EFFECT OF TRAINING PRIMARY HEALTH CARE WORKERS ON THEIR KNOWLEDGE ATTITUDE AND PRACTICE IN THE PLANNING AND MANAGEMENT OF IMMUNIZATION SERVICES IN IKORODU LAGOS STATE

Abstract

Immunization is the most cost effective public health intervention. Nigeria attained the universal child immunization goal of 80% in 1990. This coverage was not sustained by 1996 the coverage had declined to 30% for DPT3 and 21% for three doses of oral polio vaccine. Recent surveys reveal low immunization coverage, with marked variations in the various states of the federation. Poor system performance and inadequate political will, poor planning and management was identified as being responsible for the non attainment of programme goals and objectives.
An interventional study was therefore done to assess the effect of training primary health care workers on their knowledge, attitude and practice in planning and management of immunization services in Ikorodu local government area (LGA) of Lagos State.
One hundred and thirteen primary health care workers in Ikorodu and Ajeromi LGAs were studied. The survey involved the use of a self administered questionnaire survey, an adapted checklist and training of the intervention group using the mid level management modules for planning and management of immunization. At follow up three months after intervention, questionnaire interviews and observation checklist survey was carried out. The data were analysed with EPI INFO 2007 3.1.5 software and the level of significance set at p ≤ 0.05.
The study revealed a low level of knowledge of planning and management issues in immunization at baseline both in the intervention and control groups. Pre intervention 6.3% of the respondents in the intervention group had good knowledge compared to 2.0% of the control. Overall mean knowledge score was 40.8±10.8 for the intervention group and 30.6±10.3 for the control group respectively. Age, marital status, years of qualification and length of work in PHC did not significantly influence the total knowledge scores in the
intervention group. In the control however years of qualification and technical qualification had a significant effect on the over all knowledge scores (p≤0.05).
The training significantly improved the overall knowledge scores in the intervention group relative to the control. Post intervention, 12.7% of the respondents in the intervention group had good knowledge compared to the 6.3% pre intervention, a percentage change of 6.4% .In the control on the other hand; none of the respondents at three months follow up had good knowledge. There was a negative change of 2.0%. The effect of the training on their attitude was not significant. Although there was positive change in the immunization safety practice of the intervention group, the training was not generally effective in improving their practice of data recording and vaccine utilization.
These findings support the need for pre service and in service training for primary health care workers in the public service. There is also a need for the Mid- level management training to be stepped down to state and local government levels. In addition, regular refresher trainings and supportive supervision which would improve health worker knowledge, attitude and practice should be made available.

EFFECT OF TRAINING PRIMARY HEALTH CARE WORKERS ON THEIR KNOWLEDGE ATTITUDE AND PRACTICE IN THE PLANNING AND MANAGEMENT OF IMMUNIZATION SERVICES IN IKORODU LAGOS STATE