1.1 Introduction
Immunization is defined as the process by which an individual is made resistant or immune to an infectious disease, typically through the administration of a vaccine (World Health Organization, 2022). Immunization programs aim to reduce morbidity and mortality from diseases such as measles, polio, tuberculosis, and diphtheria, which continue to pose significant health risks in developing countries (Oladimeji, 2016). In Nigeria, childhood immunization is a key strategy under the National Primary Health Care Development Agency to ensure that all children receive life-saving vaccines at the recommended ages. However, the effectiveness of these programs depends largely on maternal awareness and acceptance, as mothers are primarily responsible for ensuring that their children complete the immunization schedule (Anyadi, Ude, & Chukwu, 2021).
Awareness refers to the knowledge and understanding of immunization programs, while acceptance refers to the willingness of mothers to participate in these programs and adhere to recommended vaccination schedules. As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the aim and objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
The practice of immunization dates back several centuries, with early forms of inoculation observed in Asia and Africa before the development of modern vaccines. According to Plotkin (2014), the principle of immunization is to stimulate the immune system to recognize and fight specific pathogens, thereby preventing disease. In Nigeria, organized immunization programs began formally during the colonial era, with smallpox vaccination campaigns in the early 20th century.
Post-independence, the Nigerian government established the Expanded Programme on Immunization (EPI) in 1979, with support from the World Health Organization (WHO) and UNICEF, aimed at reducing childhood mortality from six vaccine-preventable diseases: tuberculosis, poliomyelitis, diphtheria, pertussis, tetanus, and measles. According to Oladimeji (2016), the introduction of the EPI marked a significant turning point in public health efforts, particularly in urban and semi-urban communities, by providing vaccines free of charge at primary health care centers.
According to the World Health Organization (2022), immunization prevents millions of deaths annually and remains one of the most effective strategies for improving child survival. In Nigeria, childhood immunization is implemented under the National Primary Health Care Development Agency, with the goal of ensuring that all children receive timely and complete vaccinations (Oladimeji, 2016).
Maternal awareness and acceptance are key determinants of the success of immunization programs. Anyadi, Ude, and Chukwu (2021) reported that maternal knowledge significantly influences the likelihood of children completing recommended vaccination schedules. Brotobor, Nwadike, and Ochiaka (2021) asserted that socio-cultural beliefs, religious practices, and misconceptions about vaccines affect mothers' participation in immunization programs. Uwaibi (2020) stated that systemic factors such as inadequate healthcare personnel, vaccine stock-outs, and limited access to health facilities impede full immunization coverage in rural communities.
It is also affirmed that peer influence and community engagement play a vital role in shaping maternal attitudes toward immunization (Adedire et al., 2022). Mothers who receive guidance and support from community leaders and peers are more likely to adhere to vaccination schedules. Conversely, fear of side effects, myths, and misinformation contended that maternal hesitancy continues to be a challenge, particularly in rural areas with limited access to reliable health information (WHO, 2022). On the other hand, maternal education and exposure to health campaigns reported that they improve awareness, promote positive attitudes, and increase acceptance of immunization programs.
This study is set against the backdrop of these observations, aiming to investigate the awareness and acceptance of immunization programs among mothers of children aged 0 to 5 years in Okada Community, Ovia North East Local Government Area of Edo State.
1.3 Statement of Problems
Investigation revealed that the level of awareness and acceptance of immunization programs among mothers in many rural communities in Nigeria remains inconsistent. Studies reported that limited knowledge of vaccination schedules, inadequate understanding of vaccine-preventable diseases, and misconceptions about immunization outcomes influence maternal participation (Anyadi, Ude, & Chukwu, 2021).
Additionally, there are insufficient healthcare personnel, irregular vaccine supply, long distances to health facilities, and inadequate follow-up of defaulters reduce mothers' opportunities to fully participate in immunization programs (Uwaibi, 2020).
Furthermore, the interaction between maternal knowledge, socio-demographic factors, cultural beliefs, and health service delivery creates a complex environment that influences immunization uptake in rural communities. It is against this backdrop that this study seeks to examine the awareness and acceptance of immunization programs by mothers of children within the ages of 0 to 5 years in Okada Community, Ovia North East Local Government Area of Edo State.
1.4 Aim and Objectives of Study
The aim of this study is to examine the level of awareness and acceptance of immunization programs among mothers of children within the ages of 0 to 5 years in Okada Community, Edo State. The objectives of the study include:
- To assess the level of awareness of immunization programs among mothers in Okada Community.
- To determine the level of acceptance of immunization programs by mothers.
- To identify the factors influencing mothers' awareness and acceptance of immunization services.
- To examine the relationship between maternal socio-demographic characteristics and immunization uptake.
- To provide recommendations for improving immunization coverage and maternal engagement in child health programs.
1.5 Research Questions
Based on the stated objectives, this study seeks to answer the following research questions:
- What is the level of awareness of immunization programs among mothers in Okada Community?
- What is the level of acceptance of immunization programs among mothers?
- What factors influence mothers' awareness and acceptance of immunization services?
- How do socio-demographic characteristics of mothers relate to immunization uptake?
- What recommendations can improve immunization coverage and maternal participation in Okada Community?
1.6 Research Hypothesis
Based on the stated objectives, the research study formulates the following hypothesis:
Hypothesis One
- H0: There is no significant relationship between mothers' awareness and acceptance of immunization programs and the uptake of vaccines among children aged 0 to 5 years in Okada Community
- H1: There is a significant relationship between mothers' awareness and acceptance of immunization programs and the uptake of vaccines among children aged 0 to 5 years in Okada Community
1.7 Significance of Study
It is believed that at the completion of the study, the findings will inform public health practitioners and policymakers on effective strategies to enhance immunization uptake. Also, the research will empower mothers by increasing knowledge about vaccine schedules and benefits, thereby reducing vaccine-preventable illnesses among children.
Furthermore, healthcare providers will improve communication and maternal counseling during immunization sessions. In addition, mothers and caregivers will become more informed and confident in utilizing immunization services for their children.
Lastly, this study will contribute to the existing body of knowledge on maternal behavior, child health, and immunization programs in Nigeria. Researchers will be able to reference the findings to inform future studies in similar communities.
1.8 Scope of Study
The study is limited to mothers of children aged 0 to 5 years within Okada Community in Ovia North East Local Government Area of Edo State, Nigeria. The research focuses on awareness, acceptance, and uptake of routine childhood immunization programs available through primary health care centers in the community.
1.9 Limitations of the Study
A study of this nature is bound to experience certain problems as such the constraints imposed on the research include:
- Time Constraints: A study of this nature needs relatively long time during which information for accurate or at least near accurate inference could be drawn. The period of the study was short, time posed as constraints to the research.
- Financial Constraints: The research would have extended the survey to other area at the empirical level, but limitation as included cost of transportation to the source of material and the cost of time setting of the already completed work.
- Lack of Cooperation: Many of the respondents are usually aggressive on issue that border cooperation among the respondents border.
- Response Bias: The study will involve surveys and interviews with cooperative managers and members. Response bias may occur if respondents provide socially desirable answers or if there is reluctance to disclose negative financial information due to privacy concerns or fear of repercussions.
1.10 Definition of Terms
Awareness: The level of knowledge mothers have regarding immunization programs, including vaccine schedules, benefits, and potential side effects. According to Adedire et al., awareness is a key predictor of child immunization uptake.
Acceptance: The willingness of mothers to participate in immunization programs for their children, reflecting attitudes, perceptions, and compliance with vaccination schedules. Oladimeji asserted that acceptance is influenced by socio-cultural and systemic factors.
Immunization: The process by which children are made immune or resistant to vaccine-preventable diseases through vaccines. Plotkin stated that immunization is a cornerstone of public health interventions aimed at reducing child mortality.
Maternal Factors: Characteristics of mothers, such as educational level, age, occupation, parity, and knowledge, which affect decisions on child health interventions. Anyadi et al. reported that these factors significantly influence immunization uptake.
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