BACKGROUND OF THE STUDY
Immunization is a process in which a person is protected against or made resistant to an infectious disease, and it often involves the injection of a vaccine. This protection or resistance is delivered to the individual. Vaccines work by revving up the immune system of the body, which then helps to protect the individual from any illnesses or diseases that may follow. One of the most successful and cost-effective public health interventions is immunization, which prevents approximately 3 million deaths annually and has the potential, if coverage increases, to save the lives of an additional 1.5 million children annually. Immunization is widely regarded as one of the most successful public health interventions (Araoye 2014).
The World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) together with Rotary International established the Expanded Program on Immunization (EPI) in 1974 as a component of their child survival programs. The Expanded Program on Immunization (EPI) was established with the intention of broadening the scope of immunization services to include vaccinations against six additional diseases that can be avoided in addition to smallpox: diphtheria, measles, pertussis, poliomyelitis, and tetanus and tuberculosis. Immunization might be done on a regular basis or as a supplement (taking the form of immunization campaigns). The term "routine immunization" refers to the practice of giving predetermined doses of vaccine to newborns according to a predetermined schedule and at certain ages. In most children, the health's parents or other primary caregivers are the ones who bring them to the medical facility so that they may get dosages of antigens that are suitable for their age group. Since vaccines are often distributed in multi-dose vials in order to keep costs down, immunizations are typically scheduled on specified days of the week throughout the majority of developing nations. This is done in order to minimize the amount of vaccine that is wasted. The primary goal of regular immunization is to eventually deliver immunity against the diseases that are being targeted by delivering the full planned number of doses of powerful vaccines in a timely manner that is both safe and effective for all children as well as women (Awosika 2015).
Diseases that may be prevented with vaccination have a significant role in the death rate among children under the age of five. Vaccines exist to protect against maternal and neonatal tetanus, measles, and rubella; yet, these diseases still affect a significant number of children across the world. One of the most contagious diseases ever discovered is measles, which is caused by a virus that targets the respiratory system. In 2013, it was estimated that around 84% of children throughout the world have been inoculated against measles. Despite the existence of a vaccine that is risk-free, efficient, and inexpensive, an average of 367 young children each day still lose their lives to measles.
Nigeria, like with many other African nations, is working to improve its health care system in order to attain enough regular immunization and hence reduce the prevalence of vaccine-preventable diseases (VPDs). The low level of immunization coverage in Nigeria may be attributed to a number of factors, including a lack of political will, a lack of motivation, a poor level of education and awareness, and insufficient infrastructure. Other characteristics that are related with low immunization coverage in resource-limited nations include high rates of community illiteracy, high fertility rates in the country, and residing in urban areas, as shown in a multi-level study covering 24 African countries. At the individual level, however, the low immunization rate may be associated to the poorest families, parents with low health-seeking habits, parents with low levels of education, parents who do not have access to the media, and/or parents who are illiterate. There is a significant lack of immunization coverage in Nigeria. The nationwide routine immunization coverage in Nigeria was a disgraceful 12% in the year 2003 and 36% in the year 2006. (Awosika 2015). Nigeria was responsible for approximately 3.5 million (14%) of the 23.2 million children around the world who did not receive all three doses of the diphtheria, tetanus toxoids, and pertussis (DPT) vaccine during their first year of life in 2009. This statistic refers to children who were born in 2009. In spite of the fact that global immunization coverage has increased since 2013, over 16 percent of the world's children still have not finished the three-dose DTP series. The projected global DTP-3 coverage among children aged 12 months in 2013, which is a critical measure of the performance of immunization programs, was 75% in the African Region of the World Health Organization (WHO) in 2013 and 84% overall. Throughout 6.2 million children under the age of five perished around the world in 2013, with three million of these fatalities occurring in sub-Saharan Africa. In 2009, the WHO calculated that if global vaccine coverage climbed to 90 percent by 2015, it would avoid roughly two million deaths among children under the age of five. However, as a result of the EPI, children immunization coverage in the WHO African Region is increasing, despite the fact that it is still below optimum in many locations.
STATEMENT OF THE PROBLEM
An essential first step in understanding the variables that influence vaccine nonacceptance in specific situations is to conduct a survey on the knowledge and attitudes toward childhood immunizations (KATCI) (Awosika 2015). To assist in the development of strategies to boost vaccine coverage rates, it will be helpful to have a better knowledge of the connection between KATCI and actually vaccinating children to the necessary extent. The purpose of this study is to ascertain the level of knowledge, attitude, and compliance about the immunization of children under the age of five that is held by mothers who visit Primary Health Care centers (PHCs) in Nigeria.
CHAPTER ONE
INTRODUCTION
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