Apstrakt
Background: Immunization is an effective public health intervention for reduction of childhood mortality. The expected target coverage is 90%, however, Nigeria currently has coverage below this target and this has implications for childhood morbidity and mortality. Several reasons may account for this low coverage. The study was carried out to determine the socio-demographic factors associated with immunization completion.
Methods: This is a cross- sectional household survey that utilized multistage sampling technique. Four hundred mothers of children aged 12-24 months randomly selected from four communities were interviewed using structured questionnaire.
Results: Data from 383 (95.8%) participants were analysed and only 145 children (37.9%) were fully immunized. The results showed that children of mothers with secondary education or more (OR=3.45, 95% CI = 2.11, 5.66, p < 0.001), those children whose mothers were married to their fathers (OR=3.17, 95% CI = 1.39, 7.21, p = 0.006), children born to Christian families (OR = 1.72, CI = 1.07, 2.78, p= 0.026) and those in urban area (OR = 3.89, 95% CI = 2.24, 6.74, p<0.001) are more likely to complete immunization.
Conclusion: Improving female education, strengthening at risk mothers, and designing adequate public health interventions to reach families in rural locations can improve immunization uptake.
Keywords: Immunization, uptake, household- survey, socio-demography.
Résumé
Contexte: La vaccination est une intervention efficace de la santé publique pour la réduction de la mortalité infantile. La couverture cible prévue est de 90%, cependant, le Nigeria dispose actuellement d’une couverture en dessous de cette cible et ceci a des implications pour la morbidité infantiles et la mortalité en générale. Plusieurs raisons peuvent expliquer cette faible couverture. Les études ont été faites afin de déterminer les facteurs sociodémographiques associés à l’achèvement des vaccinations.
Méthodes: C’une enquête transversale auprès des ménages qui est menée en utilisant la technique d’échantillonnage à plusieurs degrés. Quatre cents mères d’enfants âgés de 12-24 mois choisies au hasard dans quatre collectivités ont été interrogées en utilisant le questionnaire structuré.
Résultats: Les données ont montré que parmi 383 (95,8%) des participants qui ont été analysées, 145 enfants (37,9%) ont été complètement vaccinés. Les résultats ont montré aussi que les enfants dont les mères ont une instruction secondaire ou plus sont de (OR = 3,45, IC à 95% = 2,11, 5,66, p <0,001), les enfants dont les mères se mariées avec leurs pères sont de (OR = 3,17, IC 95% = 1,39, 7.21, p = 0,006), les enfants nés de familles chrétiennes (OR = 1,72, CI = 1,07, 2,78, p = 0,026) et ceux en zone urbaine (OR = 3,89, IC à 95% = 2,24, 6,74, p <0,001) sont les plus susceptibles de compléter la vaccination.
Conclusion: L’amélioration de l’éducation des femmes, le renforcement de mères au risque, et la conception adéquate des interventions de santé publique d’atteindre les familles dans les régions rurales peuvent améliorer le taux d’immunisation.
Correspondence: OA Oluwatosin, Department of Nursing, College of Medicine, University of Ibadan, Oyo State, Nigeria
Reference
Feilden Battersby Analysts, The state of routine immunization services in Nigeria and reasons for current problems. Bath: FBA Health Systems Analysts; 2005: p 27.
World Health Organization. Global Immunization Vision and Strategy 2006-2015. Geneva: WHO; 2005.
Antai D. Faith and child survival: the role of religion in childhood immunization in Nigeria. J Biosoc Sci 2009; 41: 57-76.
Sadoh AE and Eregie CO. Timeliness and completion rate of immunization among Nigerian children attending a clinic-based immunization service. J Health Popul Nutr 2009; 27: 391-395.
Centres for Disease Control and Disease Prevention (CDC). Progress toward poliomyelitis eradication – Nigeria, 2005-2006. MMWR Morb Mortal Wkly Rep. 2007; 56: 278-281.
National Population Commission (NPC) and ICF Macro. 2009. Nigeria Demographic and Health Survey 2008: Key Findings. Calverton, Maryland, USA: NPC and ICF Macro.
Chhabra P, Nair P, Gupta A, Sandhir M and Kannan AN. Immunization in urbarnized villages of Delhi. Indian J Pediatr 2007; 74: 131-134.
Odusanya OO, Alufohai EF, Meurice FP and Ahonkhai VI. Determinants of vaccination coverage in rural areas in Nigeria. BMC Public Health 2008; 8: 381.
Babalola S and Lawan U. Factors predicting BCG immunization status in northern Nigeria: a behavioural-ecological perspective. J Child Health Care 2009; 13: 46-62.
Smith PJ, Chu SY and Barker LE. Children who have received no vaccines: who are they and where do they live? Paediatrics 2004; 114: 187-195.
Torun DS and Bakirci N. Vaccination coverage and reasons for non-vaccination in a district of Istanbul. BMC Public Health 2006; 6: 125.
Bates AS, Fredric D and Wolinsky P. Personal, financial, and structural barriers to immunization in socioeconomically disadvantaged urban children. Pediatrics 1998; 101: 591-596.
Babalola S and Adewuyi A. Factors influencing immunization uptake in Nigeria: A theory-based research in six states. Abuja: Partnership for Transforming Health System (PATHS); 2005.
Okolo SN, Adeleke OA and Chukwu GA, Egbuaba, NH, Hassan A, Onwuanaku C. Immunization and nutritional status survey of children in selected rural community of Sokoto State. Nig J of Paediatr 2003; 30: 123-127.
Babalola S and Aina O. Community and systemic factors affecting the uptake of immunization in Nigeria: a qualitative study in five states. Partnership for Transforming Health System (PATHS), Abuja; 2005.
Altinkaynak S, Ertekin V, Guraksin A and Kilie A. Effect of several sociodemographic factors on measles immunization in children of Eastern Turkey. Public Health 2004; 118: 565-569.
Federal Government of Nigeria. Legal notice on publication of 2006 Census Final Results. Federal Republic of Nigeria Official Gazette 2009; 96(2): B38
Adegbite EO. A giant stride: Chief Taye Ogunyemi. Ibadan: Linkup Books; 1994.
World Health Organization. Immunization coverage cluster survey reference manual. WHO/IVB/04.23. Geneva: World Health Organization; 2005.
Jani VJ, Jani VI, Barreto J and Sahay S. The role of recorded and verbal information in health information systems: a case study of the expanded programme on immunization in Mozambique. Ethiop J Health Dev. 2007; 21: 136-141.
Kidane T and Tekie M. Factors influencing child immunization coverage in a rural district of Ethiopia, 2000. Ethiop J Health Dev. 2003; 17: 105-110.
Babalola S. Household baseline surveys on factors affecting routine immunization in northern Nigeria. Baltimore: Partnership for Reviving Routine Immunization in Northern Nigeria (PRRINN); 2007.
Roodpeyma S, Kamali Z, Babai R and Tajik Z. Mothers and vaccination: knowledge, attitudes, and practice in Iran. J Pediatr Infect Dis 2007; 2: 29-34.
Bomar P J. Promoting health in families: applying a family research and theory in nursing practice. 3rd ed. Philadelphia: Saunders; 2004; 61-80.
Nath B, Singh JV, Awasthi S, Brushan V, Kumar V and Singh SK. A study on determinants of immunization coverage among children in urban slum of Lucknow district, India. Indian J Med Sci 2007; 61: 598-606.
Som S, Pal M, Chakrabarty S and Bharati P. Socioeconomic impact on child immunisation in the districts of West Bengal, India. Singapore Med J 2010; 51: 406-412.
Onyiriuka AN. Vaccination default rates among children attending a static immunization clinic in Benin city. JMBR 2005; 4: 71-77.
Mushtaque A, Chowdhury R, Bhuiya A et al, Mahmud S, Abdus Salam AKM and Karim F. Immunization divide: who do get vaccinated in Bangladesh? J Health Popul Nutr 2003; 21: 193-204.
Aderinto AA. Subordinated by culture: constraints of women in a rural Yoruba community. Nordic J Afr Stud 2001; 10: 176 -187.
Orji EO and Onwudiegwu U. Contraceptive practice among married men in Nigeria. East Afr Med J 2003; 80: 357-60.
Oluwadare C. The social determinants of routine immunisation in Ekiti state of Nigeria. Ethno-Med 2009; 3: 49-56.
Kandala N, Chen J, Nigel CJ, Stranges SS and Cappuccio FP. Spatial analysis of risk factors for childhood morbidity in Nigeria. Am J Trop. Med. Hyg. 2007; 77: 770-778.
Tarrant M, Thomson N. Secrets to success: a qualitative study of perceptions of childhood immunisations in a highly immunised population. J Paediatr Child Health. 2008; 4: 541-547.