CHAPTER ONE

INTRODUCTION

1.1     BACKGROUND OF THE STUDY        

The preventive measure against diseases at childhood stage is through immunization which is complete course of injection that is administered to children soon after birth. Mojoyinola and Olaleye (2012) assert that immunization of children is aimed at providing primary prevention against killer diseases during childhood. These diseases take several precious lives to death all over the world especially in the third world, like African and Asian countries. There is a schedule for children below the ages of five by the health department for the immunization of children, and vaccines are provided by expanded program on immunization (EPI) which plays a vital role in controlling childhood diseases.

Immunization program is more systemized in developed countries, but the situation is poor in most populous countries. In Nigeria, educational level of mothers is not up to the mark unlike in the developed countries. Unfortunately, despite a lot of effort by the government to eradicate childhood diseases like polio, measles, tetanus, whooping cough etc. the challenges still remains. However, Nigeria was recently declared polio free by the United Nations. The main reason behind these problems is lack of public awareness about the importance of immunization and lack of education. Due to these factors disease rate is high in developing countries.

Parents’ education (especially women) and their attitude play also an important role in determining the health condition of children. Immunization helps the child to be mentally healthy and active. Most people are reluctant to allow their women to go for education and other chores in life due to low literacy rate. Along with this, there are several obstacles that influence the attitude of mothers toward the immunization of their children which are religious, social and cultural misconceptions.

The promotion of health is social as well as individual responsibility. It has been known that 5 million children were dying each year and another 5 million were disabled by infectious diseases (WHO, 2001).

The growth and development of children is a long term contribution of country as a whole. The key to attain the goal of health for all primary health care emphasizes on the preventive principles. One of the most cost effective health interventions is vaccine for all infectious disease. Immunization is a high priority area in care of infants and children. High immunization rates have almost eliminated many infectious diseases which used to decimate sizable of the population for countries. A number of deadly and disabling infectious diseases can be prevented by timely administration of vaccines when child is effectively immunized at the right age, most of these diseases are either entirely prevented or at least modified so that child suffer from a mild disease without any disability. (Wong’s, 2007).

Immunization is one of the most effective, safest & efficient Public Health Interventions. While the impact of Immunization on childhood morbidity & mortality has been great, full potential, has not yet been reached. Still, Thousands of children die from Vaccine-Preventable diseases each year. (Haneef et al., 2006)

Vaccines have eradicated small pox, eliminated wild polio virus in the U.S. and lastly Egypt. Also

Immunization had significantly reduced the number of deaths of measles, diphtheria, rubella, Pertussis, and others, but despite these efforts, today tens of thousands of people in the U.S. still die from these and other vaccine preventable diseases. (NIAM, 2007)

The expanded program of immunization started by the WHO in 1974 and has improved coverage for

BCG, DPT, polio and measles to about 80% of children in developing countries (Loevinsohn and Hong 2006). Over the past years, the Egyptian Ministry of Health and Population (MOHP) has implemented a national program for childhood immunization (DCD, 2005). Immunization is the most cost effective health intervention known to mankind. When countries can successfully provide vaccines to their children, they are already making an immense difference to the health of their citizens. But immunization alone is not sufficient because all areas of health care deserve attention and resources (Hong, 2005).

Poverty is a factor that has affected the success of childhood immunization. In developing countries and by extension northern part of Nigeria (Bauchi), as millions of people are living below the poverty line which is one dollar a day. Consequently, the earnings of people are prioritized on daily sustenance, such as food, shelter rather than medical expenses for the survival of their children. Health facilities are mostly situated in the urban centers, this means for the rural dwellers to access health facility, they have to travel a distance, which many cannot due to transportation difficulty and other charges. This discourages mothers from complying with childhood immunization.

The patriarchal nature of our society also deepens the challenges of childhood immunization. This means that women are under the strict control of their husbands; their actions or inactions depends on the permission (approval) of their husbands. This especially in the northeastern part of Nigeria is the culture which is strictly observed. Even if mothers have the knowledge of childhood killer diseases and immunization, her movement to comply is determined by her husband. So the attitude of the husbands is determined by their knowledge and the importance of childhood immunization. Therefore, many mothers who are willing to immunize their children cannot unless permitted by the husband.

1.2     STATEMENT OF THE PROBLEM

Mortality rate may be greater in developing countries, because of low resistance of these children against infection. In the developing world some 23% of deaths among children under five years occur in the first month. However about 3 million babies in the developing countries die during early childhood. In recent years however relatively low immunization levels in this age group have occasional scattered outbreak of certain disease. For this reason in spite of the national effort some immunizations are administered optionally to improve the immunization levels of all children. This vaccination helps to making the babies’ immune system stronger. People who are duly partially immunized or not immunized at all may be at risk for the disease that these vaccines prevent. Still the people are unaware of the immunization Schedule and its importance.

Mothers are responsible for the immunization of their children therefore knowledge about vaccines preventable diseases can ensure the success or otherwise of the campaign against the prevailing childhood killer diseases. In the northeastern part of Nigeria, Bauchi state in particular, which is one of the educationally backward states, mothers’ knowledge on childhood immunization is poor, as very few of them have acquired western education which serves as a channel of knowledge. Human actions are supposed to be based on proper knowledge, without which it may not be taken or taking wrongly. Though many mothers may have been informed about childhood immunization through the mass media e.g. radio, television, newspapers etc., they need to be encouraged by important others, such as Imams, Pastors and community head to avail their children for immunization. But, most of them are skeptical about the exercise having different perspectives about it let alone promoting and urging their followers to key into the program for their children.

Moreover, religion and culture also contribute to the attitudes of mothers toward childhood immunization. In the northeastern part of Nigeria, childhood immunization is seen as a western strategy to control their population which goes contrary to religious injunction to ‘multiply and fill the earth’. This makes the acceptance of childhood immunization difficult. These problems make it glaring that there is a need to carry out a study on the Knowledge, attitude and practice of nursing mothers towards immunization, a case study of Bogoro LGA of Bauchi State.

1.3     OBJECTIVES OF THE STUDY  

The general objective of this study is to examine the Knowledge, attitude and practice of nursing mothers towards immunization, a case study of Bogoro LGA of Bauchi State. The specific objectives of this study include the following:

1.     To find out the prevalence of the practice of immunization among nursing mothers in Bogoro LGA of Bauchi State.

2.     To ascertain the awareness of nursing mothers in Bogoro LGA of Bauchi State on the importance of immunization.

3.     To investigate the attitude of nursing mothers in Bogoro LGA of Bauchi State towards immunization.

4.     To determine the factors influencing the practice of immunization by nursing mothers in Bogoro LGA of Bauchi State.

5.     To determine the challenges facing the practice of immunization by nursing mothers in Bogoro LGA of Bauchi State.

1.4     RESEARCH QUESTIONS