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Introduction: immunization is one of the most effective interventions to prevent disease and early child death. A substantial number of children worldwide do not complete immunization schedules because neither health services nor conventional communication mechanisms regularly reach their communities. Knowledge and perception of mothers/caregivers regarding VPDs influence demand and utilization of immunization services. We examined the associations between knowledge, perception and information on routine immunization received by mothers/caregivers in Kaduna State. Methods: We enrolled 379 eligible caregivers in a community-based cross-sectional study. We sampled respondents using multistage sampling technique. We collected data on socio-demographic characteristics; knowledge and perception on routine immunization using semi-structured interviewer-administered questionnaire. We conducted bivariate analysis and logistic regression using Epi-InfoTM version 7 at 5% level of significance. Results: Mean age of respondents was 28.6 years (standard deviation=±6.6 years), 34% completed secondary school, 65% were unemployed, 49% lived in rural settlements. Among respondents’ children 53.3% were females and 62.8% fell within 2nd-5th birth order. Only 15.6% of these children were fully immunized. Seventy-five percent of respondent did not obtain information on routine immunization within 12 months prior to the study. About 64% had unsatisfactory knowledge while 55.4% exhibited poor perceptions regarding routine immunization. Commonest source of information was radio (61.61%). On logistic regression educated participants (Adjusted odds ratio (AOR)=1.9, 95% CI: 1.1-3.3), mothers’ perception (AOR=2.6, 95% CI: 1.5-4.5) and monogamous family setting (AOR=2.4, 95% CI: 0.2-0.6) were likely to have obtained information on routine immunization. Conclusion: There is low access to information, poor maternal knowledge on routine immunization with low vaccination coverage in this community. Efforts should be made by the Governments to scale up sensitization of mothers/caregivers to improve their knowledge on routine immunization through radio jingles.
Study area: Kaduna State, the third most populous state in Nigeria, is in the North West geographical zone and shares boundaries with Niger State to the West, Zamfara, Katsina and Kano States to the North, Bauchi and Plateau State to the East, and Federal Capital Territory (FCT) and Nasarawa State to South. The state is culturally diverse with a projected population of 7,589,699 people (projection from 2006 Census). The state is divided into three Senatorial zones and has 23 Local Government Areas (LGAs) with rural and semi-urban settlements in most of the LGAs. Kaduna State has five tertiary hospitals, 28 secondary hospitals, >1,000 primary health care facilities (PHCs) and an estimated 656 private facilities with under 5 year old population of about 1,536,988 [12]. The majority of the Government-owned facilities conduct facility based sessions on routine immunization and outreaches to the hard to reach areas. Study population, design, and sampling: The study population was mothers or caregivers whose children were within the age group 12-23 months in Kaduna State who consented. Mothers or caregivers that were too sick to participate or not available at the time of interview were excluded from the study. We conducted a cross-sectional study between April and June 2015 with minimum sample size required for the study calculated by using the formula for single proportions and based on an estimate of 34% which is the proportion of mothers with knowledge on immunization from a study conducted in Zamfara State, standard normal deviate set at 1.96 (for 95% confidence level), and precision of 0.05. The calculated minimum sample size was 345. Adjusting for non-response and missing data of 10% gave a minimum sample size of 379 respondents. We used a multi-stage sampling technique using the three senatorial zones in Kaduna State. Kaduna State was stratified into three (according to senatorial zones) and two LGAs (Rural and Semi-urban LGA) were selected from each stratum using simple random sampling. Two wards were selected from each of the six LGAs using simple random sampling. Two settlements were selected from each of the 12 wards using simple random sampling and finally we administered 16 questionnaires to contiguous households in each of the selected settlements after spinning a bottle to identify the first household. Data collection methods: We collected data using a pre-tested, interviewer-administered questionnaire, which had five sections: socio-demographic factors; sources of information on routine immunization; child’s immunization record, reasons for not immunizing children and knowledge and perception of mothers or caregivers on immunization. Having selected the study LGAs, the survey instrument was pre-tested in Zaria and questions found to be unclear or unnecessary were modified or deleted accordingly. Appropriate corrections were captured subsequently to establish validity and reliability. Twelve research assistants, two per LGA with minimum health qualification community health extension worker, were recruited and trained to standardize data collection procedures for the purpose of this study. Data management and analysis: We entered data, cleaned and analyzed using Epi InfoTM version 7 (US centers ford disease control and prevention). We performed descriptive statistics using absolute numbers for univariate for simple percentages, range, and measures of central tendency, bivariate analysis where the odds ratio and chi-square test were determined between variables and p≤0.05 was considered statistically significant and lastly multivariate analysis was conducted using logistic regression. Method of grading knowledge and perception of respondents: A total of seven variables were assessed for knowledge with a score range of 0-21. Respondents who scored 10-21 were classified to have satisfactory knowledge while those with scores of 0-9 had unsatisfactory knowledge. Similarly, 11 variables were assessed for practices with a score range of 0-33. Respondents with scores of 16-21 were classified to have perception while those with scores of 15 and less had poor perception [10]. Ethical considerations: We obtained ethical clearance from the Kaduna State Research Ethics Committee, Kaduna state Ministry of Health. A verbal and written consent was obtained from the respondents.
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