SOCIO-DEMOGRAPHIC CORRELATES OF ROUTINE IMMUNIZATION SERVICES ADOPTION AMONG MOTHERS IN JALINGO LOCAL GOVERNMENT AREA, TARABA STATE

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Table of Contents

Title Page        —    —      —      —      —      —      —      —      —      —     —           i

Approval Page —   —   —-   —   —   —   —   —   —   —   —   —   —   —   —   —           ii

Dedication        —   —  —   —   —   —   —   —   —   —   —   —   —   —   —   —          iii

Acknowledgement       —   —   —   —   —   —   —   —   —   —   —          iv

Table of Contents         —    —   —   —   —   —   —   —   —   —   —   —   —         v

List of Tables               —    —    —   —   —   —   —   —   —   —   —   —   —          vii

Abstract     –   —   —   —   —   —   —   —   —   —   —   —   —   —   —   —         ix

CHAPTER ONE:    Introduction     –  —   —   —   —   —   —   —   —   —   —          1

Background to the Study      –   —   —   —   —   —   —   —   —   —       —          1

Statement of the Problem     —   —   —   —   —   —   —   —   —       —           9

Purpose of the Study            —  —   —   —   —   —   —   —   —   —   —       —           10

Research Questions     —   —   —   —   —   —   —   —        —          11

Hypotheses  —   —   —   —   —   —   —   —   —   —   —   —         —          12

Significance of the Study —   —   —   —   —   —   —   —   —         —           13

Scope of the Study            —   —   —   —   —   —   —   —   —   —         —            14

CHAPTER TWO:  Review of Related Literature    –   —   —   —   —            16

Conceptual Framework    –   —   —   —   —   —   —   —   —   —   —            16

Theoretical Framework           —   —   —   —   —   —   —   —   —   —   —             22

Constraints Encountered by Mothers in the Adoption of RIS    –   —   —             25

Socio-demographic Factors Related to Adoption of Immunization Services   —   —              33

Empirical Studies on Socio-demographic Correlates of Adoption of

Immunization Services          —   —   —   —   —   —   —   —              37

Summary of Review of Literature      —   —   —   —   —   —   —              42

CHAPTER THREE:      Methods         —  —   —   —   —   —   —   —              44

Research Design             —   —   —   —   —   —   —   —   —   —   —              44

Population for the Study     –   —   —   —   —   —   —   —   —              44

Sample and Sampling Technique     –   —   —   —   —   —   —   —   —   —              44

Instrument for Data Collection      —   —   —   —   —   —   —   —   —              45

           Validity of the instrument      —   —   —   —   —   —   —   —              46

           Reliability of the instrument    —   —   —   —   —   —   —   —   —              46

Method of Data Collection        —   —   —   —   —   —   —   —   —   —              46

Method of Data Analysis    –   —   —   —   —   —   —   —   —   —               47

CHAPTER FOUR:                Results and Discussion       —   —   —               49

Results  –   —   —   —   —   —   —   —   —   —   —   —   —   —   —   —               49

Summary of Findings   —   —   —   —   —   —   —   —   —   —   —   —   —               74

Discussion of Findings    —   —   —   —   —   —   —   —   —   —               76

CHAPTER FIVE: Summary, Conclusion and Recommendation              83

Summary               —   —   —   — —   —   —   —   —   —   —   —   —               83

Conclusion            —   —   —-   —   —   —   —   —   —   —   —   —   —               87

Implications of the Study for Health Education      —   —   —   —               88

Recommendations       —   —   —   —   —   —   —   —   —   —   —   —                90

Limitations of the Study       — —   —   —   —   —   —   —   —   —                92 

Suggestions for Further Study    —   —   —   —   —   —   —   —   —                 92

References            —   —   —   —   —   —   —   —   —   —   —   —   —                 93

Appendices             —   —   —   —   —   —                 97

Appendix I:  Routine Immunization Schedule for 0-1year old Children        —   —                 97

Appendix II:  Pilot Study on RIS Available for Adoption    –   —                  98

Appendix III:  Letter of introduction from the Department    —      103

Appendix IV:  Questionnaire          —   –   —   —   —   —   —                 104

Appendix V:    Hausa Translation of Questionnaire   – —   —   —                  107

Appendix VI:   Training Module for Research Assistants      —   —                  111

                                                         List of Tables

1.    Routine Immunization Services Available for Mothers’ Adoption in Jalingo LGA — — 49

2.    Types of RIS Adopted by Mothers for their Children –   —   —   —   —          51

3.    RIS (Tetanus Toxoid) Adopted by Women of Childbearing Age –          52

4.    Constraints to Mothers’ Adoption of RIS for their Children     —          53

5.     Correlation Analysis Showing the Relationship between Mother’s Age and   Adoption of RIS    —      —   —   —   —   —   —   —   —   —   —   —   —         54

6.     Correlation Analysis Showing the Relationship between Mother’s Educational Status and Adoption of RIS   —   —   —   —   —   —   —        55 

7.     Correlation Analysis Showing the Relationship between Mother’s Marital  Status and Adoption of RIS    —  –   —   —   —   —   —   —   —   — —         56

8.     Correlation Analysis Showing the Relationship between Mother’s Location and Adoption of RIS    –  —   —   —   —   —   —   —   —   —   —         57 

9.     Correlation Analysis Showing the Relationship between Mother’s Occupation and Adoption of RIS  —   —   —   —   —   —   —   —   —   —        59 

10.    Correlation Analysis Showing the Relationship between Mother’s Parity and Adoption of RIS    —   —   –   —   —   —   —   —   —   —   —   —   —   —         60 

11.   Correlation Analysis Showing the Relationship between Mother’s          Religious Affiliation and Adoption of RIS       —   —   —   —   —   —         61 

12.   Correlation Analysis Showing the Relationship between Identified Constraints   and Adoption of RIS   —   —   —   —   —   —   —   — —         62

13.   Summary of Simple Regression Analysis Testing the Null Hypothesis of No Significant Relationship between Mother’s Age and Adoption of RIS      63

14.   Summary of Simple Regression Analysis Testing the Null Hypothesis of No   Significant Relationship between Mother’s Educational Status and       Adoption of RIS    —   —   —   —   —   —   —   —   —   —   —   —   —   —   —   —   —            64                                                                                         

15.   Summary of Simple Regression Analysis Testing the Null Hypothesis of No    Significant Relationship between Mother’s Marital Status and Adoption of RIS —     66  

16.   Summary of Simple Regression Analysis Testing the Null Hypothesis of No    Significant Relationship between Mother’s Location and Adoption of RIS   — —        67  

17.   Summary of Simple Regression Analysis Testing the Null Hypothesis of No  Significant Relationship between Mother’s Occupation and Adoption of RIS —         68  

 18.   Summary of Simple Regression Analysis Testing the Null Hypothesis of No   Significant Relationship between Mother’s Parity and Adoption of RIS –   — —           69  

 19.   Summary of Simple Regression Analysis Testing the Null Hypothesis of No   Significant Relationship between Mother’s Religious Affiliation  and Adoption of RIS   —   — —   —   —   —   —   —   —   —   —   —   —   —   —   —              70  

20.   Summary of Multiple Regression Analysis Testing the Null Hypothesis of No   Significant Relationship between Mother’s Age, Educational Status,        Marital Status, Location, Occupation, Parity, and Religious Affiliation on  the Adoption of RIS   —    —   —   —   —   —   —   —   —   —         71  

Abstract

The study was designed to find out the socio-demographic correlates of mothers’ adoption of routine immunization services in Jalingo L.G.A, Taraba State. To achieve the purpose of the study, eleven objectives were formulated, eleven corresponding research questions were posed and nine hypotheses were postulated for testing. A cross-sectional survey research design was used for the study. The instrument for data collection was a 14-item questionnaire. The sample for the study consisted of five hundred and sixty (560) mothers with 0-1 year old children who bring their children for routine immunization in the health facilities offering routine immunization in the L. G. A. The data were analyzed using percentages to establish the rate and trend in the adoption of routine immunization services (RIS) and to identify the constraints encountered by mothers in adoption. The Pearson Product Moment correlation coefficient index was used to determine the relationship of the socio-demographic variables and constraints on mothers’ adoption of RIS. The nine null hypotheses were tested using the linear and multiple regression statistics. The major results of the study were that: All the RIS were available and mothers adopted all of them though there was a downward trend in adoption of the RIS ranging from the first to the sixth child; mothers encountered some constraints in adopting RIS and their adoption of the RIS was significantly related to some of the identified constraints; there was a significant relationship between mothers age and adoption of adoption of majority of the RIS; education and religious status had  significant relationship in the mothers’ adoption of all the RIS except for tetanus toxoid (T.T); marital status had no significant relationship to the adoption of majority of the RIS; maternal location, occupation and parity had significant relationships with the adoption of majority of the RIS; the regression of  maternal age on the adoption of all the RIS was significant while the regression of maternal education, marital status, parity, occupation, religion and location were not significant for majority of the RIS. Based on the major findings and conclusions, recommendations were made among which include that adequate health education about adoption of RIS should be intensified and continuous through proper and genuine dissemination of helpful information using current and local IEC (Information, Education, Communication) materials like posters and banners; health professionals should emphasize on social mobilization and community networking activities and provide incentives to mothers so as to arouse their interest and maintain a continuous increase in the rate of adoption; and feedback information from field experiences and research should be provided to the community leaders to assist them in tackling the influence of the identified constraints to mothers on the adoption of RIS.   

CHAPTER ONE

Introduction

Background to the Study                                                                                                                               

            Formore than two hundred years now, after the discovery of vaccines by English Physician Edward Jenner, immunization has been credited with saving millions of lives every year worldwide by means of conferring immunity on them. Obionu (1999) affirmed that immunity is the ability of the body of an immunized person to resist certain diseases. He also posited that one who is immune to a disease is protected against that particular disease by means of antibodies. Immunity according to Bradley (1997) is the ability of the body to resist infection or disease, especially germs or other poisonous products (toxins) and that immunity can be actively or passively acquired.

             Active immunity according to Bradley (1997) is one where a person’s body defence mechanism is stimulated to manufacture its own antibodies natural in response to a stimulus. This stimulus, he said, can be in form of an attack of a disease where the body defence mechanism is stimulated to produce natural antibodies against the foreign bodies or antigens of the attacking disease. The antibodies so manufactured would protect the body against future attacks of the same disease. Jelliffe (1993) earlier stated that the stimulus could be given artificially in form of a vaccine that contains the disease agent or their products in a killed or attenuated and harmless form which is introduced into the body.

            Bradley (1997) defined vaccine as a medicine made from a microorganism, which is administered to confer immunity against a dangerous disease.  She acknowledged the fact that there are various types of vaccines viz: antitoxins, live vaccines or dead vaccines. Antitoxins are the altered harmless toxins of an organism that when injected into the body, stimulate it to produce antibodies (e.g. diphtheria and tetanus antitoxins).  Live vaccines contain living but weakened microorganism (attenuated) grown especially in a laboratory (e.g., poliomyelitis, measles, tuberculosis (BCG) vaccines).  Dead vaccines contain dead microorganisms.  The body in response to the introduced vaccines (through immunization will be stimulated to manufacture its own antibodies against the disease agent contained in the vaccine (e.g., measles immunization in the routine immunization programme).  This is known as active artificial immunity. Jelliffe (1993) confirmed that active immunity whether brought about by illness or vaccines lasts a long time, sometimes throughout life.

              In passive immunity, ready-made antibodies are introduced into the body of a person to immunize and protect him against certain specific diseases, and could be acquired naturally or artificially. Obionu (1999) posited that in passive natural immunity, maternal antibodies pass from the mother to the child through the placenta. This will make the baby have some protection against some diseases at birth such as, neonatal tetanus, measles, and malaria). Obionu added that passive artificial immunity is giving the antibodies ready-made as vaccine like tetanus antitoxin for a person who already has the tetanus disease). When a person’s body defence mechanism is stimulated through the introduction of a vaccine to develop immunity that will prevent him from contracting an illness, the person is said to have received an immunization.              The World Health Organization-WHO (2002) defined immunization as a process of administering special medicine(s) into a person’s body to make the body resist certain vaccine- preventable diseases. Azubike and Nkanginieme (1999) suggested that immunization may be active or passive and confers some protection or immunity to the receipient. Onuzuluike (2002) posited that active immunization is a deliberate stimulation of the body’s defences against a specific harmful germ or bacteria. Obionu (1996) opined that it is the most powerful cost-effective means of preventing some deadly diseases of childhood and the best practical community-based health measure known today for protecting children against the major killer diseases. This study will be limited to active immunization which involves the administration of all or part of an infecting agent (that is, microorganism or a modified product of an infecting agent) using a vaccine.     

SOCIO-DEMOGRAPHIC CORRELATES OF ROUTINE IMMUNIZATION SERVICES ADOPTION AMONG MOTHERS IN JALINGO LOCAL GOVERNMENT AREA, TARABA STATE