EFFECT OF HEALTH WORKERS TRAINING ON THE PROPORTIONS OF MISSED OPPORTUNITIES FOR CHILDHOOD IMMUNIZATION IN KHANA LOCAL GOVERNMENT AREA OF RIVER STATE

EFFECT OF HEALTH WORKERS TRAINING ON THE PROPORTIONS OF MISSED OPPORTUNITIES FOR CHILDHOOD IMMUNIZATION IN KHANA LOCAL GOVERNMENT AREA OF RIVER STATE

Abstract

Immunization of children against communicable diseases has been recognized as perhaps the most cost-effective public health intervention of all times. However, this veritable tool has remained tragically underutilized in many developing countries, resulting in high infant and child morbidity and mortality rates. Missed opportunities for childhood immunization have been implicated as contributing substantially to this dilemma. It is against this background that this study was conducted to evaluate the effectiveness of update training for health workers at reducing the proportions of missed opportunities for childhood immunization in Khana Local Government Area of Rivers State.
The study was a cross-sectional study with an intervention component. It was conducted in three phases: The first phase was a baseline assessment of
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immunization practices of health workers in the study and control groups using a semi-structured questionnaire, and the establishment of a baseline level of and reasons for missed immunization opportunities through exit interviews of mothers/caregivers. During this phase, a non-participatory “walk through survey” was also conducted in the health facilities to investigate availability of immunization resources and practices. The second phase was a training programme for health workers in the study group, while the third phase was the evaluation of the effect of the training programme conducted at three months post-training.
Sixteen variables on immunization practices and two variables each on knowledge of immunization, contraindications to immunization, and false contraindications to immunization were assessed. Results showed that the two groups (study and control) were similar at baseline. At pre-intervention stage, about one quarter of health workers in the study and control groups correctly identified that severe malnutrition was not a contraindication to immunization (22.7% and 26.7%) respectively. Similarly, only 35.7% of health workers in the study group and 42.7% of those in the control group immunized children with fever.
Evaluation at three months post intervention showed increases in the knowledge and practices of immunization among health workers in the study group and minimal differences in the control group. For the study group, the proportion with correct knowledge of NPI immunization schedule increased from 21.3% to 62.7% at three months (p<0.05). In the control group, the difference was between 24.0% and 26.3% at three months (p>0.05). Immunization of children who visited the facilities for other curative services increased from 46.7% at baseline to 70.7% at three months (p<0.05). Missed vaccine doses declined from 18.3% at baseline to 10.0% at three months evaluation in the study group (p< 0.05), but remained unchanged at 15.7% in the control group.
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The training programme thus led to significant improvement in the knowledge and practices of immunization by health workers in the study group when compared with the control group and contributed to a decline in the proportions of missed immunization opportunities for children in the study group as against the control group.
Periodic update training for health workers to eliminate misconceptions about immunization and for them to clearly understand the false contraindications and the few true contraindications to immunization is recommended.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

EFFECT OF HEALTH WORKERS TRAINING ON THE PROPORTIONS OF MISSED OPPORTUNITIES FOR CHILDHOOD IMMUNIZATION IN KHANA LOCAL GOVERNMENT AREA OF RIVER STATE

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