Nivel de escolaridad de las jefas de hogar

Routine immunization remoins on area of major concern 10 lhe Federal Government of Nigeria. With on established ,vord system encompassing nine thousand, five h ^un dred ond fifty-five (9,555) ,,'Ulds, Nigeria bas seven h ^un dred and seventy-four loco! government orens. Each ,vord h ^os both public and privotc health focili1ies thnl olTer rou1ine immunizo1ion servi ^ces . As a cost­

effective tool ogoinst lhc cl1ildhood diseases, rouline immunization hos been used by 1he Federal Government to 10,vcr the rotes of childhood morbidity ond mortnlily in Nigeria. The country's

16

UNIVERSITY OF IBADAN LIBRARY

AFRICAN DIGITAL HEALTH REPOSITORY PROJECT

infant mort.ollty rote is I 04 per I .000 live births, while under- 5 mort.olity rate still stood at 150 (World Dank Reports, 1993).

ROUTINE IMlvtUNIZATION SCHEDULE

Routine immunization is the immunization given to persons \Yho ^ore susceptible 10 ccrtnin discoscs ol 11 designotcd hcal1h ccn1rc. II is done routinely eilher on 11 ,veckJy, bi- ,..-cckJy or

monlhly bnsis to prevent them from contracting the disease. Four vaccines ore no,v being adminis1crcd to children lo prolcct them from the childhood killer diseases. These include live 11ttenu111cd measles voccine ogoinst measles infection, triple ontigcn ogoinst diphlhcri o. pertussis, ond letanus, orol polio vaccine agoinst poliomyelitis, nnd Bacillus Calmc11c - Guerin (DCG) ago.inst tuberculosis.

\Vomcn of child bearing nge ond pregnant ,,'Omen are administered ,vith tetnnus toxoid for protection ogninst tetanus. Mosl mothers ond cnrcgivcrs still find it difficuh to con1plete the immunizotion schedule for their children, ns evidenced by the high d _rop-o ut rotes experienced notion-\vide. The immunizotion schedule for children under one ycor of age provides for the follo,ving administration of vaccines: ot birth OCG, OPV O. HBV I ore given, ,vhile ot six ,,"eeks DPT I, OPV I, and HBV 2 cue odministcred. At ten ,veeks, the vaccines include DPT 2 and OPV 2, ,vhile at fourteen ,veeks DPT 3. OPV 3 and I IBV 3 ^ore administered. Fionlly at nine to eleven

months, Measles, Yello,v fe..-cr. nod Vitomin A capsules ore also administered.

It then folJo,vs thot o fully immunized child must hnvc received before the li ^rs t birth doy, four doses of OPV, three doses each of DPT and liDV and one dose of BCG, Mensles and Yellow fever.

In a short term evaluation of a rurol immunization programme in Nigeri ^o. Od ^US11D yo ct ol (2003) found out lluu only 43.0% of children 0-2 years old ,vcrc fully imrnuni ¹ .cd ,vhen the p ^ro gnunmc cornmcnccd in 1998. The baseline study gothcrcd information obout coverage figures ot commencement. using o sample of 229 children. Coverages ,verc DCG 75.1%, OPV O (not ovoileblc), OPV I 75.1 %, OPV 2 67.6 %, OPV 3 66.0%, DPT I 66.7 %, DPT 2 66.0 %, and DPT 3 66.0 %. Measles coverage ,vns 43.7 %, ,vhilc that for a fully immunized child ogoi ^ns t the sL�

diseases ,vos 43.2 %. DPT covcmge rates still remoincd ot 30 % for children ot 12 months of oge

·�

UNIVERSITY OF IBADAN LIBRARY

AFRICAN DIGITAL HEALTH REPOSITORY PROJECT

(Akanni, 2001). Although routine immunization ,vas re-launched in 1984 due to poor coverage it is provided through the public health systems ,vith significant vnrintions in some states and the Federal Capital Territory, FCT. The Nigeria Immunization coverage survey (NlCS) also found out that private and NGO providers account for about 2 ⁰ % of the routine immunization activities in

seven states including Anambm. Ebonyi, Enugu, Logos, Ogun, Edo and Benue.

Appendix 6 sho,vs the results obtained by the Notional lmmunimtion Coverage Survey conducted in 20 ⁰ 3.

\Vhcn mothers were asked ,vhy their children ,vere not fully immunized, the NlCS found out llu1t the most con1mon reasons out of a number of 24,11 ⁶ given ,\"ere vaccine not available (4, ³⁶⁰ ), place of immunimtion too fnr (2,919). una,vacc of the need, or una\\'lll'e of the need for 2 ^{nd ,} and 3 ⁿ¹ doses (1,858), fcnr of side reactions (1,383), n1other too busy (1,049), rumours (687),

place and / or time of immunization unkno,vn (862, and no faith in immuniwtion (704). The survey further found out that there ,vos a correlation bcl\\'een mother's educational level o.nd immunizorion of her child. \Vhercos notionally, 31.1 % of children of mothers ,villi second _ary education ,vcrc fully immunized, only 3.9% of children of motJ1ers ,vilh no education ,vere found to be fully immunized. Also, children in rural areas ,vere disadvantaged agninst other children in urban areas. Nationally, 7. ⁰ % of rural children o.nd 25. ⁰ % of urban children \\"ere found to ^be fully

immuniz.ed by the survey. Only 7 ⁰ .0% of the populace in 2001 hod access to health care of any type, ,vhcther public, private, traditional. prin1ary, second _ary . and teniary (United Nations

Development Programme, UNDP 2004).

Routine immunization coverage obtained for Lagos state for lhe vnrious routine o.ntigens in year 2002 and 200.3 respectively were as fotlo,vs: BCG 61.0 % and 48% , OPV 3 58.0 % and 43.0

%. DPT 3 56. ⁰ % nod 14.00/o, �teosles 48.0% nod 41. ⁰ %. and 1T (\Vomcn of child bearing age, WCBA) for 12 months 5.0 % and 4 .00/o (Lagos state monthly routine immuniwtion returns).

Ho,vever, the three Local Government areas in this study hod the follo,ving covemge data from 20 ⁰ 2 ¹⁰ 20 ⁰ 5 ns ore shown in Appendix 7.

18

UNIVERSITY OF IBADAN LIBRARY

AFRICAN DIGITAL HEALTH REPOSITORY PROJECT

FACTORS INFLUEi�CINC 11\li\lUNIZATION COVETU.CE

llenhh bchnviour has been identified ns nc1ions ,vhich are taken by n person ,vho belie, es he 1s healthy for the purpose of preventing disease or detecting disease in an :1S)mptoma1ic singe (Rosenstock. 1974). Routine immuniz.11ion hos been recognised as one of the most cost cITecti, c 111cosures aimed n1 reducing childhood diseases and conscqucntly reduction in infant and child 1nonoli1y l'l\lcs. In Nigeria, other vaccines such ns CSM, Ycllo\\' fever and l-lep:i1itis B ha,e been included especially in endemic o.rcas, ,vhile tctnnus toxoid injections ore given 10 prcgnnn1 ,,omen

,,

hich ser,c os pro1cc1ion for the unborn child. (Feilden Bauersby Annolysts, FBA 2005). Nigeria os 01 2005 recorded 13% ns her full imn1uniz.11ion coverage rote using DPT 3 as the 1ndc, of 1ncasun:1ncn1; ,vhereas other African countries such ns Democratic Republic of Congo (DRC), Chad and Niger had higher figures in con1porlson.

lntemntionol CO\ ^l cragc figures recorded by the \Vorld I lcnhh Organiz:ition throughout ¹ l!t regions in 1990 ,, ith respect 10 child imn1uni1..a1ion ,,ere as follo,,�:

\fricnn - BCG = 64.0%. DPT 3 - 49.0%, OPV 3 .. 49.0%,

An ¹ cricas - OCG = 85.0 %, DPT 3 = 81.0 %, OPV 3 = 85.0 °/4, Me:i.sles = 77.0%.

Eastern l\lcditcrrancnn - BCG = 82.0%, DPT 3= 74.0%, OPV 3= 79.0%, l\1cnslcs = 74.0%.

European - BCG • 82.0%, DPT 3 = 81.0%, OPV 3 = 82.0%, tvleasles = ^82.0%.

South East Asinn: OCG • 96.0%, DPT 3 = ^{89.0%, OPV 3} = 91.0%, fvlensles • 85.0� ^o .

\\lestcm Pacific· BCG = 85.0%. DPT 3 = ^92.00/4, OPV 3 "'92.0%, Measles 91.0%.

Global summary- BCG ""85.00/4, DPT 3- 79.0%, OPV 81.0%, fvlcaslcs - 78.0%.

From the above picture it appeared lhnt immuniz.ntion ,,·as in top pcrformnncc:, but )horlly nficr the period, there ,vos a sharp decline in routine lmmunizntion figures. f-or instance, In Ital), a stud) among pre-school and clen1cntnry school children in the I 990s sho\\cd that co, eragc for OPV 3 ,,as o,cr 98%. ,.,_hilc 1h01 of pcnu)�h vocc111c ranged fro ¹ n 12% in the south, to 15°-' ^o 1n the nor1h, and measles vaccine ranged from 6% 1n the south to 9':. in the north.

In Nigeria, it h.u been found 1h01 one child out of every five die before the fiflh b ¹ nhdn}.

represented by 872,000 de111hs in 2002 alone from vaccine prcvcntnblc disensc� (NICS, 2003, rDA 200S). A child born in N1gcrrn is 1hlny tlines more likcl) to die before ot1a1n ¹ ng age Ii, c �cnrs than one bon1 in un industrioli1,ed country. (NPC / UNICf-r, 200 I). Nigeria ronl..ed I 5 ^"' h ¹ ghc,1 ..1 1 11onf:

19

•