Chapter 1

INTRODUCTION

BACKGROUND OF THE STUDY

Health professionals have stated that modern immunization programs are facing increasing
challenges as people stall or refuse to accept vaccines for themselves and also for their children.
This creates special challenges for nations that have the goal of closing the vaccination gap.
Around the world, one out of every five children has not received routine vaccinations.
Approximately 1.5 million children die every year from illnesses that the World Health
Organization (WHO) believes can be prevented with vaccines.

According to (Dr. Philippe Duclos, 2015) “Vaccines can only improve health and prevent
deaths if they are used, and immunization programs must be able to achieve and sustain high
vaccine uptake rates and Vaccine hesitancy is an increasingly important issue for country
immunization programs.”

The World Health Organization (WHO) has defined immunization as the process whereby
a person is made immune or resistant to an infectious disease, typically by the administration of a
vaccine. These vaccines help to stimulate the body’s own immune system to protect the person
against subsequent infection or disease (WHO, 2013). Immunization therefore depicts the ability
to develop immunity. Immunity being the state of having sufficient biological defences to avoid
infection, disease, or other unwanted biological invasion (Gherardi, 2014). Immunity also depicts
the capability of the body to resist harmful microbes from gaining access into it.

Immunization is one of the most successful and cost effective public health interventions
in the constant effort of human beings against diseases that affect our wellbeing. Immunization
has prevented more deaths in the past years than any other health intervention globally (Awosika,
2012).

WHO (2013) also stated that immunization is a proven tool for controlling and eliminating
life-threatening infectious disease and has been estimated to alleviate 2 to 3 million deaths each
year. WHO (2013 ) further stated that although global vaccination coverage is holding steady but
an estimated 22 million infants worldwide are still missing out on basic vaccines.
 Every year more than 10 million children in low- and middle-income countries die before
they reach their fifth birthdays. Most die because they do not access effective interventions that
would combat common and preventable childhood illnesses (Lee, 2013).Vaccine preventable
diseases remain the most common cause of childhood mortality with an estimated three million
deaths each year (Odusanya et al., 2014). They also observed that uptake of vaccination services
is dependent not only on provision of these services but also on other factors including knowledge
and attitude of mothers, density of health workers, accessibility to vaccination clinics and
availability of safe needles and syringes.

Kapoor and Vyas (2010) had stated that although immunization is one of the most effective,
safest and efficient Public Health Interventions, and that its impact on childhood morbidity and
mortality has been great, its full potential was yet to be reached. Through proven strategies,
immunization has been made accessible to even the most hard-to-reach and vulnerable populations
since it involves clearly targeted groups (WHO, 2013). When immunization rates are high, it is
much less likely a pathogen will be carried and transmitted from person to person. Declines in
vaccination rates allow diseases to emerge in the population again.

According to Birhanu et al., (2016) Only 55.0%, and 53.8 of respondents had good
knowledge and attitude towards immunization of infants, respectively. Despite inadequate
knowledge and attitude of mothers towards infant immunization, the majority 84.0% of mothers
had good practice of infant immunization. From this point of view, it is possible to conclude that
mothers’ immunization practice was not really based on their knowledge and attitude regarding
immunization of infants. Maternal education and birth order were significantly associated with
good knowledge. Similarly, Mothers’ education, infants’ aged from 2-3 months was significantly
associated with favorable attitude towards immunization of infants. Good infant immunization
practice was significantly associated with mothers who have ever heard information about
vaccination, who know correctly the time when infants should begin immunization, who know
correctly the number of sessions needed, who know the time when infants should complete
immunization and place of delivery.

Galea et al., (2016) concluded that lack of awareness of the availability of vaccines, and
lack of knowledge about preventable illnesses are principal reasons for missed vaccinations.
However, encouragingly, the findings show that parents are interested and willing to obtain more
information by discussing with their trusted healthcare professionals.

The knowledge of mothers on immunization- a public health intervention that has greatly
reduced mortality and morbidity globally- is very vital as they play a great role in child care. Their
ability to have the right knowledge will enhance their practice and attitude towards immunization.
Thus, Parental attitudes and beliefs about vaccines are an import ant factor in predicting child’s
immunization status. Keeping the point of view, this study was conducted to assess mothers’
knowledge, attitude and practice regarding infants’ immunization and their associated factors.
STATEMENT OF THE PROBLEM

This study was set to assess the knowledge, attitude and practice of mothers as regards
immunization and the influence of socio demographic characteristics on immunizable children.

This study will answer the following questions:

1. What is the Socio-demographic profile of the study respondents?

2. What are the Knowledge of Respondents on Infant Vaccination and Vaccine Preventable
Diseases?

3. What are the attitude of respondent mothers towards infants’ immunization?

4. What are the practice of Study Participants Regarding Immunization of Infants?

5. What are the factors Affecting Knowledge of Mothers About Their Infants Immunization?

6. What are the Factors Affecting Attitude of Mothers About Infants’ Immunization?

7. What are the Factors Affecting Practices of Mothers Towards Their Infants Immunization?