1.1 Introduction
One public health intervention that works to prevent sickness among pregnant women in society is Immunization. The most often utilized method of immunization is vaccination. It comprises injecting a vaccine into the body to boost defences against bacteria, viruses, parasites, and fungus. Biological preparations known as vaccines are designed to stimulate the creation of antibodies and so create immunity against a disease. Vaccines are safe and effective, however the immunization process itself and the subsequent vaccination may cause unpleasant responses.
This chapter will address the background information that motivated this study, the challenges that prompted it, its aim, and its objectives as a preface to subsequent sections of the study. Additional factors include the study's significance, scope, limitations, research questions and hypotheses, and the definition of technical terms.
1.2 Background of Study
In the past 50 years, vaccinations have saved the lives of more children than any other medical procedure. Vaccines are one of the easiest, safest, and most economical ways to save and enhance the lives of children everywhere. However, because they frequently reside in remote areas and are among the most marginalized members of their communities, a large number of youngsters in developing nations do not have access to vaccinations. All children, regardless of their circumstances, have an equal chance at a healthy life because to vaccinations. Measles is still the leading cause of death for children in East Africa, where vaccine-preventable illnesses like it continue to claim lives.
In developing countries in the twenty-first century, it not only prevents around three million child deaths every year, but if coverage increases, it may also save an additional two million fatalities. Despite the government's free vaccination programme, Nigeria's vaccination rate has remained low. According to Onuzulike (2008), vaccination is the intentional introduction of disease-carrying but non-infected organisms into the human body in order to trigger the production of anti-bodies and enable the body to defend against the actual disease.
According to the World Health Organisation (WHO), measles, hepatitis B, haemophilia influenza, whooping cough, tetanus, diphtheria, and polio cause a great deal of deaths among children worldwide, particularly in impoverished countries. Children's immune systems are still developing, hence their immunity is poor. Children are therefore more vulnerable to microbial infections. A particular age must be reached for vaccinations in order to guarantee that children have a strong defence against illness (Omer Qutaiba Bader Aldeen Allela, October, 2017).
It is evident that one of the most economical public health initiatives for lowering childhood morbidity, mortality, and lifetime disability worldwide is vaccination (Lee, 2003; Chen et al., 2004). Each year, vaccinations save the lives of about 2.5 million children worldwide (WHO/UNICEF and World Bank, 2009, WHO 2009). With millions of kids hospital admissions and deaths avoided year due to the widespread use of vaccinations, global public health has significantly improved, making immunization the most effective public health intervention (CDC, 2010 CDC 2009). Infectious illnesses such measles, diphtheria, smallpox, and pertussis were the main causes of child mortality prior to the introduction of immunization programmes (Stern et al., 2005). Tetanus toxoid vaccine is given to pregnant women to prevent against neonatal tetanus, which can be a major cause of infant deaths (KDHS 2014).
A notable progress has been made in the United States in the control of illnesses that may be prevented by vaccination, leading to a decrease in the morbidity and death rates associated with these diseases (CDC 2010). The total rate of immunisation coverage in Africa has significantly increased, albeit at a somewhat slower pace (WHO 2004, WHO 2014). However, according to Ghana News Agency (2012), WHO (2014), UNICEF (2014), and other sources, certain African nations including Ghana, Morocco, and the Gambia; have succeeded in achieving coverage of above 90%. Since the vaccination plan was implemented, the incidence of diseases that may be prevented by vaccination has steadily decreased.
The vaccination agenda is still far from complete, with 24 million children either unvaccinated or undervaccinated (WHO, UNICEF, & World Bank 2009), despite the tremendous advancements and improvements in immunisation programmes. About 22.4 million newborns worldwide, or one-fifth of all children, lack the VPD vaccine. Of them, 70% are from ten countries, Nigeria included (WHO/UNICEF 2014), (UNICEF/WHO 2011), and UNICEF Australia 2013.
Vaccine-preventable illnesses are one of the factors contributing to Nigeria's high death rates. Although the majority of these studies concentrated on the demand side aspects, earlier research has examined factors related to the implementation of paediatric immunization programmes. Demand-side factors that have been demonstrated to impact the effectiveness of immunization programmes include, but are not limited to, parity, household income, ethnicity, place of delivery, mother's educational attainment, proximity to a health facility, culture, religion, age, and guardian forgetfulness from being distracted by other activities (Abdulraheem et al 2011., Bbaale, 2013,Barman et al, 2009) (Bates, 1994) (Calhoun et al., 2014) (Kariuki, 2004) (Mutua et al., 2011, Maina et al,. 2013, Ndiritu et al. 2007, Njeru, 2011, Ophori et al, 2014, Odusanya, et al 2003). Studies assessing supply-side variables affecting children immunization programme implementation in Nigeria are very scarce, especially in the country's mostly rural areas. The county is a viable candidate for studying the factors impacting the implementation of immunization programmes in primary healthcare institutions in Nigeria because of its huge size and relatively low health indices.
Therefore, in Ovia North-East Local Government Area of Edo State where the research was carried out, the activities that was conducted is to know the Knowledge and attitude of pregnant women towards immunization during pregnancy.
1.3 Statement of Problems
Investigation revealed that immunization program is a key strategy for prevention of child and neonatal deaths and lifetime disabilities. Immunization prevents 2.5 million child deaths each year (WHO, 2009). Despite the global improvement in vaccine coverage that has seen 84% of children around the world receiving this life-saving intervention, 10 million children in low and middle level countries die before reaching age of five (Arevshatia et al, 2007) (WHO, 2014). Full immunization potential has not yet been realized in many countries where 22.4 million Children around the globe are not fully immunized. Majority of not fully immunized children 70% are from 10 countries, Nigeria being one of them (WHO/UNICEF 2014).
Low immunization coverage remains a challenge even in a committed country like Nigeria. This study sought to identify intervention targets for improving immunization coverage by investigating Knowledge and attitude of pregnant women towards immunization during pregnancy, Nigeria. The focus was to identify factors contributing to missed immunization and ways to reduce the number of missed opportunities for immunization at the health facilities. Much effort has been made to provide vaccines through the GAVI alliance, enabling states to acquire the recommended vaccines.
In Nigeria for instance, vaccines are made freely available to the public, yet over 20 percent of Nigerian children are not immunized each year. There is a need to identify strategies for improving implementation of vaccination programs in the country, particularly at primary health care level in predominantly rural areas and this study aimed to fill this gap.
1.4 Aim and Objectives of Study
The aim of the study is to examine the Knowledge and attitude of pregnant women towards immunization during pregnancy. In achieving this aim, the following specific objectives were laid out as follows:
- To find out the extent to which the pregnant women’s age influences the practice of immunization against childhood killer diseases;
- To examine the attitude of pregnant women towards immunization uptake against childhood killer diseases;
- To investigate the immunization practice among pregnant women against childhood killer diseases; and
- To determine whether the pregnant women educational level influences the practice of immunization against childhood killer diseases.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the extent to which the pregnant women’s age influences the practice of immunization against childhood killer diseases?
- What is the attitude of pregnant women towards immunization uptake against childhood killer diseases?
- What is the immunization practice among pregnant women against childhood killer diseases?
- To what extent does pregnant women educational level influence the practice of immunization against childhood killer diseases?
