IMPROVING THE UPTAKE OF TETANUS TOXOID BY PREGNANT WOMEN THROUGH THE TRAINING OF FAITH-BASED TRADITIONAL BIRTH ATTENDANTS

IMPROVING THE UPTAKE OF TETANUS TOXOID BY PREGNANT WOMEN THROUGH THE TRAINING OF FAITH-BASED TRADITIONAL BIRTH ATTENDANTS

Abstract

Background
Religious organizations set up delivery centers which are largely managed by traditional birth attendants (TBAs) particularly in the suburban and rural areas where women have reduced access to health facilities. These faith-based delivery centers usually organize prayer meetings for the pregnant women and often neglect important preventive health measures such as tetanus immunization. These ante-natal meetings however present a window of opportunity to provide the women with health education on important health issues. This study was designed to assess the effect of providing immunization education to TBA’s and their clients with the aim of improving subsequent immunization uptake in the study population.
Methodology
A quasi-experimental design was employed with a baseline cross-sectional assessment of the immunization status of the pregnant women and their knowledge on childhood and maternal tetanus immunizations. The immunization knowledge of TBAs was also assessed. Using simple random technique, two peri-urban Local Government Areas (LGAs) were selected from a list of eleven LGAs in Ibadan. An intervention group of TBAs had health education sessions about vaccines, vaccine-preventable diseases and infection control while the control group of TBA had health education on infection control only. A one-week and a twelve week post intervention evaluation of the knowledge about vaccination by TBAs and a 12-week evaluation of the changes in TT coverage as well as the knowledge of pregnant women about immunization were then obtained in both the intervention and control LGAs. There was also a qualitative
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component that involved two focus group discussion sessions which provided information on the TBAs views on immunization.
Results
A total of 325 pregnant women and 90 TBAs were surveyed in the intervention LGA while an equal number were surveyed in the control LGA. The mean age of pregnant women who participated in the baseline survey in the intervention group was 28.5 ± 5.3 years and 26.4 ± 4.3 years in the control group. Only 54 (16.6%) women in the intervention group had received at least 2 doses of TT or more by 36 weeks while 57 (17.5%) had received at least 2 doses of TT or more by 36 weeks in the control group. The difference observed in the TT status among the two groups was statistically significant (p< 0.001). Women in the age bracket 26-35 years had the highest coverage across the intervention and control groups.
The knowledge of pregnant women about Tetanus Toxoid and vaccine-preventable diseases was low across board. However, the knowledge of diseases such as poliomyelitis was high. Most of the respondents got the major source of information about vaccines from the electronic media (26% in intervention and 28% in control group) and social mobilization during NIDs (17% in intervention and 11% in control group). Married women, women holding a job that required some skill and those who had at least primary school education had higher coverage for TT in the national immunization regime. The overall attitude to vaccine-preventable diseases was good although the coverage for all antigens was low.
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Statistically significant differences were observed in the knowledge of TBAs in the one-week post-intervention period (p<0.001), as well as in the 12 week post-intervention period (p<0.001). The knowledge of pregnant women about TT and vaccine-preventable diseases increased from 7.8±2.4 at the one-week post-intervention survey to 20.6±3.7 at the 12-week post-intervention survey. The difference observed was statistically significant (p<0.001).
Conclusion
This study indicates that educational interventions targeted at TBAs do have an impact on their knowledge of and attitude to TT vaccination. It also shows that the knowledge and attitude of pregnant women who patronize TBAs can also be increased by immunization-education of TBAs. This mode of education should be further explored to ensure that the TBA’s promote this health preventive option so as to further optimize the health benefits of the pregnant women who patronize them.

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

IMPROVING THE UPTAKE OF TETANUS TOXOID BY PREGNANT WOMEN THROUGH THE TRAINING OF FAITH-BASED TRADITIONAL BIRTH ATTENDANTS

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