ASSESSMENT OF THE KNOWLEDGE OF COMPLICATION OF NON IMMUNIZATION OF CHILDREN AMONG NURSING MOTHERS

Abstract

This study examined the knowledge of nursing mothers regarding the complications of non-immunization of children. A cross-sectional survey research design was adopted, with data collected using a structured questionnaire administered to a sample of 133 respondents. The data was analyzed using SPSS version 27, and a one-sample t-test was employed to test the hypotheses. The study aimed to assess the factors influencing nursing mothers' knowledge of non-immunization complications, the role of education in shaping immunization decisions, and the influence of socio-demographic factors on the level of awareness about the potential risks of non-immunization. The results revealed that a majority of nursing mothers were aware of the risks associated with non-immunization, but their understanding of the severity of these complications was limited. The study found that education level and socio-economic status significantly influenced the knowledge and immunization decisions of nursing mothers, with higher educational levels linked to more informed decisions. Additionally, limited access to health education and information was identified as a significant barrier to understanding the dangers of non-immunization. The hypothesis testing confirmed a significant relationship between education and knowledge about the complications of non-immunization, and socio-demographic factors were found to affect knowledge acquisition. In conclusion, the study emphasized the importance of improving access to health education and resources for nursing mothers, especially in areas with lower educational attainment, to enhance their understanding of the complications of non-immunization and improve immunization rates.

CHAPTER ONE
INTRODUCTION

1.1 Background to the Study

Immunization plays a crucial role in safeguarding children from a range of potentially fatal diseases. As a primary strategy for preventing infectious diseases, vaccines have been instrumental in reducing childhood morbidity and mortality rates globally. Vaccines protect against diseases such as measles, polio, hepatitis B, and diphtheria, all of which can lead to significant long-term health complications or even death if left unaddressed (Adeyanju et al., 2022). Despite the proven efficacy of immunization programs, global reports still highlight a significant gap in vaccination coverage, particularly in rural and underserved areas. In these regions, children remain vulnerable to preventable diseases due to low vaccination rates, influenced by factors such as misinformation, lack of access, and vaccine hesitancy (UNICEF, 2020).

In Nigeria, the situation is no different. Despite substantial efforts to improve immunization coverage, various challenges persist in ensuring that all children, particularly those in remote areas, are vaccinated. The Nigerian government, along with international partners, has made significant strides to increase vaccination rates, but persistent barriers continue to hinder these efforts. Research indicates that many mothers lack adequate knowledge about the complications associated with non-immunization, and this lack of awareness contributes to the hesitancy in seeking immunization for their children (Obanewa & Newell, 2020). Understanding the factors contributing to this knowledge gap is crucial for designing effective public health interventions aimed at improving vaccine uptake.

Immunization programs in Nigeria have faced various challenges, including inadequate healthcare infrastructure, limited access to immunization services, and cultural factors that influence people's attitudes toward vaccination. However, studies have shown that one of the most significant barriers to immunization is vaccine hesitancy. Vaccine hesitancy refers to the delay in acceptance or refusal of vaccines despite availability of vaccination services (MacDonald, 2015). Vaccine hesitancy is a complex issue influenced by various psychological, cultural, and societal factors. For instance, some mothers may lack trust in the healthcare system, while others may be influenced by misinformation about vaccine safety (Betsch et al., 2024). Such factors contribute to the low immunization rates, which, in turn, increase the risk of children contracting preventable diseases that could otherwise have been avoided with proper vaccination.

The complications resulting from non-immunization are severe and can lead to lifelong disabilities or death. Diseases such as pneumonia, tuberculosis, and meningitis, which are preventable through vaccines, remain major causes of child mortality in many low-income settings, including Nigeria (Piot et al., 2019). The World Health Organization (WHO) estimates that vaccination prevents approximately 2-3 million deaths annually from diseases like diphtheria, tetanus, and whooping cough (WHO/UNICEF, 2019). These statistics underscore the importance of vaccination in preventing childhood diseases that would otherwise contribute to high morbidity and mortality rates. However, despite the availability of vaccines, the reluctance to immunize children remains a significant public health challenge.

Recent studies have shown that nursing mothers' knowledge of the complications associated with non-immunization plays a vital role in vaccination decision-making. A mother’s awareness of the dangers of not vaccinating her child is directly linked to her decision to vaccinate (Betsch et al., 2024). Many mothers, especially in rural areas, may not be fully aware of the consequences of not vaccinating their children. As a result, they may delay or refuse immunization, putting their children at risk of serious health issues. Awareness programs that focus on educating mothers about the health risks associated with non-immunization can significantly improve vaccination rates. Such initiatives are vital for empowering mothers to make informed decisions about their children’s health, ultimately contributing to a reduction in preventable diseases.

The role of healthcare providers in disseminating accurate information cannot be overstated. Studies indicate that healthcare professionals, particularly nurses, play a pivotal role in shaping parents' attitudes toward vaccination. Nursing mothers often rely on healthcare providers for information about vaccines, and their recommendations can influence vaccination decisions (Opel et al., 2013). However, the effectiveness of healthcare providers in addressing vaccine hesitancy depends on their ability to communicate the importance of immunization clearly and convincingly. Nurses who are well-informed about vaccine safety and the potential consequences of non-immunization are better equipped to educate mothers and address their concerns, thus enhancing vaccination uptake.

The Nigerian healthcare system is confronted with several challenges that complicate immunization efforts. Among these challenges are a lack of healthcare infrastructure, insufficient trained healthcare personnel, and poor communication strategies. These issues are particularly pronounced in rural areas, where healthcare services are often sparse, and transportation barriers prevent mothers from seeking immunization services. Furthermore, cultural beliefs and religious influences play a significant role in shaping attitudes toward vaccination. For instance, in some communities, there may be misconceptions about the safety of vaccines or beliefs that vaccination is unnecessary if the child appears healthy (Adeyanju et al., 2021). These beliefs, combined with a lack of awareness about the potential risks of non-immunization, can lead to vaccine hesitancy and low immunization coverage.

Research has shown that knowledge of vaccine-related complications is a crucial factor in improving vaccination rates. When mothers are educated about the potential dangers of vaccine-preventable diseases, they are more likely to seek immunization services for their children. This highlights the need for targeted educational interventions that provide clear, evidence-based information about the consequences of non-immunization. These interventions should be designed to address the specific knowledge gaps that exist within communities, particularly in rural areas where access to information may be limited. Moreover, such interventions should involve healthcare providers at all levels to ensure that accurate information reaches mothers effectively.

1.2 Statement of the Problem

Immunization remains one of the most effective ways to prevent infectious diseases in children, yet significant gaps persist in vaccination coverage across various parts of Nigeria, particularly in rural and underserved areas. Despite substantial efforts by the government and international bodies, a high number of children remain unimmunized, leaving them vulnerable to diseases that could otherwise be prevented (Betsch et al., 2024). The primary barrier to achieving higher immunization rates is vaccine hesitancy, which is influenced by various factors, including a lack of awareness about the potential health complications of non-immunization. While numerous studies have explored factors contributing to vaccine hesitancy, few have specifically focused on the knowledge of nursing mothers regarding the complications associated with non-immunization.

Existing research has primarily addressed vaccine hesitancy through general demographic factors such as socioeconomic status, access to healthcare, and cultural beliefs (Opel et al., 2013). However, there is a lack of in-depth studies examining the specific knowledge gaps among nursing mothers regarding the long-term health risks of non-immunization. While some studies have assessed mothers' attitudes toward vaccination, they have often failed to link these attitudes directly to their understanding of the serious health complications resulting from vaccine-preventable diseases (Piot et al., 2019). This leaves a significant gap in knowledge regarding how awareness of these complications influences vaccination decisions among mothers in Nigeria.

Furthermore, while healthcare providers are recognized as essential agents in shaping vaccine attitudes (MacDonald, 2015), there is insufficient research on the effectiveness of healthcare workers, especially nurses, in educating mothers about the risks associated with non-immunization. This gap suggests a need for research focused on how nurses, as frontline healthcare providers, can improve mothers' knowledge about vaccine-related complications and, by extension, increase immunization uptake. Additionally, most existing studies have concentrated on urban populations, with little attention given to rural communities where vaccination rates are notably low (Obanewa & Newell, 2020). Rural areas present unique challenges such as limited access to healthcare services and a higher prevalence of misconceptions about vaccines.

In light of these gaps, this study aims to fill the void by assessing the knowledge of nursing mothers regarding the complications of non-immunization, particularly in rural Nigerian communities. By doing so, it seeks to contribute to a more nuanced understanding of how knowledge influences vaccination behaviors and to inform targeted interventions aimed at improving immunization rates in underserved regions. This research will also explore the role of healthcare providers, especially nurses, in addressing the knowledge gaps that hinder effective vaccination campaigns.

1.3 Objective of the Study

1. To assess the level of knowledge nursing mothers have regarding the complications of non-immunization.

2. To identify factors influencing nursing mothers’ knowledge of the complications of non-immunization.
3. To determine the impact of education on nursing mothers’ decision to immunize their children.

1.4 Research Questions

1. What is the level of knowledge of nursing mothers regarding the complications of non-immunization?

2. What factors affect the knowledge of nursing mothers about the complications of non-immunization?

3. How does education influence the immunization decisions of nursing mothers?

1.5 Research Hypotheses

1. There is no significant relationship between the level of education and knowledge of complications of non-immunization.

2. Knowledge of complications of non-immunization is not associated with the decision to immunize children.

3. Socio-demographic factors do not influence the knowledge of nursing mothers on non-immunization complications.

1.6 Significance of the Study
This study is significant as it aims to provide valuable insights into the knowledge gaps among nursing mothers regarding the complications associated with non-immunization. Immunization plays a crucial role in protecting children from preventable diseases; however, despite the known benefits, non-immunization remains prevalent, especially in rural and underserved areas. A critical factor contributing to low immunization rates is the lack of awareness among parents, particularly nursing mothers, about the serious consequences that result from not vaccinating their children. Understanding the extent of this knowledge gap is essential to addressing vaccine hesitancy and ensuring better health outcomes for children.

The findings from this study will be instrumental in informing health education strategies aimed at increasing the awareness of nursing mothers about the severe complications arising from non-immunization, such as disabilities, prolonged illnesses, or even death. By highlighting the specific areas where nursing mothers lack knowledge, healthcare providers and policymakers will be better equipped to develop targeted educational programs. These programs can focus on educating mothers on the importance of immunization, the risks of non-immunization, and the direct benefits of vaccines in safeguarding children's health. With improved knowledge, nursing mothers are more likely to make informed decisions regarding vaccination, thereby improving vaccination coverage and reducing childhood morbidity and mortality rates.

Moreover, the study's findings will provide evidence to guide the development of more effective immunization campaigns, particularly in vulnerable and rural populations where vaccine hesitancy is often most pronounced. These areas face unique challenges, such as limited access to healthcare, cultural misconceptions, and misinformation, all of which contribute to lower vaccination uptake. By addressing the specific knowledge gaps identified in this study, health education interventions can be tailored to these communities, ensuring that they resonate with nursing mothers and overcome barriers to vaccination.

Additionally, this research will emphasize the role of healthcare providers, especially nurses, in bridging the knowledge gap. Nurses are often the first point of contact for nursing mothers seeking healthcare, and their ability to educate and influence mothers' perceptions of immunization is crucial. This study will provide evidence on how healthcare providers can enhance their communication strategies and become more effective in promoting vaccination.

Ultimately, this study's outcomes will contribute to improving immunization rates, reducing vaccine-preventable diseases, and safeguarding public health in Nigeria, particularly in rural and underserved communities.

1.7 Scope of the Study

This study will be conducted in a selected health facility in the region, focusing on nursing mothers with children under five years. It will assess their knowledge of the complications arising from non-immunization.

1.8 Operational Definition of Terms

Immunization: The process of providing vaccines to prevent disease.

Non-immunization: The failure or refusal to immunize children.

Complications: Negative health outcomes resulting from lack of immunization.

Nursing Mothers: Women who are breastfeeding or have children under five years of age.

Knowledge: The understanding or awareness of the effects and complications of non-immunization.

Health Education: Informational programs aimed at improving health awareness.

Socio-demographic Factors: Characteristics such as age, education, income, and occupation.

Vaccination Decision: The choice made by a mother to either vaccinate or not vaccinate her child.