ABSTRACT
Introduction
Vaccine preventable diseases (VPDs) cause significant morbidity and mortality in children under the age of five years. In Nigeria only 23% of children received all recommended vaccines, according to the 2018 Nigeria Demographic and Health Survey (NDHS), 31.0% of children aged 12 to 23 months had received all basic immunization. Federal Capital Territory (FCT) has a coverage of 47.1% and the routine coverage for Bwari Area Council was reported to be lower than the recommended target to ascertain herds immunity despite the huge investment in immunization in Nigeria. Reluctance and refusal to immunize children despite the availability of vaccine is among the top ten threats to public health.
Methods
We conducted a descriptive cross-sectional study in FCT and sampled 467 children aged 12-23 months. Data was collected on socio-demographic characteristics, knowledge on immunization, immunization status of children. The World Health Organization Cluster Sampling Technique was utilized for this study. The results were analyzed using Epi-info software.
Results
The predominant age of mothers/caregivers was 29 years with a standard deviation of (5.4) and the mean age of children was 17months with a standard deviation of (5.4). Majority 256(54.8%) of the children were females, forty-five 211 (45.7%) were males and 46% of them were in the 1st-2nd birth order. More than half, 257 (58.7%) of mothers/caregivers had only secondary education, while 94 (20.1%) and 54 (11.6%) had primary and tertiary level of education respectively. Majority of the respondents 388(83.0%) had good knowledge of immunization, and although 168 (54.1%) of them mentioned malaria as a VPD. Majority, 434 (92.9%) of respondents had positive attitude towards immunization and 376 (80.5%) respondents believe vaccines are safe, while 24(5.1%) used local herbs such as agbo as substitute. Three-quarters, 346 (74.1%) of respondents had good practice of immunization and most respondents jointly decided their child’s immunization with their spouses. Fully immunized children in this study was 336 (72.0%), while children who have never been immunized was 28(6.9%) and the partially immunized were 99(21.1%). The coverage of specific vaccines received by children which was verified by card was lower than the maternal history, where BCG coverage was 164 (35.1%) by card, 261(66.9%) by maternal history and Measles was 137 (29.3%) by card and 243 (52.0%) by maternal history respectively.
Conclusion
Knowledge of vaccine preventable disease was good and increased with the age group of mothers/caregivers. The level of mother/caregiver’s knowledge and literacy level on VPDs are essential to improving immunization coverage. The attitude of mothers/caregivers, is based on their educational level, occupation, motivation and willingness to accept immunization for their children. The study showed that despite the good knowledge of VPDs and immunization, a vast majority of children were not fully immunized using the card as a verification tool and which can lead to increase susceptibility to VPDs. Findings from this study points to a great need for approaches to target interventions such as: (institutionalisation of the use immunization cards as a requirement for school admission, continuous health talk concerning immunization targeting mothers at the community, health facility and place of worship) are aimed to increase childhood uptake of complete immunization. The completion rate of immunization is lower than the recommended target, which could lead to low herds immunity in the communities. Verification of immunization status by card was very low and emphasis on the importance of retaining immunization card by mothers/caregivers should be discussed in the communities and health facilities
Keywords: Knowledge, attitude, practice, uptake, routine immunization, under-5 children, mothers, Bwari, Abuja, Nigeria
