Community participation and childhood immunization coverage: A comparative study of rural and urban communities of Bayelsa State, south-south Nigeria

Abstract

Background:Immunization coverage rates in Nigeria have remained very poor, in spite of numerous programs and strategies, specifically designed to improve coverage. This study was to assess the possible effects of greater community participation on immunization coverage, by comparing the immunization coverage in a rural community with a functional community health committee, with an urban community, with no distinct community structure.Materials and Methods:The study was carried out in Ondewari, a rural, riverine community, in Bayelsa State; and Yenagoa, the capital of Bayelsa State, south-south Nigeria; using a cross-sectional, comparative study design. The data were collected using a structured interviewer-administered questionnaire, administered on female head of households in both communities, with under-five children; and used to collect information on the socio-demographic characteristics of the respondents, the immunization status of children in the household below the age of 2 years, and reasons for none and incomplete immunization.Results:A total of 288 respondents were studied in the rural community, while 270 respondents were studied in the urban center. The respondents in the urban center were significantly younger (P<0.01), better educated (P<0.001), and had fewer number of children (P<0.01). The immunization status of children in the rural community was significantly better than those in the urban community (P<0.000). Only 11.46% of the children in the rural community were not immunized, compared to 47.04% in the urban community. However, the dropout rate in the rural community was much higher; with a DPT dropout rate of 77.34%, compared to 12.39% in the urban community. Most of the reasons given in the urban community for the incomplete immunization were linked lack of motivation, and include relocation (11.34%) and the adverse rumor about childhood immunization (17.23%), while the reasons in the rural community were mostly health facility related, and included the absence of the vaccinator (20.46%) and nonavailability of vaccines (26.64%).Conclusion:The immunization coverage in the rural community was surprisingly better than that of the urban community, which can be attributed to better mobilization and participation in the delivery of immunization services.

A Systematic Review on Factors Affecting Community Participation towards Polio Immunization in Nigeria

“…Three of the studies (Antai D, 2010;Baba and Ayivor, 2012;Antai D, 2012) are retrospectives with secondary data (readymade), in which the first assessed the effect of individual and community level participation, the second evaluate the good, the bad and the ugly aspects of polio in Nigeria, and assessed the association between multiple dimensions of gender inequalities and full childhood immunization. The remaining fifteen articles (Alfred and Alfred, 2012;Nnenna et al, 2013;Iliayasu Z, et al, 2014;Itimi et al, 2012;Ogwumike et al, 2012;Ekure et al, 2013;Tagbo B N, et al, 2012;Oyefara J L, 2014;Awodele O. et al, 2010;Oladejo O P et al, 2013;Abdulraheemetet al, 2011;Singh et al, 2013;Rahji and Ndikom, 2013;Ita et al, 2012;Olawepo and Fashagba, 2014) were purely cross sectional descriptive studies. Two (Iliayasu Z, et al, 2010;Oladejo O P et al, 2013)of the studies were conducted to assess the serological response of OPV to trivalent formulation in order to observe the seroconversion rate among the OPV recipients and the other was a seroprevalence survey of neonates and infants children.…”

“…(Nnenna et al, 2013;Ekure et al, 2013;Tagbo B N et al 2012;Oyefara J L, 2014;Awodele O, et al, 2010;Singh et al, 2013;Rahji and Ndikom, 2013)have discussed about the knowledge, attitude, perception and practice of mothers towards polio immunization. Two papers (Iliayasu Z et al, 2014;Oladejo O P et al, 2013) discussed the seroprevalence and neutralization of antibodies, children with paralytic poliomyelitis (Ogwumike et al, 2012), gender inequalities (Antai D, 2012), reasons for incomplete vaccination (Abdulraheem I S et al, 2011), immunization coverage (Ita et al, 2012), polio vaccination in Nigeria the good, the bad, and the ugly (Baba and Ayivor, 20212), and community participation in childhood immunization in Nigeria (Itimi et al, 2012).…”

“…Another study found that 65.2% of the children were fully immunized (Ita et al, 2012), also positive findings have shown that 52.5% of the children were immunized irrespective of gender (Oladejo et al, 2013). In contrast, some studies indicated low participation towards polio immunization as the DPT dropout rate was 77.34% (Itimi et al, 2012) and 27% (Olawepo and Fashagba, 2014), of the total respondents were partially immunized and did not complete their immunization package. There is also a likelyhood of not receiving full participation in immunization from the children of women lacking decision making autonomy, odd ratio 0.74 (Antai, 2012).…”

“…Only one article was written by a professor in geography. Five surveys from pharmacists, pediatricians and doctors were conducted at practice settings which included teaching hospitals, general hospitals and laboratories (Nnenna et al, 2013;Iliayasu Z et al, 2014;Ogwumike et al, 2012;Tagbo B N et al, 2012;Awodele O et al, 2010), while thirteen conducted the research within the community settings (Antai D, 2010;Alfred and Alfred, 2012;Baba and Ayivor, 2012;Itimi et al 2012;Ekure et al, 2013;Oyefara J L, 2014;Oladejo O P, 2013;Antai D, 2012;Abdulraheem et al,2011Singh et al, 2013Rahji and Ndikom, 2013;Ita et al, 2012;Olawepo and Fashagba,2014). Two of the articles focused on rural households' perception and rural women childhood immunization (Alfred and Alfred, 2012;Olawepo Fashagba, 2014).…”

“…A study reported that out of 84 polio cases obtained so far 42%were from high risk LGAs in northern Nigeria (Baba and Ayivor, 2012), 65.2% immunization coverage double the estimate of the zonal coverage (Ita et al, 2012), as more 50% (Itimi et al, 2012) of the respondents in the urban community than in the rural community. The opposite result was found in a study by epidemiologists that 77.7% (Antai, 2010) of the rural non-migrant children received Oral Polio Vaccine (OPV)1, but most of the rural-urban had not been fully immunized as 8.5% only received OPV1.…”