UTILISATION OF IMMUNISATION SERVICES AMONG NURSING MOTHERS IN LAGELU GOVERNMENT AREA, IBADAN, NIGERIA

Abstract

Immunization is an effective preventive measure against some childhood disease. Recent studies have shown that there is a decline in immunization coverage and a resurgence of vaccine preventable childhood diseases in Nigeria. There is scarcity of information on reasons for the decline in immunization coverage especially in rural areas. This study therefore, assessed the factors which influence the immunization services in rural communities of Lagelu Local Government Area (LGA), Ibadan. The study was cross-sectional in design. The WHO expanded programme on immunization model cluster sampling technique was used to select 370 mothers of children aged 1-2 years from 37 randomly selected rural communities. A validated questionnaire was used to obtain data from the participants. Six Focus Group Discussion (FGD) sessions were conducted among nursing mothers. An In-Depth-Interview (IDI) guide was used to collect information on perceptions from 15 health workers in charge of primary health care facilities in the LGA. Descriptive and Chi-square statistics were used to analyse the quantitative data while the qualitative data were recorded on audio-tapes, transcribed and analysed using thematic approach. The participant’s mean age was 30±6.4 years. Only 37.6% of participants’ children completed their immunization schedule. 43.5% had not while 18.9% had zero does. Participants’ pattern of completion of immunization for their by level of education was as follow; no formal education (20.9%); primary education (28.1%), and secondary education (31.7%), with no significant difference. More married participants (89.2%) completed immunization for their children than those divorced (5.8%) and widowed (1.4%) (p<0.05). Participants with child completed immunization for their children (23.7%) compared to their counterparts with 4th child (20.9%) and those with 5th child (10.1%), with no significant difference (p<0.05). Of the 62.4% children who were under immunized, 68.8% did not receive yellow fever vaccination while 43.7% did not take measles vaccination. Reasons given by the mothers for having zero dose immunization coverage for their children includes fear of side-effects (30%) and inconsistence with religious beliefs (30%). The factors which prevented some women from completing immunization for their children included non-availability of vaccines (46.3%), distance (14.6%) and inconvenient time for immunization (12.8%). More Christians (68.3%) than Moslems (29.5%) and adherents of traditional religion (2.2%) completed the immunization schedule (p<0.05). About half (53.2%) were aware of the immunization schedule. Fifty seven percent got immunization from only public clinics. Knowledge about benefits of immunization and immunization schedule were listed as most important factors for improving adoption and completion of childhood immunization by IDI participants. Fear of side effects, irregular availability of some vaccines and long distance of clinics were identified by majority of FGD participants as factors which negatively affect utilization of immunization services by mothers. Few FGD participants disclosed that delay at clinics and economic reasons played major roles in mothers’ failure to allow their children to be fully immunized. Utilization of childhood immunization was relatively low among nursing mothers in Lagelu Local Government Area. Health education strategies such as public enlightenment and advocacy are needed to increase childhood immunization coverage in the LGA.