ASSESSMENT OF FACTORS INFLUENCING ROUTINE IMMUNIZATION IN AGEGE, LAGOS ISLAND AND ETI OSA LOCAL GOVERNMENT AREAS OF LAGOS STATE, NIGERIA.

Abstract

Routine immunization has been declining in Nigeria since early 1990s due to weak health systems, poor funding, lack of vaccines and parental involvement at community levels. Lagos state has been experiencing poor routine immunization coverage in the past few years. There is therefore the need for scientific determination of the factors which influence routine immunization services in Agege, and Lagos Island Local Government Areas (LGAs) representing the poorest performing LGAs and Eti Osa LGA which is a LGA with a high immunization coverage in Lagos state. The study was cross- sectional in design. Data were obtained using two sets of pre-tested semi-structured questionnaires (one for mothers and the other for health workers) and a Focus Group Discussion (FGD) guide. A total of 246 mothers were randomly' selected to participate in the survey while six focus group discussions were conducted with each group ranging from 6 -10 persons. Descriptive and inferential statistics were used to analyze the quantitative data. The FGDs were analyzed using thematic approach. The mean age of mothers was 29.0 ± 1.2 years. Ninety-five percent were aware of routine immunization, but 26.0% could not name any of the immunisable diseases. There was no relationship between mothers' age and knowledge of immunization. Young mothers below 24 years with knowledge were 34.0%. while older mothers above 35 years had correct knowledge of immunization. Income levels affected routine immunization with respondents on higher income level (41.0%) completing immunization schedules than their counterparts at lower income (59.0%). The list of reasons for failure to complete immunization included the perception that immunization is not the only preventive measure against childhood diseases (52.0%), long distances to health facilities (34.1%), inconvenient timing of period or immunization (35.4%) and the attitude that sick children should not be immunized (33.7%). The facilitating factors include a belief that immunization offers children protection against diseases (87.4%), that early childhood immunization ensured healthier growth (79.3%), and the motivation and health workers showed concern when vaccines are not available. The FGD results showed majority of the mothers were aware of immunization but cited far distances to the health facilities as a militating factor to completing the scheduled immunization. While the protection and health development of children as are offered by immunization facilitated routine immunization services, structural barriers related to time and distance constituted hindrances. There is need to use health education strategies such as counseling and awareness to bring about the desired change.