Abstrakt
Objectives: Vaccination is a life-saving public health measure, but poor adherence to the national routine immunization schedule reduces its effectiveness in reducing the burden of vaccine preventable diseases. Thus, this study was aimed at estimating the level of non-compliance with vaccination appointments and missed opportunities as well as factors associated with receiving vaccinations at the appropriate time among infants attending immunisation clinics in Ile-Ife.
Methods: A cross-sectional analytical study was carried out in Ile-Ife among 128 caregivers of children aged one year and below attending immunisation clinics in 3 health facilities selected using simple random sampling. Data was analysed using the IBM SPSS at univariate and bivariate levels with p at <0.05.
Results: Incomplete vaccination was reported in 23(18%) of the infants, distributed as: 19(82.6%) due to non-compliance and 4(17.4%) due to missed opportunities. The most prevalent reasons for missing vaccination appointments were child’s illness (34%), travelling (17.4%), forgetting appointment (17.4%) and distance from the clinic (13%). Only 35.9% of caregivers had good knowledge of vaccination. Appropriate timing of vaccination in the index child was associated with a history of appropriate immunisation timing in an older sibling, (p=0.015) but not with caregiver’s knowledge of vaccination, (p=0.632).
Conclusion: Non-compliance was majorly responsible for not receiving vaccination at appropriate time. Health workers should educate caregivers on the need to still attend immunisation clinics even when their children are sick and also initiate recall efforts to prevent caregiver forgetfulness of vaccination appointments.
Keywords: Childhood immunisation, missed opportunities, incomplete vaccinations, appointments, compliance, timeliness
Résumé
Objectifs: La vaccination est une mesure de santé publique qui sauve des vies, mais le défaut d’adhérence au programme national de vaccination systématique réduit son efficacité à réduire le fardeau des maladies évitables par la vaccination. Ainsi, cette étude visait à estimer le niveau de non-respect des rendez-vous de vaccination et des occasions manquées ainsi que les facteurs associés à la vaccination au moment opportun chez les nourrissons fréquentant les cliniques de vaccination d’Ile-Ife.
Méthodes: Une étude analytique transversale a été menée à Ile-Ife auprès de 128 nourrices d’enfants âgés d’un an et moins fréquentant les cliniques de vaccination de 3 établissements de santé sélectionnés par échantillonnage aléatoire simple. Les données ont été analysées à l’aide de l’IBM SPSS à des niveaux univariés et bivariés avec p <0,05.
Résultats: Une vaccination incomplète a été signalée chez 23 (18%) des nourrissons, répartis comme suit : 19 ( 82,6 %) en raison de non-respect et 4 ( 17,4 %) en raison d’opportunités manquées. Les raisons les plus courantes pour avoir manqué les rendez-vous de vaccination étaient la maladie de l’enfant (34%), les voyages (17,4%), l’oubli de rendez-vous (17,4%) et l’éloignement de la clinique (13%). Seulement 35,9% des nourrices avaient une bonne connaissance de la vaccination. Le moment approprié de la vaccination chez l’enfant de référence était associé à un antécédent moment approprié d’immunisation chez un (e) frère (sœur) plus âgé (p = 0,015), mais pas avec la connaissance de la vaccination de la nourrice (p = 0,632).
Conclusion: Le non-respect était principalement responsable du fait de ne pas avoir été vacciné au moment opportun. Les agents de santé devraient informer les nourrices de la nécessité de continuer à se rendre dans les cliniques de vaccination même lorsque leurs enfants sont malades et également d’initier des efforts de rappel pour éviter que les nourrices oublient les rendez-vous de vaccination.
Mots clés: Vaccination à l’enfance, occasions manquées, vaccinations incomplètes, rendez-vous, conformité , opportunité
Correspondence: Dr. O.T Esan, Department of Community Health, Obafemi Awolowo University, Ile Ife, Nigeria. E-mail: seunkayo@yahoo.com
Bibliografia
National Primary Health Care Development Agency. Nigerian National Routine Immunization Strategic Plan(2013-2015) [Internet]. Abuja, Nigeria; 2013 [cited 2020 Jan 20]. Available from: http://www.nationalplanningcycles.org/sites/default/files/planning_cycle_repository/nigeria/ri_strategic_plan_combined_mahmud_draft_1.pdf
Ophori EA, Tula MY, Azih A V, Okojie R and Ikpo PE. Current Trends of Immunization in Nigeria: Prospect and Challenges. Trop Med Health [Internet]. 2014 [cited 2020 Jan 19];42(2):67–75. Available from: https://www.jstage.jst.go.jp/article/tmh/42/2/42_2013-13/_article/-char/ja/
Kennedy AM, Brown CJ and Gust DA. Vaccine beliefs of parents who oppose compulsory vaccination. Public Health Rep. 2005;120(3):252–8.
Abdulraheem IS, Onajole AT, Jimoh AAG and Oladipo AR. Reasons for incomplete vaccination and factors for missed opportunities among rural Nigerian children. J Public Heal Epidemiol [Internet]. 2011 [cited 2020 Jan 19];3(4):194–203. Available from: http://www.academicjournals.org/jphe
Adebiyi JA and Ajani TA. Childhood immunization in Nigeria: factors influencing noncompliance. Educ Res [Internet]. 2017 [cited 2020 Jan 21];8(3):34–8. Available from: https://pdfs.semanticscholar.org/be71/ee7c3fb048dbd969c3691b24d6eeb2281c65.pdf
World Health Organization. The Expanded Programme on Immunization: Benefits of immunization [Internet]. Immunization, Vaccines and Biologicals. Geneva, Switzerland; 2013 [cited 2020 Jan 20]. Available from: https://www.who.int/immunization/programmes_systems/supply_chain/benefits_of_immunization/en/
World Health Organization., United Nations Children’s Fund. GIVS Global Immunization Vision and Strategy 2006-2015 [Internet]. United States of America; 2005 [cited 2020 Jan 19]. Available from: www.who.int/vaccines-documents/%0Awww.unicef.org
Hull B, Lawrence G, MacIntyre C and McIntyre P. Reasons for incomplete immunisation among Australian children: a national survey of parents [online]. Aust Fam Physician. 2004;33(7):568–571.
National Population Commission (NPC) [Nigeria] and ICF. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF; 2019.
Onyiriuka AN. Vaccination default rates among children attending a static immunization clinic in Benin City, Nigeria. J Med Biomed Res [Internet]. 2005 [cited 2020 Jan 19];4(1):71–7. Available from: https://www.researchgate.net/publication/27798399
Sadoh A, Health CE-J of, Population U, Nutrition A, 2009 U. Timeliness and completion rate of immunization among Nigerian children attending a clinic-based immunization service. J Heal Popul Nutr [Internet]. 2009 [cited 2020 Jan 19];27(3):391–5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2761795/
Phadke VK, Bednarczyk RA, Salmon DA and Omer SB. Association Between Vaccine Refusal and Vaccine-Preventable Diseases in the United States: A Review of Measles and Pertussis. JAMA [Internet]. 2016 [cited 2020 Jan 20];315(11):1149–58. Available from: https://jamanetwork.com/journals/jama/article-abstract/2503179
Fatiregun AA and Okoro AO. Maternal determinants of complete child immunization among children aged 12-23 months in a southern district of Nigeria. Vaccine [Internet]. 2012;30(4):730–6. Available from: http://dx.doi.org/10.1016/j.vaccine.2011.11.082
Adebiyi AJ and Ajani TA. Nursing mothers knowledge and positive attitude towards childhood immunization: a panacea to childhood immunization noncompliance in Nigeria. J Res Nurs Midwifery [Internet]. 2017 [cited 2020 Jan 21];6(4):068–75. Available from: https://pdfs.semanticscholar.org/9c15/6a891d49583a5bd8c0154c6abd0994ef8d6e.pdf
Donsa LD. An Examination of Mothers’ Socio-Demographic Factors Associated With Incomplete Vaccination Status among Under-five Populations in Malawi. [Internet]. Georgia State University; 2013. Available from: http://scholarworks.gsu.edu/iph_theses/285
Gentle S. Knowledge and Attitude of Mothers towards Immunization in Emohua Local Government Area of Rivers State. Int J Innov Healthc Res. 2019;7(4):38–52.
Abdulraheem I and Onajole A. Reasons for incomplete vaccination and factors for missed opportunities among rural Nigerian children. J Public … [Internet]. 2011;3(April):194–203. Available from: http://www.academicjournals. org/article/article1379427155_Abdulraheem et al.pdf
Adebiyi, Joseph A and Ajani YA. Nursing mothers knowledge and positive attitude towards childhood immunization/ : a panacea to childhood immunization noncompliance in Nigeria. J Res Nurs Midwifery. 2017;6(4):68–75.
Ajala OA and Olayiwola A. An Assessment of the Growth of Ile-Ife, Osun State Nigeria, Using Multi-Temporal Imageries. J Geogr Geol. 2013;5(2):43–54.
Salahdeen HM and Murtala BA. Relationship between Admission Grades and Performances of Students in the First Professional Examination in a New Medical School. Med Educ [Internet]. 2005;8:51–7. Available from: https://www.ajol.info/index.php/ajbr/article/view/35760
Anyanwu GE and Ugochukwu AI. Impact of the use of cadaver on student’s ability to pass anatomy examination. Int J Exp Clin Anat. 2010;4:24–38.
Rahji F and Ndikom C. Factors influencing compliance with immunization regimen among mothers in Ibadan, Nigeria. IOSR J Nurs Heal Sci [Internet]. 2013 [cited 2020 Jan 19];2(2):01–9. Available from: http://www.academia.edu/download/32474343/A0220109.pdf
Luman E and Shaw K. Medicine SS-A journal of preventive, 2008 U. Compliance with vaccination recommendations for US children. Am J Prev Med [Internet]. 2008 [cited 2020 Jan 19];34(6):463–70. Available from: https://www.sciencedirect.com/science/article/pii/S0749379708002390
Awasthi A, Pandey CM, Singh U, Kumar S and Singh TB. Maternal determinants of immunization status of children aged 12-23 months in urban slums of Varanasi, India. Clin Epidemiol Glob Heal [Internet]. 2015;3(3):110–6. Available from: http://dx.doi.org/10.1016/j.cegh.2014.07.004
Babalola S and Adewuyi A. Factors influencing immunisation uptake in Nigeria: theory-based research in six states. PATHS. Abuja, Nigeria; 2005.