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ASSESSMENT OF IMPLEMENTATION OF CHILDHOOD ROUTINE IMMUNIZATION SERVICES IN PRIMARY HEALTH CARE CENTRES IN BENIN CITY, EDO STATE, NIGERIA
Abstract
Introduction: Childhood routine immunization (RI) is one of the most cost-effective interventions for reducing childhood morbidity and mortality due to VPDs. The ultimate goal of immunization programs is to reduce the incidence of vaccine preventable diseases (VPDs) by attaining high levels of routine immunization coverage with potent vaccines administered at the appropriate ages, and at the right intervals. In Nigeria routine immunization services are provided through the Primary Health Care system by the government to the populace. A gap exist in the immunization services offered by the PHCs regarding the knowledge and practice of routine immunization and the PHCs readiness in terms of infrastructure and equipment to render childhood routine immunization to the population of more than 150 million in Nigeria.
Aim and Objectives: The aim was to assess childhood routine immunization services in Benin City, Edo State, and the specific objectives were to ascertain the knowledgeand satisfaction regarding childhood routine immunization among mothers/caregivers attending primary health care centres, to ascertain immunization coverage and factors affecting childhood routine immunization coverage in primary health facilities, determine the level of missed opportunities in childhood routine immunization, assess the knowledge and practice of injection safety among healthcare providers in primary health care centres and ascertain the facility readiness for childhood routine immunization service delivery in the primary health care facilities in Benin City, Edo State.
Methods: This was a descriptive cross-sectional study that utilised (quantitative and qualitative methods of data collection)Mothers and caregivers were selected by systematic sampling technique while a total population of health workers involved in immunization were included in the study. Pretested-structured questionnaires were used to obtain information from mothers/caregivers and healthcare workers at the PHCs centres while key informant
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interview and focus group interview guides were used for qualitative data collection. Observational checklist was also used to assess facility readiness for immunization services. Data analysis was by IBM SPSS 20.0 and level of significance was set at p < 0.05.
Results: A total of 640 mothers/caregivers, 270 healthcare workers, 18 FGD participants and 7 key informants were interviewed for the purpose of the study. Almost half (48.8%) of the mothers/caregivers had good knowledge, 247 (38.6%) had poor knowledge while 81(12.6%) had fair knowledge of childhood routine immunization. About one-fifth (19.4%) of the caregivers were satisfied with the immunization services, 514 (80.3%) were indifferent while 2 (0.3%) were dissatisfied with the immunization services received.Most of the children (85.2%) were completely immunized for age while 14.8% were not completely immunized for age. The prevalence of missed opportunity for routine immunization was 16.1%. About 71.5% of the health workers had good knowledge, 27.0% had fair knowledge while 1.5% had poor knowledge of immunization.
None of the health facilities was fully ready for routine immunization services. The key informant interviewed agreed that training and re-training of health personnel was a major setback in routine immunization implementation and much needed to be done to improve the current situation.
Conclusion: The study showed that majority of the mother/caregivers had good knowledge of immunization with almost all the caregivers being undecided regarding satisfaction with routine immunization services. Majority of the children were completely immunized for age and prevalence of missed opportunities was high. Health workers’ knowledge and practice of injection safety in routine immunization was high while health facilities were partially ready to offer childhood routine immunization services.
Recommendations: The State Government should enhance provision of equipment to promote readiness for the delivery of routine immunization services in PHC centres.
