FACTORS INFLUENCING THE ATTITUDE OF MOTHERS TOWARDS IMMUNIZATION (A STUDY OF LAPAI LGA, NIGER STATE)
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CHAPTER ONE
INTRODUCTION
1.1 Background of the Study
Immunization is widely recognised as one of the most effective and affordable public health strategies for preventing childhood illnesses and deaths caused by vaccine-preventable diseases. These diseases include measles, poliomyelitis, tuberculosis, pertussis, diphtheria and tetanus. Despite years of substantial investment in routine immunization programmes at both international and national levels, Nigeria continues to experience challenges in achieving the desired childhood immunization coverage. Consequently, many children remain exposed to diseases that could otherwise be prevented through timely vaccination. Since mothers are generally the primary caregivers responsible for ensuring that their children receive scheduled vaccines, their attitudes towards immunization play an important role in determining whether children complete the recommended vaccination schedule. These attitudes are influenced by factors such as knowledge, personal beliefs, socioeconomic circumstances and experiences with healthcare services (Abidoye & Odeyemi, 2013).
The Health Belief Model, developed by Rosenstock (1974), provides a useful theoretical explanation of maternal attitudes towards childhood immunization. According to this model, an individual's decision to adopt a health-protective behaviour, such as taking a child for vaccination, is influenced by their perception of the seriousness of a disease and the likelihood of being affected by it. These perceptions are considered alongside the expected benefits of taking preventive action and the obstacles that may discourage such action. The model helps explain why mothers may demonstrate general awareness of immunization but still fail to maintain positive attitudes or consistently follow recommended vaccination practices. In their study of mothers in Kosofe Local Government Area of Lagos State, Abidoye and Odeyemi (2013) reported that although most mothers were aware of childhood immunization and generally expressed favourable attitudes towards it, their understanding of the specific diseases prevented by individual vaccines was considerably limited. This difference between general awareness and detailed knowledge may affect the consistency of immunization practices.
Other studies conducted in Nigeria have also examined the demographic and social factors that influence maternal knowledge, attitudes and practices regarding childhood immunization. Adedire, Ajumobi, Bolu, Nguku and Ajayi (2021), in a household-based survey carried out in Atakumosa-West Local Government Area of Osun State, discovered that most mothers possessed adequate knowledge of routine immunization and demonstrated positive attitudes towards the programme. However, differences were observed according to certain sociodemographic characteristics. Similarly, Asiegbu, Obu, Una, Ezeonu and Asiegbu (2020), in their investigation of the low uptake of childhood immunization in Ebonyi State, identified maternal knowledge and attitudes as important factors contributing to immunization coverage. Their findings suggest that improving childhood immunization requires more than ensuring vaccine availability and strengthening healthcare facilities. It also requires attention to the beliefs, attitudes, knowledge and personal circumstances of mothers. In view of these concerns, the present study examines immunization attitudes and practices among mothers in Lapai Local Government Area of Niger State, with particular emphasis on the influence of maternal age and educational attainment.
1.2 Statement of the Problem
Although routine childhood immunization services are generally provided free of charge in Nigeria, including Niger State, vaccination coverage in several parts of the country remains below the levels required to provide adequate population protection against vaccine-preventable diseases. Consequently, outbreaks of illnesses such as measles and diphtheria continue to pose public health concerns in different communities. Several health-system challenges contribute to inadequate immunization coverage, including vaccine shortages, long distances to healthcare facilities and insufficient healthcare personnel. However, existing research also identifies maternal attitudes as an important factor influencing whether children receive and complete their recommended vaccinations (Asiegbu et al., 2020).
While the availability and accessibility of immunization services are important, mothers' willingness to utilise these services is equally essential. Negative perceptions, inadequate knowledge, misconceptions and other personal or social circumstances may discourage mothers from presenting their children for vaccination or completing the required immunization schedule.
Despite the importance of maternal attitudes and practices, limited information is available regarding the specific nature of these factors among mothers in Lapai Local Government Area of Niger State. In particular, there is a need to understand how maternal age and educational attainment influence their attitudes towards childhood immunization and their actual vaccination practices. Without adequate information about these relationships, it may be difficult to develop targeted health education programmes that respond to the needs of different groups of mothers.
It is against this background that the present study seeks to assess immunization attitudes and practices among mothers in Lapai Local Government Area, Niger State, and determine the extent to which maternal age and educational level are associated with these attitudes and practices.
1.3 Aim and Objectives of the Study
The main aim of this study is to assess immunization attitudes and practices among mothers in Lapai Local Government Area of Niger State.
Specifically, the study seeks to:
1. Examine mothers' attitudes towards immunization against childhood killer diseases.
2. Assess mothers' immunization practices concerning childhood killer diseases.
3. Determine the extent to which maternal age influences their attitudes towards immunizing their children against childhood killer diseases.
4. Examine the extent to which mothers' educational levels influence their attitudes towards childhood immunization.
5. Determine the extent to which maternal age influences their practices regarding childhood immunization.
6. Assess the extent to which mothers' educational levels influence their practices regarding childhood immunization.
1.4 Research Questions
The following research questions are formulated to guide the study:
1. What are the attitudes of mothers in Lapai Local Government Area towards immunization against childhood killer diseases?
2. What are the immunization practices of mothers in Lapai Local Government Area concerning childhood killer diseases?
3. To what extent does maternal age influence mothers' attitudes towards immunizing their children?
4. To what extent does mothers' educational level influence their attitudes towards immunizing their children?
5. To what extent does maternal age influence mothers' immunization practices concerning their children?
6. To what extent does mothers' educational level influence their immunization practices concerning their children?
1.5 Significance of the Study
This study is important to health policymakers and programme coordinators responsible for implementing routine immunization services in Niger State. The findings are expected to provide useful information about how maternal age and educational attainment relate to attitudes and practices concerning childhood immunization. Such information may help identify groups of mothers who require additional health education, counselling and community-based interventions to improve vaccination uptake.
The study will also be beneficial to primary healthcare workers and community health extension workers by providing insight into the beliefs, perceptions and possible attitudinal challenges that influence mothers' participation in routine immunization programmes. This information may support the development of more effective health education and counselling approaches during antenatal, postnatal and child welfare clinic visits.
Furthermore, the research will contribute to the existing academic literature on maternal knowledge, attitudes and practices regarding childhood immunization in Nigeria. It extends previous studies, including those conducted by Abidoye and Odeyemi (2013), Adedire et al. (2021) and Asiegbu et al. (2020), by examining these issues within the specific context of Lapai Local Government Area of Niger State, where further location-specific research may be useful.
Finally, the study will serve as a reference material for students, researchers, public health professionals and other individuals interested in maternal attitudes, childhood vaccination and immunization programme implementation. It may also provide a foundation for further investigations into factors affecting childhood immunization coverage in Nigeria.
1.6 Scope of the Study
This study focuses on mothers with children who are eligible for routine childhood immunization and who reside in Lapai Local Government Area of Niger State. It examines mothers' attitudes towards immunization against childhood killer diseases, their actual immunization practices and the extent to which maternal age and educational attainment influence both attitudes and practices.
The research is primarily concerned with maternal-related factors. It does not directly investigate broader health-system determinants, such as vaccine supply chain management and the availability of healthcare personnel, except where respondents mention such issues in explaining their attitudes or immunization experiences.
1.7 Limitations of the Study
The study is subject to certain limitations commonly associated with survey-based health research. First, information concerning mothers' attitudes and immunization practices is largely obtained through self-reported responses. Consequently, some respondents may provide answers they consider socially acceptable rather than accurately describing their actual attitudes or behaviours. This may introduce social-desirability bias and affect the accuracy of the information collected.
Secondly, the cross-sectional research design captures information at a particular period and does not establish the direction of cause-and-effect relationships between maternal characteristics and immunization outcomes with certainty.
Another limitation is that the research is restricted to Lapai Local Government Area of Niger State. Therefore, the findings may not be directly generalisable to all communities within Niger State or other parts of Nigeria.
In addition, limitations relating to time, finances and available research resources may affect the sample size and the extent of investigation possible. Despite these challenges, efforts will be made to ensure that the research procedures are properly implemented and that the findings provide a reliable representation of the study population within the available resources.
1.8 Definition of Terms
Immunization: This refers to the process of developing protection or resistance against an infectious disease, usually through the administration of a vaccine.
Attitude: This refers to an individual's established way of thinking, feeling or responding towards a particular subject. In this study, it describes mothers' positive or negative perceptions and dispositions towards childhood immunization.
Immunization Practice: This refers to the actual actions taken by mothers to ensure that their children receive the recommended vaccinations at the appropriate ages and intervals. It is different from what mothers know or believe about immunization.
Childhood Killer Diseases: These are serious vaccine-preventable diseases that can cause severe illness, disability or death among children. Examples include measles, poliomyelitis, tuberculosis, pertussis, diphtheria and tetanus.
Health Belief Model: This is a theoretical framework used to explain and predict health-related behaviours. It suggests that individuals' decisions to take preventive health actions are influenced by their perceived susceptibility to a health condition, its perceived seriousness, the benefits of taking action and the barriers that may prevent them from doing so.
Educational Level: This refers to the highest stage of formal education completed by an individual, which may range from no formal education to primary, secondary or tertiary education.
REFERENCES
Abidoye, A. O., & Odeyemi, K. A. (2013). Knowledge, attitude and practice of mothers to childhood immunization in Kosofe Local Government Area of Lagos State, Nigeria. International Journal of Basic, Applied and Innovative Research, 2(4), 66–72.
Adedire, E. B., Ajumobi, O., Bolu, O., Nguku, P., & Ajayi, I. (2021). Maternal knowledge, attitude, and perception about childhood routine immunization program in Atakumosa-West Local Government Area, Osun State, Southwestern Nigeria. Pan African Medical Journal, 40(1), 8. https://doi.org/10.11604/pamj.supp.2021.40.1.30876
Asiegbu, U. V., Obu, D. C., Una, A. F. I., Ezeonu, C. T., & Asiegbu, O. K. (2020). Evaluating mothers' knowledge and attitude as a contributing factor to the low childhood immunization uptake in Ebonyi State, Nigeria. African Journal of Medical and Health Sciences, 19(8), 127–135.
Rosenstock, I. M. (1974). Historical origins of the Health Belief Model. Health Education Monographs, 2(4), 328–335. https://doi.org/10.1177/109019817400200403
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