A Seminar on Barriers to Adequate Implementation of Immunization
CHAPTER ONE
Objectives of the study
Generally, this seminar work is an attempt to study the barriers to adequate implementation of immunization. The specific objectives of this study are to:
- Knowledge of the benefits of immunization.
- Overview of immunization coverage status in Nigeria.
- Challenges of immunization coverage in Nigeria.
CHAPTER TWO
LITERATURE REVIEW
Conceptual Review
Concepts of Immunization, Knowledge, and Practice
The advent of immunization worldwide is a landmark toward the prevention of children against being infected with the six killer diseases vis-à-vis tuberculosis, polio, measles, diphtheria, pertussis (whooping cough), and hepatitis B. It is an age long practice that date several decades ago.
Goodman and Gutteridge (1979); Bland and Clement (1988) traced the theory of immunization-expanded programme on immunization (EPI) to Edward Jenna in England in 1796. According these authors, Jenna was familiar with the common belief held in the countryside that people who worked with cows were less likely to catch smallpox, because they have caught similar disease called cow pox from the animals. On this basis, he set to work out whether this belief was true. They further reported that Jenna kept records patiently and accurately for a long period. He was led to believe that cowpox did confer immunity for smallpox. He experimented this by making two small cuts on a boy’s arm, and rubbed into the cuts germ-carrying pus from the sores on a woman suffering from cowpox, the boy developed cowpox. Jenna then waited for two months and conducted second part of experiment. From a patient suffering from a serious smallpox, he again obtained pus which he rubbed in the cuts made on the boy’s skin, and argued that if his theory was right the boy would not fall ill with smallpox; if he was wrong the boy would catch the disease and might even die from it. But he was relieved to find out that the boy did not develop smallpox.
Based on Jenna’s discovery of vaccine, the expanded programme on immunization (EPI) was lunched by the WHO on October 26th, 1974 (Bland & Clement, 1998). The aim was to take vaccination against the six killer disease: – measles, diphtheria, tetanus, poliomyelitis, pertussis, tuberculosis to the women and children of the world. They referred to the word “Expanded” as denoting the addition of measles and poliomyelitis to the vaccines then being in use in immunization programme and that many developing countries did not include measles and polio vaccine in their routine immunization until 1985.
It is also against this background that the FMOH (2000) and Felden Battersby Analyst [FBA] (2005) reported that Nigeria’s Expanded Programme on Immunization (EPI) was initiated and lunched in Nigeria, in 1979 and was placed within the Department of Public Health and Communicable Disease Control within the FMOH. It was re-launched in 1984 due to poor coverage ranging from 9-29 per cent and consequently minimal impact on the target diseases. In order to extend EPI to the grassroots, the programme was transferred to the local Government Areas in the country in 1990. In 1996, it became the National Programme on Immunization (NPI) lunched by the then First Lady, Mrs. Maryam Abacha. Following a review of EPI, Decree 12 of 1997 created NPI as a parastatal.
The Federal Ministry of Health (FMOH) continues to place high priority on immunization. In 1999, a new drive to sustain ably re-vitalizes the immunization system commenced in synergy with the accelerated strategy on polio eradication. Consequently, the Federal Government established the NPI to demonstrate national consciousness and ownership for immunization charged with the mandate to effectively control vaccine preventable disease through immunization and the provision of vaccines. Key focus was to provide support to the implementation of state and LGA immunization programmes (WHO, 2010).
CHAPTER THREE
CONCLUSION AND RECOMMENDATION
Conclusion
The study was carried out on barriers to adequate implementation of immunization. The result of this study has clearly indicated that mothers in Nigeria have improved on taking their children for immunization. This suggests that immunization uptake in the Nigeria has improved compared to previous reports. The challenge however is that most Muslims women, women without education, women that are poor seem not to still take their children for immunization and this affects the percentage of children fully immunized in Nigeria. This is because the majority of people in Nigeria belong to these groups. Concerned authorities should ensure that parents especially Muslim, uneducated and poor parents immunize their children since low coverage will always draw back the efforts of fighting vaccine preventable diseases. This calls for intervention towards helping these categories of mothers in Nigeria to know the advantage of taking their children to clinics for immunization.
Implication to nursing
Vaccines are an important health discovery and have saved millions of lives. By protecting against disease, vaccines keep communities and children healthy. The world can be considered a smaller place than 20 years ago, as global travel is easier and more common than ever before. Vaccine-preventable diseases are more likely to affect a greater number of communities.
References
- Adedayo, D., Olanrewaju, O., Adeyinka, E., and Aimahku, C. (2009) Uptake of Childhood Immunization among Mothers of Under-Five in South Western Nigeria. The internet Journal of Epidemiology, 2009; 7(2):2.
- Antai, D. (2009). Inequitable childhood immunization uptake in Nigeria:A multilevel analysis of individual and contextual determinants. BMC Infectious Diseases 2009; 9:181.
- Babalola, S. Determinants of the Uptake of the Full Dose of Diptheria-Pertussis- Tetanus Vaccnes (DPT3) in Northern Ngeria: A Multilevel Analysis. Maternal Child Health Journal 2009; 13(4): 550-558.
- Balogun, M. R(2009). Sekoni, A. O., Okafor, I. P., Odukoya, O. O., Ezeiru, S. S., Ogunnowo, B. E., et al. Access to information technology and willingness to receive text message reminders for childhood immunisation among mothers attending a tertiary facility in Lagos, Nigeria. S Afr J CH 2012; 6 (3):76-80. DOI:10.7196/SAJCH.439.
- Big, M. (2016) Uptake, behavoural and attitudinal determinants of immunization of Hepatitis B among infants. Thailand: Ninth International Congress of Behavioral Medicine.
- Cassell J, Leach M, Fair head J., Small M, Mercier C (2006) The social shaping of childhood vaccination practice in rural and urban Gambia. Health Policy Plan 2006, 21: 373-391.
- Dugas M, Dube E, Kouyate B, Sanou A, Bibeau G (2015) Portrait of a length vaccination trajectory in Burkina Faso: from cultural acceptance of vaccines to actual immunization. BMC Int. Health Hum Rights, 2015, 14;9 Suppl 1:S9. doi: 10.1186/1472-698X-9-S1-S9.
- Fatunde OJ and Familusi JB (2011) Post-neonatal Tetanus in Nigeria. A need for booster doses of Tetanus toxiod, Nigerian Journal of Paediatrics 2011; 21(1):72-6.
