DESCRIPTION

ABSTRACT 

Objective: This survey studied the socio-economic factors that affect the uptake of immunisation services in three selected Local Government Areas of Anambra State. 

 Materials and Methods: The study was a cross-sectional descriptive study. Multistage sampling was done in which three LGAs were selected from the state; these L.G.As are Njikoka, Ogbaru and Aguata. Four wards from each of these LGAs were also selected. A research assistant was blindfolded and he randomly pointed a number on the table of random numbers and the number was ‘3’. Every third house was, therefore, entered in each ward to enquire for eligible respondents.     Only women of child bearing age who were present in the study area at the time of the study were interviewed. Data collection instrument used is a semi-structured, pretested, interviewer administered questionnaire. Research assistants were recruited from the primary health centers in the selected wards.   

Findings: As much as 53.7% of respondents knew that every child needs immunization, while 55.1%, 35.1% and 18.2% believed that immunization should be missed in the event of diarrhea, yellowness of the eyes and fever respectively. Up to 39.3% of women with only primary education missed their immunisation sessions while 30% of women with tertiary education missed it. Only 23.5% of mothers who are public/civil servants missed immunisation while 42.6% of mothers who are farmers missed it. As high as 42% of women in Ogbaru (with very bad terrain) missed immunisation while 23% of women in Njikoka (semi-urban) missed immunisation.  The study showed no correlation between the mother’s educational level and whether she missed her child’s immunisation. This does not agree with the finding of National Immunisation Coverage Survey (NICS) 2003; there was a positive correlation between mothers’ education and the fully immunised child: nationally 31.1% of children of mothers with secondary education are fully immunised; the figure for 3 children of mothers with no education is 3.9%. The possible reason why this survey varied from a previous study in 2003 is that public enlightenment campaigns on immunisation have been so elaborately utilised in Anambra State that the importance of immunisation is presently equally known to the illiterate as the literate.      Conclusion: The statistical significance of these compared variables shows that occupation and geographical location significantly affect utilisation of immunisation services in Anambra State, therefore, health education promotion and programming must take into consideration such factors.                         

CHAPTER ONE  

    Introduction

1.1 Background of the study

  In 1979 Nigeria’s Expanded Programme on Immunization (EPI) was initiated, and was placed within the Department of Public Health and Communicable Disease  1 Control of the Federal Ministry of Health (FMOH) . It was re-launched in 1984 due 2 to poor coverage. In 1996 it became the National Programme on Immunisation (NPI), launched by the then First Lady, Mrs Abacha. Following a review of EPI, Decree 12 of 1997 created NPI as a parastatal. NPI has a sole responsibility of supervising and  2 enhancing routine and supplemental immunisations in Nigeria.   Routine immunisation (RI) is provided largely through the public health system, with significant variations between the 36 States and Federal Capital Territory (FCT); 3 private or NGO providers are the source of up to one-third of RI in Anambra state. Public sector provision is by health staff based at facilities run by the 21 Local Government Areas (LGAs) who have a Primary Health Care Coordinator (PHCC), a Local Immunisation Officer and a Cold Chain Officer. These staff members are under the control of the Head of Local Govt Administration and are employees of the State Government (Ministry of Local Government and Local Government Service Commission).    Routine immunisations are done at the fixed posts in the health centres, health posts, General hospitals and tertiary health facilities in the State. Supplemental immunisations in the State are aimed at boosting the immunisation coverage and 2         2 mopping up missed opportunities. It also becomes imperative in epidemics. These supplemental immunisations are achieved through National Immunisation Days (NIDs), Local Immunisation Days (LIDs), Immunisation Plus Days (IPDs) and Child  2 Health Week.