Factors associated with immunization of children in Kaduna State, Nigeria, 2016

Objective1. To assess the knowledge, perception, and practices of mothers/caregivers on vaccine preventable diseases in children aged 12-23months in Kaduna State, Nigeria2. To determine the immunization coverages in Kaduna State, Nigeria3. To determine the sources of information on routine immunizationamong mothers/caregivers of children aged 12-23months in the study areaIntroductionImmunization is one of the safest and most effective interventionsto prevent disease and early child death1. Although, about threequarters of the world’s child population is reached with the requiredvaccines, only half of the children in Sub-Saharan Africa get accessto basic immunization2. A substantial number of children worldwidedo not complete immunization schedules because neither healthservices nor conventional communication mechanisms regularlyreach their communities3. Separate studies in Australia and PapuaNew Guinea have shown that knowledge gaps underlie lowcompliance with vaccination schedules3, 4. Mothers are less likely tocomplete immunization schedules if they are poorly Informed aboutthe need for immunization, logistics (which includes time, date, andplace of vaccination), and the appropriate series of vaccines to befollowed5, 6. Although knowledge in itself is insufficient to createdemand, poor knowledge about the need for vaccination and whenthe next vaccination is due is a good indicator of poor compliance7.Up-to-date, complete, and scientifically valid information aboutvaccines can help parents to make informed decisions8.Immunity gap created by this low immunization coverage inNorthern Nigeria favors the emergence and transmission of somevaccine preventable diseases (VPDs) especially measles and polio9.MethodsA cross-sectional descriptive study was conducted using multistagesampling technique; 379 mothers/caregivers with children aged12-23 months were recruited. Data collection was done using semistructured interviewer-administered questionnaire and analyzed usingEpi infoTMversion 7. Descriptive statistics using absolute numbers andproportions and Odds ratio/Chi2 were determined between variablesand p≤0.05 was considered statistically significant. Multivariateanalysis was conducted using logistic regression.ResultsMean age of respondents was 28.6 (SD=±6.6), 245(64.7%)practiced Islam, 128(33.8%) completed Secondary school,246(64.9%) unemployed, 361(92.3%) were married and 186(49.1%)were from rural settlements. Among the children whose mothers/caregivers were interviewed, 163(43.01%) were between aged16-19 months old while most 238(62.80%) fell within the birth orderof 2nd -5thchild. Only 59 (15.6%) of these children were found tobe fully immunized, evidenced by vaccination card history. Majorityof respondents 244(64.4%) had unsatisfactory knowledge while197(55.4%) and 204(54.0%) exhibited poor perception and badpractices respectively, regarding routine immunization. Commonestsource of information was radio 69(61.61%). Educationalstatus [OR=1.9 (95%CI:1.1-3.3)] and good perception [OR=2.6(95%CI:1.5-4.5)] of mothers were found to be associated with gettinginformation on routine immunization within 12months prior to thisstudy while Polygamous family setting [OR=0.6(95%CI:0.2-0.6)],unsatisfactory knowledge [OR=0.3(95%CI:0.2-0.7)] and badpractices [OR=0.5(95%CI:0.3-0.9)] of mothers were independentlyassociated with lack of information on routine immunization.ConclusionsThere is low immunization coverage in this community. Mother’seducational status, family setting, knowledge, perception andpractices about immunization are important factors that influenceaccess to information on routine immunization.