KNOWLEDGE OF THE IMPLICATIONS OF NON-COMPLIANCE WITH IMMUNIZATION PROGRAMS AMONG POST NATAL MOTHERS VISITING CENTRAL HOSPITAL UROMI EDO STATE

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Immunization is a critical public health intervention that has substantially p Ireduced the burden of vaccine-preventable diseases worldwide (Greenwood, 2014). Through the administration of vaccines, individuals develop immunity to specific infectious agents, thereby preventing the occurrence of diseases such as measles, mumps, rubella, and diphtheria (WHO vaccine-preventable diseases: monitoring system 2018 global summary; Major Vaccines Breakthrough in History; Aggarwal et al., 2020; Taib et al., 2017). However, despite its proven efficacy, non-compliance with immunization programs remains a significant challenge in many communities, including postnatal mothers visiting Central Hospital Uromi in Edo State (Smith et al., 2019).

The consequences of non-compliance with immunization programs can be severe, leading to outbreaks of preventable diseases and increased morbidity and mortality rates, particularly among vulnerable populations such as infants and young children (Measles; Abdulraheem et al., 2021). Studies have shown that vaccine hesitancy among parents, fueled by concerns about vaccine safety and efficacy, contributes to low immunization coverage rates (Awadh et al., 2022). Additionally, factors such as lack of awareness about the importance of immunization, misconceptions about vaccine-preventable diseases, and cultural or religious beliefs may also influence mothers' decision-making regarding vaccination for their children (Lim et al., 2016; Kibombo et al., 2020).

Understanding the factors contributing to non-compliance with immunization programs among postnatal mothers is essential for developing targeted interventions to improve immunization coverage rates and ultimately reduce the burden of vaccine-preventable diseases in the community (Bondy et al., 2009). Previous research has identified several barriers to immunization uptake among postnatal mothers, including inadequate knowledge about vaccination schedules, concerns about vaccine side effects, and difficulty accessing vaccination services (Shamsul Azhar et al., 2022; Vezzosi et al., 2017; Voorman et al., 2017). Addressing these barriers through educational campaigns, outreach programs, and improvements in healthcare infrastructure can help increase vaccine acceptance and uptake among postnatal mothers.

Therefore, this study seeks to investigate the knowledge of the implications of non-compliance with immunization programs among postnatal mothers visiting Central Hospital Uromi in Edo State (Badgujar et al., 2019). By assessing mothers' understanding of the risks associated with vaccine-preventable diseases and their perceptions of immunization, the study aims to identify areas where targeted interventions are needed to improve immunization coverage and address vaccine hesitancy. Findings from this study can inform the development of evidence-based strategies to promote immunization uptake among postnatal mothers and enhance overall public health outcomes in the community (Orenstein et al., 2018).

In conclusion, immunization is a crucial component of public health efforts to prevent the spread of infectious diseases and protect vulnerable populations from illness and death (Biellik & Orenstein, 2018). However, non-compliance with immunization programs remains a challenge, particularly among postnatal mothers in communities such as Central Hospital Uromi in Edo State. By understanding the factors influencing mothers' decisions regarding vaccination and addressing barriers to immunization uptake, healthcare providers and policymakers can work together to improve immunization coverage rates and reduce the burden of vaccine-preventable diseases in the community (Baker et al., 2021). This study aims to contribute to the evidence base on immunization practices and inform targeted interventions to promote vaccine acceptance and uptake among postnatal mothers.

1.2 Statement of Problem

Despite the significant progress made in immunization coverage globally, non-compliance with immunization programs persists as a significant public health challenge, particularly among postnatal mothers in certain communities. This issue is particularly salient in regions like Central Hospital Uromi in Edo State, where gaps in understanding the implications of non-compliance with immunization programs among postnatal mothers remain inadequately addressed.

One gap in the literature is the lack of comprehensive understanding regarding the specific factors contributing to non-compliance with immunization programs among postnatal mothers in Central Hospital Uromi. While existing studies have identified general barriers to immunization uptake, such as vaccine hesitancy and access issues, there is a need for context-specific research to elucidate the unique challenges faced by postnatal mothers in this community (Awadh et al., 2022).

Furthermore, there is limited research examining the knowledge levels of postnatal mothers regarding the implications of non-compliance with immunization programs. Understanding mothers' awareness of the risks associated with vaccine-preventable diseases and the potential consequences of not adhering to immunization schedules is crucial for designing targeted interventions to address vaccine hesitancy and improve immunization coverage rates (Smith et al., 2019).

Additionally, there is a paucity of evidence on effective strategies for promoting immunization uptake among postnatal mothers in Central Hospital Uromi. While educational campaigns and outreach programs have been proposed as potential interventions, there is a need for empirical research to assess their feasibility, acceptability, and effectiveness in this specific context (Lim et al., 2016).

Overall, filling these gaps in knowledge is essential for developing evidence-based strategies to enhance immunization coverage rates among postnatal mothers in Central Hospital Uromi and ultimately reduce the burden of vaccine-preventable diseases in the community.

1.3 Objectives of the Study

The objectives of this study were:

1. To assess the level of knowledge among postnatal mothers visiting Central Hospital Uromi in Edo State regarding the implications of non-compliance with immunization programs.

2. To identify the factors influencing non-compliance with immunization programs among postnatal mothers in the study area.

3. To explore the association between knowledge of the implications of non-compliance with immunization programs and immunization status among postnatal mothers in Central Hospital Uromi, Edo State.

1.4 Research Questions

1. What is the level of knowledge among postnatal mothers visiting Central Hospital Uromi in Edo State regarding the implications of non-compliance with immunization programs?

2. What are the factors influencing non-compliance with immunization programs among postnatal mothers in the study area?

3. Is there an association between knowledge of the implications of non-compliance with immunization programs and immunization status among postnatal mothers in Central Hospital Uromi, Edo State?

1.5 Research Hypotheses

Null hypothesis (H0): There is no significant association between the level of knowledge regarding the implications of non-compliance with immunization programs and immunization status among postnatal mothers in Central Hospital Uromi, Edo State.

Alternative hypothesis (H1): There is a significant association between the level of knowledge regarding the implications of non-compliance with immunization programs and immunization status among postnatal mothers in Central Hospital Uromi, Edo State.

1.6 Significance of the Study

This study endeavors to augment the current understanding of immunization uptake and compliance among postnatal mothers, thereby contributing to the existing body of knowledge in this field. By meticulously identifying the multifaceted factors that influence non-compliance with immunization programs and thoroughly assessing the depth of knowledge concerning the consequences of such non-compliance, the study aspires to provide valuable insights. These insights are anticipated to serve as a foundation for the development of targeted interventions aimed at enhancing immunization coverage rates not only within the study area but also in similar settings facing comparable challenges.

Immunization programs stand as pivotal pillars in public health efforts globally, and understanding the intricacies surrounding non-compliance is paramount for their effectiveness. By delving into the specific factors influencing non-compliance, such as vaccine hesitancy, accessibility barriers, and knowledge gaps, this study aims to illuminate the nuanced dynamics at play. These factors are often intertwined and influenced by various contextual, cultural, and socioeconomic factors, which necessitate a comprehensive and context-specific approach to intervention development (Awadh et al., 2022).

Furthermore, the study seeks to gauge the depth of knowledge among postnatal mothers regarding the implications of non-compliance with immunization programs. This entails assessing their awareness of the risks posed by vaccine-preventable diseases and the potential consequences of failing to adhere to immunization schedules. Understanding the extent to which postnatal mothers grasp these critical aspects not only sheds light on existing gaps in knowledge but also provides crucial insights into the efficacy of current educational initiatives and communication strategies surrounding immunization (Smith et al., 2019).

The ultimate goal of this study is to translate its findings into actionable interventions aimed at bolstering immunization coverage rates. By tailoring interventions to address the specific barriers identified within the study population, such as addressing misconceptions, improving accessibility to vaccination services, and enhancing health literacy, it is envisaged that compliance with immunization programs will be enhanced. Moreover, these interventions have the potential to yield far-reaching benefits, including improved health outcomes for infants and young children.

Reducing non-compliance with immunization programs carries profound implications for public health. By mitigating the risk of outbreaks of vaccine-preventable diseases, such as measles, mumps, rubella, and diphtheria, the overall burden of disease can be significantly diminished. This not only alleviates the strain on healthcare systems but also safeguards vulnerable populations, particularly infants and young children, from unnecessary morbidity and mortality (Orenstein et al., 2018).

In essence, this study is poised to make substantial contributions to the field of immunization uptake and compliance among postnatal mothers. By elucidating the factors underpinning non-compliance and assessing knowledge levels, it sets the stage for the development of targeted, evidence-based interventions aimed at improving immunization coverage rates. Through these efforts, the study endeavors to advance the overarching public health goals of reducing the burden of vaccine-preventable diseases and safeguarding the health and well-being of communities.

1.7 Scope of the Study

This study focused on postnatal mothers visiting Central Hospital Uromi in Edo State, Nigeria. The research examined their knowledge of the implications of non-compliance with immunization programs, factors influencing non-compliance, and the association between knowledge and immunization status. The study did not include other healthcare facilities or communities outside of Central Hospital Uromi.

1.8 Operational Definition of Terms

Immunization: The process of administering vaccines to induce immunity against specific diseases.

Non-compliance: Failure to adhere to recommended immunization schedules or refusal to vaccinate.

Postnatal mothers: Women who have recently given birth and are visiting Central Hospital Uromi for postnatal care.

Implications: Consequences or effects of non-compliance with immunization programs on individual and public health.

Central Hospital Uromi: The healthcare facility located in Uromi, Edo State, Nigeria, where the study was conducted.

Edo State: A state in southern Nigeria where Uromi is located.

Knowledge: Understanding or awareness of the importance and consequences of immunization compliance.

Immunization status: The vaccination history and current vaccination status of postnatal mothers and their infants.