Role of immunization on prevention of disease among children 0-59 months of ages in Nigeria
ABSTRACT
Childhood immunization of children between 0-5 years is a cost effective public health strategy. Expanded Programme on immunization (EPI) services have been provided in Sapale local government area of Delta State mainly through the health facilities in the LGA. The objective of this survey was to assess vaccination coverage and its determinants in this rural suburb in Nigeria. A cross-sectional survey was conducted in October 2010, which included the use of interviewer-administered questionnaire to assess knowledge of mothers of children aged 0-5years on childhood immunization and vaccination coverage of the children. Survey participants were selected using a multistage sampling method. Vaccination coverage was assessed by vaccination card and material history. A child was said to be fully vaccinated if he or she had received all the following vaccines: a dose of BCG, three doses of OPV and DPT, and one dose of measles by the time he or she was enrolled in the survey. Person chi-square (x2) test was performed to identify determinants of full immunization status. 250 mothers and 250 children (each mother had one eligible child) were included in the survey. 80 (32%) of the children were fully immunized while 112 (44.8%) were not immunized from the vaccination cards while with maternal history 86 (34.4%) were fully immunized, though this difference was not statistically significant P = 0.210 45 (26.5%) of 170 children who defaulted had visited a health facility since their last vaccination or since they attained appropriate age. Majority of the children 109 (43.6%) received their vaccination in Public health facilities. Chi-square test showed that mothers educational status (P = 0.004), religious denomination (P = 0.019) and child’s problem after immunization P = 0.012 were significantly associated with under immunization.
It is therefore concluded that despite all the efforts made by the government, the vaccination coverage in this rural suburb is still at a level that does not provide high protection (80%) against DPT/ OPV and even measles.
To improve on the low immunization coverage, attention should be paid to female education, health education, capacity building of the immunization service providers and supportive supervision.
CHAPTER ONE INTRODUCTION
- BACKGROUND OF THE STUDY
Immunization remains one of the most important public health interventions and a cost effective strategy to reduce both the morbidity and mortality associated with communicable diseases. Over two million deaths are prevented through immunization each
year worldwide1. Despite this, vaccine preventable diseases remain the most common cause of childhood mortality with an estimated 3 million deaths each year2. Uptake of vaccination services depends
not only on provision of the services but also on other factors
including knowledge and attitude of mothers3,4, density of health
workers5, accessibility of vaccination centres and availability of safe needles and syringes.
Nigeria like many countries in Africa is making efforts to strengthen its health system especially routine immunization so as to reduce disease burden from vaccine preventable diseases (VPDs).
In 1979, Nigeria’s Expanded Programme on Immunization (EPI) was initiated6 (though created in 1974 by WHO, UNICEF and Rotary International as partners). It was relaunched in 1984 due to
poor coverage7. In 1996 it became the National Programme on Immunization (NPI). Following a review of EPI Decree 12 of 1997, NPI was made a parastatal.
- NPI has a sole responsibility of supervising and enhancing routine and supplemental immunization activities in
- Routine immunization (RI) is provided largely through the public health system, with significant variation between the
36 states and Federal Capital Territory (FCT). In Delta State, private or NGO providers are the source of up to one
third of RI in Delta State8.
Public sector provision is by health staff based at facilities run by the 21 Local Government areas (LGAs), the General hospitals run by the state government and the tertiary institution run by the federal government.
There is also supplemental immunizations done periodically in the state in the form of National Immunization days (NIDs), local immunization days (LIDs), immunization plus days (IPDs) and
child health week all aimed at boosting immunization coverage and mopping up and reaching every child (including those not already reached) irrespective of their immunization status
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