A CRITICAL EXAMINATION OF THE IMMUNIZATION STATUS OF CHILDREN IN A RURAL SUBURB AREAS OF LAGOS STATE

CHAPTER ONE

INTRODUCTION

1.1 BACKGROUND OF THE STUDY

Vaccine-preventable diseases (VPDs) like measles, tetanus, tuberculosis, poliomyelitis, pertussis, diphtheria, yellow fever, and hepatitis B contribute significantly to morbidity and mortality in children under the age of five in developing nations (HRFN,2006). VPDs are expected to cause over 2 million deaths worldwide each year, with roughly 1.5 million happening in children under the age of five, accounting for 15% of all under-five mortality (UNICEF). They are responsible for 22% and 17% of under five mortality and morbidity in Nigeria, respectively (WHO, 1997). According to the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), and the National Program on Immunization (NPI), a child should receive four doses of Oral Polio Vaccine (OPV), three doses of Hepatitis B Vaccine, three doses of Diphtheria, Pertussis, and Tetanus (DPT) vaccine, and one dose of Bacille Calmette-Guerin In developing countries, routine immunization with these vaccines is a cost-effective way to reduce childhood morbidity and mortality. The prevention of these diseases in one child has a positive rippling effect on the rest of the population, since the immunized child will not pass the sickness on to another child (herd immunity). The World Health Organization estimated in 2008 that 1.5 million deaths among children under the age of five were caused by diseases that could have been prevented by routine vaccination, accounting for 17% of global total mortality in children under the age of five (WHO). Immunization has lowered the incidence of vaccine-preventable infections in children by 98–100% in the United States (CDC). The level of immunization coverage attained is required for efficient control of vaccine-preventable diseases. The coverage rate is used to estimate the success of routine immunization. In Nigeria, the findings of the National Demographic Health Survey in collaboration with UNICEF revealed a decline in immunization coverage from around 30% to 17% between 1990 and 1999, and a further gradual decline to 13% in 2003. (CDC and NPC). Poor coordination and planning, political instability, and the ongoing economic recession were cited as factors for this (Follen 2015). In the absence of effective monitoring and assessment of childhood immunization programs, vaccination rates may decline unobserved for some time before the increasing incidence of target diseases is noticed. Low under-five mortality rates are inversely related to immunization coverage rates in countries with low under-five mortality rates. With 98 percent vaccine coverage, Sweden has a 4/1000 under-five mortality rate, which is comparable to Japan, France, and the United States of America, all of which have immunization coverage rates of more than 90 percent (UNICEF). Nigeria, a developing country with a vaccination coverage rate of less than 80%, has an under five death rate of more than 100 per 1000 people (UNICEF). Although high under-five mortality rates are reasonable in war-torn nations such as Angola and Liberia, this is not the case in Nigeria, thus health-care providers must figure out why the country's vaccine coverage is so low. There is a scarcity of published statistics on immunization coverage in underdeveloped countries' populations (Tore,2008). Some reports on immunization coverage surveys contained data from both urban and rural areas, whereas others were conducted in rural areas. The requirement for exact and accurate documentation of immunization rates, as well as the likely causes of low coverage in specific regions, in order to enable well-directed (or targeted) treatments, should aid in the reduction of under-five mortality.

1.2 STATEMENT OF THE PROBLEM

Children in the suburbs of Nigeria continue to suffer from various health challenges. The visible, commonly seen diseases suffered by children and young adults range from polio, yellow fever, mother to child transmission of HIV/AIDS, malaria, and even tuberculosis. These diseases affect not only the psychological well being of the children, but, as Philips (2002) notes, the physical well being of the children is also heavily affected. Children's immunization has been identified by Wale (2009) to be effective in reducing the extent and severity of health challenges suffered by children. Olawale (2009) noted that the child mortality rate can be greatly reduced if children receive the right vaccines and are immunized timely. Children in rural areas suffer from health challenges mostly because their parents do not have quick access to health care services as there may not be good healthcare centres in these areas. Also, Tolu (1990) noted that the perception of parents also contributes to the health challenges of children, as parents prefer cultural methods of healthcare to modern methods. This situation is facilitated by the religious beliefs of some parents. Hence, the immunization of children in rural areas can be hampered and have no effect. This study was therefore undertaken to investigate the immunization status of children in the suburbs of Lagos state.

1.3 OBJECTIVE OF THE STUDY

The overall goal of the research is to critical examine the immunization status of children in a rural suburb areas of Lagos State. Specifically, the study is set to;

1.      To investigate the perception among parents in the suburbs of Lagos state about immunization.

2.      To determine if the children of the suburbs of Lagos have quick access to vaccines?

3.      To examine the challenges children suffer due to the unavailability of vaccines.

1.4 RESEARCH QUESTIONS

The following research questions guide the objective of the study:

1.      What is the perception among parents about immunization?

2.      Do the children have quick access to vaccines?

3.      What challenges do children suffer due to the unavailability of vaccines?

1.5 SIGNIFICANCE OF THE STUDY

The overall goal of this study is to Critically Examine the Immunization Status Of Children In The Rural Suburb Areas Of Lagos State. The purpose of the study is to determine the availability of vaccines and how quickly they are administered to children in the suburbs. And, this study will contribute to the current literature in this field and will also serve as a resource for academics, researchers, and students who may want to do future research on this or a comparable issue.

1.6 SCOPE OF THE STUDY

The research is limited to Amuwo Odofin of Lagos state and it examines the immunization status of children.

1.7 LIMITATION OF STUDY

The study was limited due to lack of study materials and also the budget and study duration were also constraints.

1.8 DEFINITION OF TERMS

IMMUNIZATION: the action of making a person or animal immune to infection, typically by inoculation.

RURAL SUBURB: The rural suburbs include municipalities (or urban units) that do not belong to the predominantly urban area and that have 40% or more of their employed residents working in the rest of the rural area's employment area.