CHARACTERISTICS OF NON-COMPLIANT HOUSE-HOLDS DURING NATIONAL IMMUNIZATION PLUS DAYS IN SOKOTO STATE, NIGERIA
CHARACTERISTICS OF NON-COMPLIANT HOUSE-HOLDS DURING NATIONAL IMMUNIZATION PLUS DAYS IN SOKOTO STATE, NIGERIA
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Date
2012-09
Authors
ABDULAZIZ, MOHAMMED
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Abstract
In1989, World Health Assembly (WHA) resolved to eradicate poliomyelitis from the world by
year 2000. By 2008 only 4 countries were still endemic for Wild Polio Virus (WPV) namely
Nigeria, India, Pakistan and Afghanistan. Nigeria the only African country still endemic for polio
exported WPV to neighboring countries previously declared polio free. To break WPV
transmission, Nigeria adopted Immunization Plus Days (IPD) a strategy used to deliver OPV
(Oral Polio Virus) together with other vaccines as well as other child survival health
interventions. Refusal of vaccination by parents or guardian of children eligible for polio
vaccination (Non compliance) threatened to undermine polio eradication drive. This study was
constructed to determine the socio-demographic correlates of non-compliant households during
IPD as compared with controls in Sokoto north and Sokoto south of Sokoto state and to compare
the knowledge, attitude and practice on IPD of heads of non-compliant house-holds and that of
their controls. Finally an assessment for other risk factors associated with non-compliance in
Sokoto north and south LGA was done
The study was case-control with 124 study participants (62 cases and 62 controls). Cases were
defined as “House-hold refusing OPV vaccination in last three rounds of IPD in Sokoto north
and south local governments”, while controls were “House-holds to the right of the cases
allowing OPV vaccination”. Study participants were interviewed with a pre-designed
questionnaire with sections on socio-demographics, media habits, knowledge of IPD, and
reasons for refusal
A total of 130 interviews were conducted out of which 9 were disqualified. The mean age of cases
(47.7years) and controls (44.3 years) were similar (χ2 = 1.81, p=0.179, df = 1). Cases were more
likely to lack tertiary education OR=3.74 (1.55-9.15), but religion, age and type of marriage was
not statistically significantly different among the cases and control. A total of 45 cases and 14
controls lack knowledge of the benefit of immunization which was shown to be a statistically
significant difference OR=35.32 (9.75-141.18). Cases were also more likely to lack knowledge of
Global nature of polio eradication OR= 18.98 (6.91-54.09) and knowledge of other childhood
survival strategies attached to Immunization Plus Days (IPD). Cases were more likely to have a
negative attitude towards OPV OR=22.4 (7.11-75.56) and believe that government promote IPD
for selfish interest OR=4.36 (1.81-10.67). Cases were significantly more likely to lack access to
functional television and radio and source there information from town criers
It was concluded that lacking tertiary education was a risk factor for non compliance and that non
compliant house hold heads had unsatisfactory knowledge and negative attitude towards IPD.
There was a general lack of knowledge among them about the global nature of polio eradication
initiative and they also have insufficient knowledge about other IPD initiatives for child survival.
Sourcing information about IPD from town crier and lacking access to functional radio and
television were other risk factors associated with non compliance. Majority of the controls who
were previously not vaccinating their children were convinced to start accepting polio vaccines by
the persuasiveness of their traditional rulers. I recommended that community dialogue targeted at
identified high risk group precede every round of IPD. Involvement of traditional rulers and
religious leaders should be scaled. Communication message of the town criers should be
standardized and the town criers trained in communication skills
Description
A DISSERTATION SUBMITTED TO THE POSTGRADUATE SCHOOL
AHMADU BELLO UNIVERSITY, ZARIA, NIGERIA
IN PARTIAL FULFILMENT FOR THE AWARD OF
MASTER OF PUBLIC HEALTH (FIELD EPIDEMIOLOGY)
DEPARTMENT OF COMMUNITY MEDICINE
AHMADU BELLO UNIVERSITY, ZARIA, NIGERIA
SEPTEMBER, 2012
Keywords
CHARACTERISTICS,, NON,, COMPLIANT,, HOUSE,, HOLDS,, DURING,, NATIONAL,, IMMUNIZATION,, PLUS,, DAYS,, SOKOTO,, STATE,, NIGERIA