Factors contributing to delay in commencement of immunization in Nigerian infants

Abstract

Delay in receipt of immunisation may result in a child being susceptible to vaccine preventable diseases for prolonged periods. Identification of factors which contribute to delay in receipt of immunisation will help in developing targeted interventions. This study examined prospectively factors contributing to delay in the commencement of infant immunisation in Benin City, Nigeria. This was a cross-sectional descriptive study of 153 consecutive mothers of infants presenting for their first immunisation at the Institute of Child Health Child Welfare Clinic of the University of Benin, Benin City. Reasons for not presenting in the first 24 hours were ascertained and associations between various factors and delay in commencement of immunisation were examined. Of the 153 mothers only 2 (1.3%) brought their babies for immunisation within 24 hours of birth while 66 (43.1%) brought their babies in the first week of life. The most cited reason (30.3%) for not presenting within 24 hours of birth was that BCG, one of the immunisations that should be given at birth is given only on a specific day. Mothers who did not know that immunisation should commence at birth (P=0.0054), those from low socioeconomic class (P=0.0056) and those with less than 12 years of schooling (P=0.0001) were significantly less likely to bring their babies for immunisation in the first week of life. Delivery outside of health facilities was also associated with later presentation for immunisation (P=0.0069). In conclusion, there is significant delay in the receipt of birth doses of immunisation. Change in clinic practices to enable daily immunisation as well as education of health care personnel on the importance of timely commencement of immunisation will ensure timeliness of receipt of birth doses of vaccines. ____________________________________________________________________________________

Immunization, urbanization and slums – a systematic review of factors and interventions

“…Studies were conducted in populations in India ( n  = 23) [7, 9, 38–58], Pakistan ( n  = 3) [59–61], Iran ( n  = 1) [62], China ( n  = 1) [63], Kenya ( n  = 6) [10, 64–68], Nigeria ( n  = 4) [8, 69–71], Burkina Faso ( n  = 1) [10], Ethiopia ( n  = 1) [72], Democratic Republic of Congo (DRC)( n  = 1) [37], Central African Republic (CAR)( n  = 1) [73], Zambia ( n  = 1) [74], and Brazil ( n  = 2) [75, 76],…”

“…In two studies conducted in Pakistan, maternal knowledge of immunization was an important factor; [61] and the reasons for under-immunization given by mothers were to do with ‘carelessness’ or difficulty in accessing services [60]. In Ibadan, Nigeria, a study found fear of side-effects, maternal awareness, and parents being too busy to attend clinic to be significant; [8] in neonates in Benin City, Nigeria, a study found that SE and education status were associated with delayed immunization; [69] and the 3 main reasons for under-vaccination identified in a study from Bangui, Central African Republic, were the mother being too busy, negative attitude of health workers, and lack of access to information [73]. …”

“…A similar study in Lusaka, Zambia, showed that further distance from service points were associated with lower coverage [74]. Timing of services is also important, where offering services only on one particular day is associated with reduced coverage in neonates in Nigeria [69]. However, slum-dwelling populations may also be less likely to access health services due to fear of costs, risk of lost income, or lack of local knowledge [48].…”

Timeliness of Childhood Vaccine Uptake Among Children Attending Immunoprophylaxis Clinic in Central India

“…Similar findings were observed by Sadoh AE et al where on time vaccinations for class I, class II, class III and class IV were 75%, 52%, 50% and 25%, respectively and the difference was significant. (20) In this study, working mothers made more delayed vaccinations (67.6%) for their babies as compared to housemakers (60.5%). A study conducted by Rahji F R et al found that housewives got significantly less compliance in immunisation than working mothers.…”

“…Similar findings were observed by Sadoh AE et al conducted a study on Nigerian infants and Luman ET et al where education played one important role for timeliness of vaccination. (20), (9) Mothers with higher education group got more timely vaccination of babies as compared to lower education group.…”