KNOWLEDGE AND ATTITUDE OF MOTHERS TOWARDS TETANUS VACCINE IN PRIMARY HEALTH CENTER UYO, LGA AKWA IBOM STATE

KNOWLEDGE AND ATTITUDE OF MOTHERS TOWARDS TETANUS VACCINE IN PRIMARY HEALTH CENTER UYO, LGA AKWA IBOM STATE

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​​​​​​​Background Of The Study

In 2013, roughly 6.3 million children worldwide did not reach the age of five, and 51.8% of child mortality was attributable to infectious illnesses (Kyu, Mumford, Stanaway, Barber, Hancock, Vos, et al. 2017). It is estimated that Clostridium tetani causes around 49,000 newborn fatalities yearly, with the great majority occurring in sub-Saharan Africa and Southeast Asia. In the literature, infant mortality attributable to maternal and neonatal tetanus (MNT) decreased from 0.5 million to 0.25 million between 1980 and 2007(Kyu, Mumford, Stanaway, Barber, Hancock, Vos, et al. 2017).

Recent estimates indicated an 8.9% yearly drop in mortality over the past decade (Kunisawa, 2015). Several studies on community-based health interventions, such as improved umbilical cord care practices, a clean delivery environment, supplementary immunisation activities (SIAs), and modification of health-related behaviors, including birth practices, have demonstrated a significant reduction in the overall morbidity and mortality of children. The tetanus toxoid (TT) vaccination is a risk-free public health measure designed to reduce MNT mortality in particular (World Health Organization, 2019). Although the TT vaccination is provided at no cost to women, it is one of the vaccines in underdeveloped nations with the lowest usage rate (World Health Organization, 2019). The majority of the common variables associated with the low rate of tetanus immunization are related to the mother's knowledge and attitude, as well as her age, employment, and level of education.

In a prior research including 250 moms who were selected by multistage sampling and analyzed statistically using frequencies and percentages, 72% percent of the mothers had a solid understanding of the need of child immunization. One hundred percent of the moms held a favorable view of childhood vaccinations. 98.8% of the moms agreed that children vaccinations are needed (Eze & Adeleye 2015). In contrast, a study by Eze & Adeleye (2015), which included 60 mothers and used frequencies and percentages for statistical analysis of the collected data, revealed that the majority of mothers (65%) did not know the reason for the vaccinations, but they did know the correct age to begin vaccinations and when they must begin. 59 percent of respondents thought that vaccinations are not hazardous. Thus, the mothers' views about vaccination were positive, since the majority of mothers believed in the significance of immunization and adhered to the vaccination schedule.

According to the findings of Walters, & Ankomah, (2015), 462 out of 1050 participating moms lacked information regarding mandatory vaccines, while only six had negative attitudes toward mandatory vaccinations and 265 of the mothers earned a low score in terms of immunization practice. In addition, the study revealed a positive Pearson's correlation (0.037) between the age of the mother and the degree of knowledge. In addition, Sanford (2015) found that 55.0% (626) of the participating mothers had a good level of knowledge, 53.8% had a positive attitude, and 84.0% had a good practice with regards to child vaccines. The study found that the mothers' knowledge and attitudes towards child immunization were insufficient, and they advised that mothers get further health education to increase their understanding. Sandhurst, (2017), who included 200 mothers in their study, discovered that the mothers lacked knowledge regarding the importance of vaccination: 26.5 percent did not know about routine vaccinations and the vaccination schedule, and only 37.0 percent knew the names of infectious diseases and when their children should be vaccinated.

Rustein, (2016) performed a research with 200 moms. Using a t-test, it was discovered that urban moms and rural mothers varied significantly in their knowledge, attitudes, and behaviors towards kid vaccines. In comparison to rural moms, 75,6 percent of urban mothers had a high level of expertise, according to the survey. In addition, 95.9% of urban moms had better practices than their rural counterparts. A research including 300 moms indicated that just 17.0% of the mothers had adequate knowledge on kid vaccines, whereas 96.6% had a favorable attitude and 88.1% had appropriate vaccination practices. Moreover, this study advocated expanding vaccine education initiatives for children. In addition, in their research of 143 mothers, Rustein, (2016) discovered that 50.4% of mothers had good knowledge, while 34.2% had mediocre understanding on kid vaccines. In addition, 64.3% of the moms had a positive attitude toward kid vaccines, and 90.2% had good vaccination practices.

Nigeria is among the nations that have failed to meet the World Health Organization's (WHO) MNT worldwide eradication objective of 'less than 1 case per 1000 live births in every district' (Eze & Adeleye 2015; World Health Organization, 2019). The World Health Organization strongly advocated better than 90 percent TT vaccination coverage in high-risk locations (World Health Organization, 2019). The Nigerian National Immunization Policy provides free TT vaccinations to all pregnant women and women of reproductive age. The current regimen recommends five doses of TT vaccine, including TTV-1 at first encounter, TTV-2 at least four weeks after the initial dose, TTV-3 at least six months after the second dose, TTV-4 at least one year after the third dose, and TTV-5 at least one year after the fourth dosage (World Health Organization, 2017). Local figures indicate that more than fifty percent of rural regions in Nigeria are at risk for MNT. It is estimated that 54–70 percent of women have received at least two doses of the TT vaccination, and there are substantial coverage discrepancies between urban and rural regions. Studies done elsewhere indicated a lack of awareness of tetanus illness, inadequate immunization schedule information, misunderstandings regarding the TT vaccine, and a lack of comprehension of the advantages of the TT vaccine (Adudu, Ogunrin & Adudu 2017).

Gains in community-level knowledge and favorable attitudes are crucial for improving TT vaccination coverage in Nigeria (Adudu, Ogunrin & Adudu 2017). There is a paucity of published literature to support mothers knowledge and attitudes towards TT vaccination especially in primary health care centres, hence the need for this study.

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