ATTITUDE OF MOTHERS TOWARDS THE UPTAKE OF BASIC CHILDHOOD IMMUNIZATION AMONG MOTHERS ATTENDING CHILD WELFARE CLINIC IN EGBELLE PHC UROMI, EDO STATE

Abstract

This study focused on investigating the attitudes of mothers towards the uptake of basic childhood immunization at Egbelle Primary Health Care (PHC) in Uromi, Edo State, Nigeria. A quantitative survey research design was adopted to gather insights into maternal attitudes, and a structured questionnaire was developed for data collection. The questionnaire was administered to a sample of 120 respondents, who were mothers attending child welfare clinics at Egbelle PHC. The survey aimed to assess factors influencing maternal attitudes, including knowledge about immunization, socio-economic status, access to healthcare services, and perceptions of childhood immunization. Upon collecting the data, frequency tables were utilized to present and analyze the responses from the participants. These tables provided a clear overview of the respondents' characteristics and their attitudes towards childhood immunization. Additionally, a t-test was employed to test the hypotheses formulated in the study, which explored the associations between maternal knowledge levels, socio-economic factors, access to services, and attitudes towards immunization. The findings of the study indicated significant correlations between maternal knowledge, socio-economic factors, access to services, and attitudes towards childhood immunization. Specifically, higher levels of maternal knowledge were associated with more positive attitudes towards immunization. Conversely, socio-economic barriers were found to influence maternal attitudes and decision-making processes regarding immunization. Based on these results, the study concluded that addressing knowledge gaps, improving healthcare access, and implementing targeted educational campaigns are crucial steps in enhancing childhood immunization uptake among mothers. The study's recommendations underscore the importance of multi-faceted approaches involving healthcare providers, community engagement initiatives, and policy interventions to promote immunization acceptance and coverage among mothers attending child welfare clinics in Nigeria.

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Childhood immunization plays a pivotal role in public health by preventing diseases that can cause significant morbidity and mortality among children. Immunization programs have been established globally to ensure that children receive vaccines at recommended ages to protect them from diseases such as measles, polio, diphtheria, and tetanus, among others (National Primary Health Care Development Agency; FMOH Nigeria, 2023). These programs are designed to provide a protective shield for children, especially during their vulnerable years, by bolstering their immune systems against preventable diseases.

In Nigeria, the Expanded Program on Immunization (EPI) has been instrumental in increasing immunization coverage rates over the years (Abdulraheem et al., 2021). However, challenges persist, particularly concerning the attitudes of mothers towards the uptake of basic childhood immunization. Maternal knowledge and perceptions about immunization can significantly impact immunization coverage and adherence to vaccination schedules (Manjunath & Pareek, 2023). Understanding these attitudes is crucial for developing targeted interventions to address barriers and improve immunization rates.

Egbelle Primary Health Care (PHC) in Uromi, Edo State, serves as a critical hub for child welfare services, including immunization (Kunle-Olowu et al., 2021). It is within this healthcare setting that the attitudes of mothers towards immunization uptake play a vital role. Factors such as maternal education, socio-economic status, and access to healthcare services can influence mothers' decisions regarding immunization for their children (Fatiregun & Okoro, n.d.). Therefore, understanding the specific context of Egbelle PHC and the attitudes prevalent among mothers attending the clinic is essential for tailored interventions.

Research indicates that overcoming barriers to routine immunization is crucial for improving coverage rates (Wonodi, 2012). Factors such as vaccine hesitancy, misinformation about vaccines, and logistical challenges in accessing immunization services contribute to gaps in immunization coverage (Antai, 2019). By addressing these barriers and understanding the underlying reasons for incomplete vaccination, healthcare providers and policymakers can implement targeted strategies to enhance immunization uptake among children in communities like Egbelle PHC in Uromi.

The Nigeria Demographic and Health Survey provides valuable insights into vaccination coverage and determinants of immunization uptake (National Population Commission (NPC) and ICF Macro, 2023). It highlights the importance of considering demographic factors, maternal perceptions, and community-level determinants in shaping immunization behaviors. Additionally, studies have shown that community perceptions and support for immunization programs can positively influence vaccination uptake (Chambongo et al., 2020). Engaging communities and addressing their concerns can foster trust in immunization services and encourage participation in vaccination campaigns.

Improving maternal knowledge and perceptions about the routine immunization program is a key strategy for enhancing immunization coverage (Odusanya et al., 2018). Educating mothers about the importance of vaccines, addressing misconceptions, and promoting the benefits of immunization can lead to higher acceptance rates (Luman et al., 2023). Additionally, involving healthcare providers in counseling sessions and providing accurate information can strengthen confidence in immunization services (Adebayo et al., 2022).

1.2 Statement of Problem

Understanding the attitudes and challenges faced by mothers towards the uptake of basic childhood immunization at Egbelle Primary Health Care (PHC) in Uromi, Edo State, is crucial for improving immunization coverage rates and reducing childhood morbidity and mortality. Despite global and national efforts to increase immunization rates, there are significant gaps in understanding the specific factors influencing maternal decisions regarding immunization for their children in this particular healthcare setting (Abdulraheem et al., 2021).

One of the critical gaps is the lack of context-specific data on factors influencing mothers' decisions about childhood immunization within the Egbelle PHC catchment area. While general determinants such as maternal education, socio-economic status, and healthcare access are known to impact immunization uptake (Fatiregun & Okoro, n.d.), a deeper understanding of these factors in the local context is needed to develop targeted interventions.

Moreover, there is a notable gap in addressing vaccine hesitancy and misconceptions among mothers attending the child welfare clinic at Egbelle PHC. Vaccine hesitancy can stem from various sources, including misinformation, fear of side effects, and cultural beliefs (Antai, 2019). Bridging this gap requires tailored communication strategies and educational programs to address concerns and promote vaccine acceptance among mothers in the community.

Additionally, there is a gap in community engagement and support for immunization programs at Egbelle PHC. Community perceptions and support play a significant role in vaccination uptake rates (Chambongo et al., 2020), yet specific insights into community attitudes towards immunization in this setting are limited. Strengthening community engagement through collaboration with community leaders and influencers can build trust in immunization services and encourage active participation in vaccination campaigns.

1.3 Objectives of the Study

The following specific objectives were investigated:

1. To assess the attitudes of mothers towards the uptake of basic childhood immunization at Egbelle PHC in Uromi, Edo State.

2. To identify the factors influencing mothers' decisions regarding immunization for their children in the study area.

3. To explore potential strategies for improving immunization uptake among mothers attending the child welfare clinic at Egbelle PHC.

1.4 Research Questions

The following research question were asked:

1. What are the prevailing attitudes of mothers towards the uptake of basic childhood immunization in Egbelle PHC, Uromi?

2. What factors influence mothers' decisions regarding the immunization of their children in this setting?

3. What strategies can be implemented to enhance immunization uptake among mothers attending the child welfare clinic at Egbelle PHC?

1.5 Research Hypotheses

The following hypotheses were tested:

1. There is no significant association between maternal knowledge about immunization and their attitudes towards immunization uptake.

2. Socio-economic factors such as income level and education do not influence mothers' attitudes towards childhood immunization.

3. Improved access to immunization services does not correlate with higher immunization uptake rates among children in the study area.

1.6 Significance of the Study

The significance of studying the attitudes of mothers towards the uptake of basic childhood immunization at Egbelle Primary Health Care (PHC) in Uromi, Edo State, extends across multiple domains within public health and healthcare delivery systems.

Firstly, understanding maternal attitudes towards immunization is crucial for improving immunization coverage rates. Mothers play a pivotal role in decision-making regarding their children's health, including vaccination. By gaining insights into their attitudes, beliefs, and perceptions related to immunization, healthcare providers and policymakers can develop targeted interventions to address barriers and increase vaccine acceptance. This can lead to higher immunization coverage rates, which in turn contribute to reducing the burden of vaccine-preventable diseases among children.

Secondly, the study holds significance in the context of reducing childhood morbidity and mortality. Immunization is one of the most cost-effective public health interventions, preventing numerous diseases that can cause severe illness, disability, and even death in children. By identifying factors that hinder immunization uptake among mothers at Egbelle PHC, strategies can be implemented to ensure that more children receive timely and complete vaccinations. This can lead to a significant reduction in the incidence of vaccine-preventable diseases and associated health complications among children in the community.

Thirdly, the study's findings can inform healthcare policies and programs aimed at strengthening immunization services. Policy decisions regarding immunization programs, resource allocation, and community engagement strategies can be better informed by understanding the specific challenges faced by mothers in the study area. For instance, if vaccine hesitancy or misconceptions are identified as major barriers, targeted educational campaigns and outreach efforts can be designed to address these issues effectively.

Moreover, the study's significance extends to improving healthcare equity and access. By identifying factors such as socio-economic status, educational level, and healthcare access that influence immunization attitudes, interventions can be tailored to meet the unique needs of vulnerable or marginalized populations. This can contribute to reducing disparities in immunization coverage and ensuring that all children, regardless of background, have equal opportunities to receive life-saving vaccines.

Furthermore, the study contributes to the body of knowledge in public health research, particularly in the Nigerian context. Research focusing on specific healthcare settings, such as Egbelle PHC, provides valuable insights into localized challenges and opportunities for improving healthcare delivery. The findings can serve as a basis for future research endeavors, program evaluations, and policy recommendations related to childhood immunization and maternal healthcare.

1.7 Scope of the Study

This study focused on mothers attending the child welfare clinic at Egbelle PHC in Uromi, Edo State. It explored their attitudes towards the uptake of basic childhood immunization, including factors influencing their decisions and potential strategies for improvement. The study was conducted during a specified period to gather relevant data for analysis and recommendations.

1.8 Operational Definition of Terms

Attitudes: Refers to the beliefs, feelings, and behaviors of mothers towards childhood immunization, including their perceptions, concerns, and acceptance levels.

Basic Childhood Immunization: Denotes the routine vaccines recommended by national immunization guidelines for children, including but not limited to measles, polio, diphtheria, and tetanus vaccines.

Uptake: Indicates the proportion of mothers who adhere to the recommended immunization schedule for their children, including timely vaccination completion.

Child Welfare Clinic: A specialized healthcare service within a primary healthcare facility that focuses on the health and well-being of children, including immunization services.

Egbelle PHC: Refers to the specific primary healthcare center located in Uromi, Edo State, where the study was conducted.

Maternal Knowledge: Represents mothers' understanding of immunization, including vaccine-preventable diseases, vaccine safety, and the importance of immunization for child health.

Socio-economic Factors: Includes variables such as income level, education level, employment status, and household resources, which can influence maternal attitudes and behaviors towards immunization.

Immunization Coverage: Denotes the proportion of children in a given population who have received the recommended vaccines according to the national immunization schedule, reflecting the extent of vaccination within the community.