in many parts of Nigeria is far from optimal, and far from equitable. According to the author, current coverage rates for the various childhood vaccines in Nigeria are among the lowest in the world. For instance, measles was responsible for 5 per cent of the child death in Africa, of an estimated 282,000 deaths in 2003, half of these occurred in Nigeria. Nigeria is among the ten countries in the world with vaccine coverage rate below 50 per cent, having been persistently below 40 per cent since 1997. The country also has the highest prevalence of circulating wild poliovirus in the world.

Certain factors influence immunization uptake at general practice level. These include the mothers’ age, gender, education level, occupation, location, media exposure, and economic status (Bhuiya, Bhuiya & Chowdhury, 1995).  They explained that the age of mothers refer to age at the time of birth of the child. According to the authors, acceptance of immunization among children also varies with mother’s age. Children of younger mothers were more likely to be immunized than those of older mothers. They stressed that the acceptance of immunization programme is predicated on the mothers’ level of education. The more mothers are educated, the more likely they are to accept the immunization programme than the lower primary level of school. The authors also stated that the sex differentials in immunization were found to be statistically significant. Male children were 20% more like to be immunized than female children. They further asserted that the economic condition of the household, as measured by ownership of chair, bed, and wardrobe, showed a positive relationship with immunization of children. Children from households with all of the above items were nearly twice as likely to be immunized as those from households with none of these items.

Location is another independent variable which was found to have a positive impact on immunization of children. Children in remote areas were more likely not immunized because of the distance and their areas of settlement (Bhuiya et al., 1995). The authors emphasized that children of mothers in areas where health facilities could easily be accessed were found to be more immunized than those in remote places. Media exposure of the mothers to radio was also found to have a positive impact on children’s immunization. Children from households with a working radio had a 47% higher chance of being immunized than those from households with no working radio Media exposure. Media exposure of the parent to radio was also found to have a positive impact on children’s immunization. Children from households with a working radio had a 47% higher chance of being immunized than those from households with no working radio (Bhuiya et al., 1995). These factors enumerated in the above literature could also be found in Lapai Local Government Area (LGA). Mothers in local government are therefore expected to have a working radio media exposure to enhance the chances of their children being immunized against the killer disease.

Since immunization exercise is a worldwide phenomenon, it seems necessary that attitude and practice of mothers towards immunization exercise be carried out in Lapai LGA of Niger state.In the previous years to date, such study has not been conducted, to the best of this researcher’s knowledge. The present study will go a long way to proffer solution to the problem of the killer diseases in the area.

 

Statement of the Problem

Survival is an enormous challenge for children under five years old, especially for those under one year. Immunization is perhaps one of the most effective and efficient ways of protecting the health of children and women worldwide against some of the most lethal and debilitating diseases in modern times. Vaccine preventable diseases are responsible for severe rates of morbidity and mortality in Africa (Babalola et al., 2005). Despite their use on infants, vaccine preventable diseases are highly endemic throughout sub-Saharan Africa. Antai (2010) reported that disparities in the coverage of immunization programmes persist between and within rural and urban areas, regions and communities in Nigeria.

Ransome-Kuti, Sorungbe, Oyegbite and Bamisanye (1991) identified diseases which claim the lives of mothers and children as follows: tuberculosis, polio, measles, tetanus, diphtheria, pertussis (whooping cough) and hepatitis B. It has been documented that the above vaccine preventable diseasesclaim lives of mothers and children worldwide including Nigeria. Lapai LGA may not be an exception. In an effort to avert this problem, UNICEP and all governments have been embarking on mass immunization of children and women including those of Lapai LGA.

Fathers of partially immunized children in Muslim rural communities see hidden motives, linked with attempt by NGOs sponsored by unknown enemies in developed countries, to reduce the local population and increase mortality rates among Nigerians. Belief in a secret immunization agenda is resonant in some of the Northern states where many believe activities are fuelled by western countries determined to impose population control on local Muslim communities (FBA, 2005).

The fear seems to translate in immunization attitude and practice with cloud be negative or positive. The situation is worrisome and could even be worsened by some recipient characteristics such as age, gender, level of education, location, occupation, economic status and religion. The above situation requires determination.

The extent Nigerian mothers exhibit their attitude toward immunization appears to have received research attention. This can not be less true about the mothers in Lapai LGA of Niger state. Finding out these, certainly, will represent a positive step forward in the effort to enhance positive immunization attitude and practice of Nigerian mothers. Following from this, one is inclined to ask what is the parent’s attitude toward immunization? What is the parent’s practice of immunization? The above, in essence, represent the problem of this study.

 

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.

Research Questions

The following research questions were formulated to guide the study:

1. What are the attitudes of mothers towards immunization against childhood killer diseases?
2. What are the immunization practices of the mothers against childhood killer diseases?
3. To what extent does the mothers’ age influence their attitudes towards immunizations of their children against childhood killer diseases?
4. To what extent do the mothers’ educational level influences their attitudes towards immunization of their children against childhood killer diseases?
5. To what extent does the mother’s age influence the practice of immunization against childhood killer diseases?
6. To what extent do the mothers’ educational levels influence the practices of immunization against childhood killer diseases?

Hypotheses

The following null hypotheses were tested at 0.05 level of significance.

1. There is no significant difference in the attitude of the young and older mothers towards immunization in Lapai LGA.
2. There is no significant difference in the attitude of educated and uneducated mothers towards immunization in Lapai LGA.
3. There is no significant difference in the immunization practice of the young and old mothers in Lapai LGA.
4. There is no significant difference in the practice of immunization among educated and uneducated mothers towards immunization in Lapai LGA.

 

Significance of the Study

The finding from this study will be of great benefit to mothers, health workers FMOH and the government. Specifically, data generated by determining the attitude and practice possessed regarding immunization programme will help in exposing the attitude and practice which the mothers posses in this area of immunization. The data generated regarding their attitude towards the reduction of measles morbidity and mortality will be beneficial to the mothers in Lapai LGA. The generated data will help the mothers to know the proper attitude to exhibit toward reduction of measles mortality and morbidity. Data generated on the attitudes of the mothers towards immunization of their children against poliomyelitis will be beneficial to the health workers because knowing how the mothers feel about the polio vaccine and the side effect of the polio injection will motivate the health workers to take proper step to correcting or preventing such reaction.

The data will help the public health care (PHC) providers determine the need and ways for positively enhancing the mothers’ attitude toward immunization of their children against poliomyelitis. Data generated on attitude of the mothers toward immunization of mothers and neonatal against tetanus will help to inform the mothers on the need to be immunized especially when she is pregnant. It will help the mothers to exhibit positive attitudes by attending antenatal care regularly. It will also help the health care providers to know the kind of attitude that is associated with mother thereby devising a means of encouraging mother and neonatal to get immunized against tetanus.

The data generated on the attitude of the mothers towards other immunization programmes in the FMOH’s10 years strategic plan will be of great help to the FMOH because the data will help the ministry to know the kind of attitude that is exhibited by the mothers toward immunization programmes and schedules respectively. This will equally help the FMOH to know how to plan and schedule desired immunization programmes.

The data generated will be of immense benefit to the mothers especially mothers. It will guide the mother on proper utilization of measles vaccine for their children. It will assist the mother to know the number of times upon which a child is expected to receive the vaccine by encouraging the mother to take the child to receive the vaccine at the appropriate periods. It will also inform the mothers on when the child is due for the vaccination. Same is also applicable to the utilization of tetanus vaccine and control of tetanus prevalence among mothers and babies. This research work will help the mothers, health care providers and the government to ascertain the extent to which education and age of mothers affect their attitude and practice towards immunization.

By implication, the younger mothers within the age bracket of (15-45 years) will find the result of the study more beneficial because these categories of mothers by their age will utilize the results of the study better than older mothers within the age bracket of 45 and above. When the mohters are educated at least from primary education to tertiary level it will enhance the attitude, understanding and practice forward immunization.

The study will be beneficial to curriculum planners when planning curriculum for certificate programmes offered in Schools of Health Technology enriching the curriculum with skills needed for proper immunization of children.

 

Scope of the Study

This study was delimited to Lapai LGA of Niger state. It was also delimited to the attitude and practice of the mothers towards immunization of the NIP target disease, namely: measles, poliomyelitis, tetanus, tuberculosis, pertussis, hepatitis B, diphtheria. Furthermore, this study was delimited to the age and level of education of the mothers in relation to immunization attitude and practice.

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