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A Research Study Presented to The Faculty of the College of Nursing
Arellano St., Dagupan City
In Partial Fulfillment of the Requirements for the Degree Bachelors of Science in Nursing
CHAPTER 1 INTRODUCTION
Background of the Study In 2005, the World Health Assembly approved, and the United Nations Children’s Fund (UNICEF) Executive Board endorsed, the Global Immunization Vision and Strategy (GIVS).The primary objective of GIVS is to reduce vaccine-preventable disease mortality and morbidity by two-thirds by 2015 compared to 2000, a contribution towards achieving the Millennium Development Goals, especially Goal 4, which calls for a twothirds reduction of under-5 mortality by 2015.GIVS identifies four strategic areas: immunizing more people against more diseases; introducing newly available vaccines and technologies; linking immunization to other critical health interventions; and managing vaccination programmed and activities within the context of global interdependence. GIVS articulates more than 25 new ideas and innovative approaches, and it is anticipated that countries will adopt the strategies most suited to their needs.GIVS was developed in the context of increasing resources for immunization; in 1999 a public–private partnership, The Global Alliance for Vaccines and Immunization (GAVI Alliance) was initiated to provide financial support for immunization in the world’s poorest countries. By the end of 2005, government and private sources had pledged a total of US$ 3.3 billion to the GAVI Alliance, enabling it to provide support to 73 of 75 eligible countries. Between 2000 and 2005, total GAVI Alliance disbursements were US$ 760.5 million.GAVI Alliance’s resource outlook over the next decade has
Immunization helps to minimize the spread of contagious agents that may be detrimental to health. Childhood immunization is not only important in protecting the young ones from disease. and measles can easily spread from one child to the others. rubella. cholera. mumps. It has prevented the small pox infection worldwide and made common infection such as measles and tetanus rarely occur (Scheider. pertussis.2008) In the Philippines most of the parent concern is all about health. Sicknesses like diphtheria. polio. and disability but also serve to protect the entire community as a whole (Samson.which could provide up to US$ 4 billion over the next 10 years. Death in childhood from infectious disease has been vastly reduced because of widespread immunization program. tetanus. The immunization of children against a number of in infectious disease has become the most important health intervention over the years. 2011). and the Pneumo Advance Market Commitment (AMC).improved with the launch of two innovative funding mechanisms: the International Finance Facility for Immunization (IFFIm).which will provide US$ 1.5 billion to support low-income countries for the purchase of new vaccines against Streptococcus pneumoniae. and hepatitis B before they 3 . 2007) Most childhood ailments are highly infectious. measles. death. particularly for those who cannot afford medical care and who often live in the communities that lack of even most basic of community health services. Virtually all children are vaccinated against diphtheria. a leading cause of childhood meningitis and pneumonia mortality (Lara J Wolfson et al.
However. Public health workers. In the face of all the obstacles and constraints affecting the health care system and the delivery Of equitable. and pertussis disease of the past.enter school. Vaccines are now available to protect children and adults against 15 life-threatening or debilitating diseases. notably the community health nurse. The mere mention of the names of certain infectious disease struck fear into the hearts of our ancestors. Immunization is one of the great public health success stories of the 20th century. Today. have made once common disease such as diphtheria. it seems that the wellness approach emphasizing a healthful lifestyle is the only viable strategy for individual who want to reach their own health goal and expectation. should give priority to and spend more time in activities that promote health and prevent disease. as well as for the community or country who wants to raise and maintain the wellbeing of its population. many preschool children are at risk because they do not receive immunization at the recommended ages. adequate. appropriate. effective and efficient health services to the majority of the population. rather than staying mainly in the clinic consulting with and treating the sick (Reyes-Bailon.2006). mumps. 4 . measles. And for able them to know the factors have affected the decrease in number of immunized children under 1 year old in Municipality of San Jacinto. because the researchers want do determine the immunization status of children under 1 year old in San Jacinto. The Researchers conducting this research. because most of these immunizations are required by law.
5 . measles and tetanus. November 2011). By 2010. And then we just want to give some advices to the mother of a child that who is not fully immunized and explain about the important of the said vaccines. less than five percent of the world's children were immunized during their first year of life against six killer diseases — polio. 996 as amended (Official Gazette of the Republic of the Philippines. 10152. an act providing for mandatory basic immunization service for infants and children. repealing for the purpose of Presidential Decree No.Conceptual Framework The basis of the study is the Republic Act No. ensure routine immunization of children under one year of age reaches 90 per cent nationally and at least 80 per cent coverage in every district or equivalent administrative unit (UNICEF/WHO. June 2011). Because vaccine is very important for the child to protect them against in many diseases. Expanded Program on Immunization (EPI) was launched in 1974. diphtheria. We are conducting this research because we just want to know about the immunization status among children in San Jacinto. tuberculosis. pertussis (whooping cough).
BASIS INPUT PROCESS What is the OUTPUT immunization What is the demographic status of the children under 1 year old in the Municipality of San Jacinto status (percentage immunized children) of the children under 1 year old in the Municipality of of Republic Act.No.10152 Is there a relationship between the immunization status of the population against the demographic data of the subjects? San Jacinto per barangay? Figure 1: Research Paradigm 6 .
such factors can be identified and learn how to avoid or resolve them in order to have a better health. What is the immunization status (percentage of immunized children) of the children under 1 year old in the Municipality of San Jacinto per barangay? 3. Nursing Education. Socioeconomic status (of parents) d. Nursing practitioners can have a source of information regarding the possible factors that may cause in obtaining the unimmunized children. Gender c. Age (in months) b. What is the demographic status of the children under 1 year old in the Municipality of San Jacinto in terms of: a. Highest Educational Attainment (of parents) 2. The results of this study will contribute to educators and lead them to have knowledge in experiencing level of unimmunized children that may 7 . 1. This study will provide wider understanding to the Immunization Status of children under 1 year old in the Municipality of San Jacinto.Statement of the Problem This study aims to determine the Immunization Status of children under 1 year old in the Municipality of San Jacinto. Is there a relationship between the immunization status of the population against the demographic data of the subjects? Significance of the Study The results of this study are believed to be significant to the following aspects: Nursing Practice.
Immunization. The process of inducing immunity artificially by either vaccination or administration of antibody. Sta. Capaoay. San Vicente. San Roque. Pag-asa. Bolo. Further studies can be conducted to gain more knowledge and safety measures for the subject. Magsaysay. The researches would be able to make recommendations for those who are unaware of immunization. Expanded Program on Immunization. Definition of Terms The researches defined the following terms for the purpose of clarity and better understanding of readers: EPI. Sta. Labney. The result of this study would be another significant finding that may be used in other nursing researches concerning Immunization Status of children under 1 year old in the Municipality of San Jacinto. Macayug. Tomas with 15 respondents each barangay with mothers with children under 1 year old. San Juan. Guibel. This result may at least help the nursing educators to know of what is the best approach or teaching strategy to encourage the mother in recognizing the difficult possible cause of being not immunized. Cruz.cause certain factors.It involved all barangay namely: Awai. Nursing Research. San Guillermo. Scope and Limitations This study focused on the Immunization Status of children under 1 year old in the Municipality of San Jacinto. Labong. San Jose. Casibong. Maria and Sto. Imelda. 8 . a program conceptualized by the Department of Health in which initiative was the early introduction of first line defense for such diseases.
Immunizations Status. or by live-attenuated agents or vectors. A preparations of proteins. Vaccine. polysaccharides or nucleic acids of pathogens that are delivered to the immune system as single entities. 9 . to induce specific response that inactivate. as part of complex particles. destroy. Rural Health Unit. or suppress the pathogen. The primary government health-care facility at the municipal level wherein health services are delivered. A relative positions or standing of immunization in a society RHU.
The four major strategies include: sustaining high route Full Immunized Child (FID) coverage of atleast 90% in all provinces and cities. The standard routine immunization schedule for infants in the Philippines is adopted to provide maximum immunity against the seven vaccines preventable disease in the country before the child’s first birthday. sustaining the polio-free country for global certification. DPT 3. OPV 3. OPV 2. DPT 2. 996 as amended (Official Gazette of the Republic of the Philippines. HB 1. an act providing for mandatory basic immunization service for infants and children. HB 2. 10152. DPT 1. Diphtheria- 10 . The Expanded Program on Immunization (EPI) in the Philippines began in July 1979 and in 1986 made a response to the Universal Child Immunization goal. repealing for the purpose of Presidential Decree No. The fully immunized child must have completed BCG 1. Here are those vaccines that they were being given during immunization at minimum age at 1st Dose. June 2011). 2009). HB 3 and measles vaccines before the child is 12 months of age (DOH.CHAPTER 2 REVIEW OF LITERATURE Local Expanded Program on Immunization (EPI) in the Philippines The basis of the study is the Republic Act No. Bacillus Calmette-Guerin this vaccine given at earliest possible age protects the possibility of TB meningitis and other TB Infection in which infants are prone and this vaccine given to children at birth or anytime after birth. eliminating measles by 2008 and eliminating neonatal tetanus by 2008. OPV 1.
Oral Polio Vaccine the reason of this vaccine is to extent of protection against polio is increased the earlier the OPV is given and it is given within 6 weeks. The EPI target diseases among infants and newborns (0-12 months) include tuberculosis. diphtheria. According to Cuevas (2007). the standard routine immunization schedule for infants is every Wednesday and this immunization day is adopted in all parts of the country to provide maximum immunity against the seven vaccine preventable diseases before a child’s first birthday. Cuevas defined immunization as the process by which vaccines are introduced into the body before infection sets in. Vaccinations promote health and protect children from diseasecausing agents. poliomyelitis. A child is said to be ―Fully Immunized‖ when a child 11 .Pertussis-Tetanus Vaccine the reason of this vaccine is to reduce the chance of severe pertussis and it is given within 6 weeks. Prevent a liver cirrhosis and liver cancer which are more likely to develop if infected with Hepatitis B early in life and this will be given at birth. pertussis. Cuevas (2007) traced how Expanded Program on Immunization (EPI) started in the Philippines from its conceptualization until to its introduction in the country in early 1990 that contributed to the declined of numerous cases of immunizable diseases. measles and hepatitis B. Infants and newborn need to be vaccinated at an early age since they belong to the vulnerable age group. Hepatitis B Vaccine the reason of this vaccine is when an early start of Hepatitis B vaccine reduced the chance of being infected and becoming a carrier. Measles Vaccine the reason of this vaccine is to prevent the measles at least 85%. neonatal tetanus.
National Wagman (2006) defined tuberculosis. 3 doses of Hepatitis B and 1 dose of Measles vaccine. It is initially characterized by symptoms during catarrhal and paroxysmal stages. night sweats. pertussis or whooping cough is a highly contagious disease caused by bacterium Bordetella pertussis. 3 doses of DPT. and weight loss. fever. low fever and a pseudo membrane on the tonsils. administration and procedures in giving the vaccine as well as the role of a nurse in improving the delivery of immunization service in the community are cited. measles or rubeola is an infection of the respiratory system caused by paramyxovirus of the genus Morbillivirus. 12 . Tetanus toxoid vaccination for mother is also important to prevent neonatal tetanus. According to Porth (2002). Tuberculosis is a common and often deadly infectious disease caused by Mycobacterium tuberculosis. 3 doses of OPV. The disease is characterized by sore throat. poliomyelitis or infantile paralysis or Heine-Medin disease is an acute viral infectious disease. Affected individuals can exhibit a range of symptoms if the virus enters the stream. pharynx and nasal cavity.receives 1 dose of BCG. An observation of Koplik’s spots is also diagnosis of measles. diphtheria and pertussis. Furthermore. Lastly. is an upper respiratory tract illness caused by Corynebacterium diphtheria. The virus infects and destroys motor neurons leading to muscle weakness and flaccid paralysis. Clinical diagnosis of measles requires a history of fever of at least three days together with at least one of the three C’s (cough. Its classic symptoms are chronic cough with blood-tinged sputum. On the other hand. Diphtheria. on the other hand. coryza and conjunctivitis).
which produces spontaneous mutations in the viral genome. hepatitis B vaccine is a vaccine developed for the prevention of hepatitis B virus infection. 13 . This vaccine is a shot given spontaneously. The vaccine contains one of the viral envelope proteins and hepatitis B surface antigen. Oral Polio vaccine. and causes an inflammation called hepatitis.Porth (2002) also defined hepatitis B as an infectious illness caused by hepatitis B virus which infects the liver of humans. Behrman (2004) characterized DPT or Diphtheria-Pertussis-Tetanus vaccine as turbid. is a live attenuated vaccine usually clear and red or pink produced by the passage of the virus through non-human cells at a sub-physiological temperature. explained BCG or Bacillus Calmette-Guérin as a vaccine against tuberculosis that is prepared for a strain of the attenuated live Mycobacterium bovis that has lost its virulence in humans by being specially cultured in an artificial medium for years. Another condition is neonatal tetanus or lockjaw. whitish suspension that may have a faint odor. Hockenberry (2005). on the other hand. measles vaccine is a live attenuated strain of the measles virus grown in chick embryo tissue culture. Lastly. a medical condition characterized by a prolonged contraction of skeletal muscle fibers. According to Hatfield (2003).
3 doses of OPV. 3 doses of Hepatitis B and 1 dose of Measles vaccine. 2007). some resort to their local manghihilot or untrained midwives. this exposes them to health risks. immunization as the process by which vaccines are introduced into the body before infection sets in. because it’s the most convenient and inexpensive method of giving birth. 14 . 3 doses of DPT. Infants and newborn need to be vaccinated at an early age since they belong to the vulnerable age group. Tetanus toxoid vaccination for mother is also important to prevent neonatal tetanus.Factors Affecting Immunization Status Local Another crucial factor in eliminating Maternal and neonatal tetanus (MNT) is the distance of health facilities from the homes of mothers in these high-risk areas. such as the use of unsterile equipment and unhygienic child-delivery environments. (Borromeo/Garcia. As such. In this study. administration and procedures in giving the vaccine as well as the role of a nurse in improving the delivery of immunization service in the community are cited. Local health workers therefore play a big role in educating and encouraging possible and expectant mothers in high-risk areas to go through tetanus immunization and to know how far they have to travel to reach a health facility. Furthermore. Vaccinations promote health and protect children from disease-causing agents. However. So that a child is said to be ―Fully Immunized‖ when a child receives 1 dose of BCG.
In Mozambique. However. the quality of the cold chain. thus. inadequate levels of immunization against childhood diseases remain a significant public health problem in resource-poor areas of the globe. to health services or to communities. the liaison of communities with health services. (Jani. The effectiveness of immunization programs in resource-poor settings can be influenced by factors such as the coverage of the health network. The Expanded Program on Immunization (EPI) aims at delivering the primary immunization series to at least 90% of infants. the reasons for incomplete vaccination and non-uptake of immunization services are poorly understood. poliomyelitis. The relative effect of each one of the above factors may significantly vary according to geographical areas. pertussis. the existence of population movements. it has also been shown that immunization coverage in not uniform throughout the country. the understanding of local hurdles for effective immunization programs is crucial to develop and implement appropriate solutions. contributing to the circulation of wild-type measles. namely tuberculosis. the existence and quality of outreach service. The reported coverage of the basic EPI vaccines in Mozambique is 80%–95%. with rural areas presenting significantly lower coverage's and.National The prevention of child mortality through immunization is one of the most costeffective public interventions in use in resource-poor settings. and several other factors that are related to the vaccines in use. Nonetheless. tetanus. 2008) 15 . diphtheria. but these figures include incomplete and incorrect vaccinations. hepatitis B and measles. et. This may be one of the reasons why measles epidemics continue to occur in Mozambique despite of the reported 80% measles vaccination coverage. the EPI targets seven diseases. Additionally. In this context.al.
Nonetheless. Because vaccine is very important for the child to protect them against in many diseases. the reasons for incomplete vaccination and non-uptake of immunization services are poorly understood. And then we just want to give some advices to the mother of a child that who is not fully immunized and explain about the important of the said vaccines. Nonetheless. 16 . That’s why many of them are prone to any desease within our community.Inadequate levels of immunization against childhood diseases remain a significant public health problem in resource-poor areas of the globe. the reasons for incomplete vaccination and non-uptake of immunization services are poorly understood. We are conducting this research because we just want to know about the immunization status among children in San Jacinto. health workers and officials told us that there are other reasons why women in rural areas are afraid to be immunized. And because of the Inadequate levels of immunization against childhood diseases remain a significant public health problem in resource-poor areas of the globe. These include the fear of needles and the misconception that the vaccines will either make them sterile or cause a miscarriage if they are already pregnant. Aside from the pain.
its result is a comprehensive presentation and interpretation of the statistical tabulation of data yielded by the survey. Cruz. Using Lynch formula we’ve come up with 15 17 . Sta. Maria and Sto. Casibong. A Descriptive Quantitative Research Method is a study that describes the nature of phenomenon under investigation after a survey of condition that relate to the phenomenon. 2006). Labney. Sta. This type of research answers the questions and satisfies curiosity about a certain phenomenon at the time of the study. Bolo. San Jose. Magsaysay. San Roque. Imelda. Capaoay. Pag-asa. its meaning and significance and then making adequate and accurate interpretations of these data with or without the aid of statistics (Tan. San Vicente. Moreover. San Guillermo. This research attempts to describe. Descriptive studies involves analysis of extremely broad range of phenomena. Tomas with 15 respondents each mother with children under 1 year old. descriptive studies are concerned with existing conditions. Guibel.Chapter 3 METHODOLOGY Research Design The researcher employed descriptive-quantitative research method in this study. interpret and analyze the Immunization Status of children under 1 year old in the Municipality of San Jacinto. Labong. Source of Data This research consisted of fifteen (15) respondent mothers who have children under 1 year old involved all barangay namely: Awai. San Juan. Macayug.
respondents. consistent with the purpose of the study.. Data and information is base on the demographic profile and perceptual assessment of the respondents regarding the variables of the study. It is paper and pencil approach in which participants are asked to answer a set of printed question. The researcher also took the same opportunity to make ocular visitation of the setting of the study. the research implements the following procedures: The researchers will seek permission from the Mayor and all Barangay Chairmen in San Jacinto to allow them to conduct their survey. V. It was drafted and submitted to their adviser for comments and suggestion. A Questionnaire is the most frequently used clerical research instruments to gather needed data from respondents pertinent to the purpose of the study. After the corrections. The researchers will prepare a questionnaire which is the instrument used in this study. 18 . the questionnaire was improved. 2008) Instrumentation and Data Collection Instruments are specially prepared tools or devices used to collect needed data or information and facilitate observation and measurement of research variables. In gathering data. The following sample size formula by Lynch and others (1972) is suggested over other available formulas found in statistic books because it yields a more adequate size when the population is small and the normal approximation of the population is poor. (Avdales.
percentage distribution.The researchers will reproduce the final copy of the questionnaire and prepared for distribution. hence frequency and percentage will be used. 1 data will be obtained from records of RHU in San Jacinto. Statistical Analysis The collected data are statistically treated by using frequency count. Percentage is computed to determine the proportion of a part to a whole such as a given number of respondents in relation to the entire population. 19 . To answer sub problem no. and verbal interpretation.
J. Reyes-Bailon. Methods of Research. Samson.R L.html 20 . M. Wagman. S. from http://www. Lippincott Williams and Wilkins. R. M. Public Health Nursing in the Philippines. (2007). F. (2002). Encyclopedia. Edition. Ermita Manila. B. (2008). J. China: Trident Press International. Educational Publishing House. V. (2011). Philadelphia: Elsevier Mosby Inc. R. (2007). J. Missouri: Prentice Hall Publishing. Edition. Porth .F. Vaccination & Its importance. (2006). Reprint Authorized by. P. C. Hatfield. G. C. E. Cuevas. et al. The New International Standard Medical and Health Stand-alone Web document Unicept and Who. Published by: National Bookstore. Philadelphia: Lippincott Williams and Wilkins. (2006). Schneider. G. Tan. Singapore: Elsevier Mosby Inc. V. A Research Guide in Nursing Education Third Edition. (2005). Community Health Nursing The Basic of Practice.unicef. Pathophysiology Concepts of Altered Health States Sixth Quezon City: Gentess Printing Press. N. Engelkirk. (2011).Bibliography Books Avdales. M.org/immunization/index_coverage. Broadribb’s Introductory Pediatric Nursing. Nelson Textbook of Pediatrics Seventeenth Edition. J. Philadelphia: Hockenberry. R. (2004). Wong’s Essentials of Pediatrics Nursing Seventh Lippincott Williams and Wilkins. (2008) Burton’s Microbiology for Health Sciences (8th Edition). (2006). Published by Jones and Bartlett Learning. Introduction to Public Health (3rd Edition). (2003). Manila: National League of Philippine Government Nurses Inc. Behrman.
jou/bme/articles/ PMC 2405792 Wolfson. 2012.hih. J. (2007). 21 . M. & Garcia.ncbi. Estimating the costs of achieving the WHO–UNICEF Global Immunization Vision and Strategy. De Schacht. I. et al. Internet-only journal Barromeo.pdf.who. (2008).org/Philippines/realives_18717. (2008).. G.. Lara J. from http://www.. Retrieved October 25. from http://www. L.int/bulletin/volumes/86/1/07-045096. Project Eliminate MNT.2012. from http://www.unicef.Journal article.nlm.G. Jani. C. Risk Factors for incomplete vaccination and missed opportunity for immunization. Retrieved October 10.html Jani.. 2012. & Bijune. Retrieved October 10.
we have chosen you as one of our respondents. the level IV nursing students of Escuela de Nuestras Señora De lasalette are conducting a study entitled “IMMUNIZATION STATUS OF CHILDREN UNDER 1 YEAR OLD IN SAN JACINTO PANGASINAN” The purpose of this study is to determine the Immunization status of children under 1 year old in San Jacinto. We assure you that the data that will be collected will remain confidential. In line with this. The Researchers Approved by: ______________________________________ Thesis Adviser 22 .Dear Respondents. Please answer the following questions as honestly as possible. Thank you! More power and God bless you! Sincerely yours. Greetings! We. Your response will help us in pursuing our research study. Your response will be highly appreciated.
B3 23 .B1 MEASLES Part II. Immunization: BCG DPT1 OPV1 Hepa.B2 DPT3 OPV3 Hepa. Kindly specifies what those vaccines were given to immunized child under 1 year old by putting a check on each acquired vaccine. Direction: Please answer the following questions by putting a check mark ( / ) on the appropriate column corresponding to your option using the scale below. Arbitrary Value 5 4 3 2 1 Descriptive Rating Strongly Agree (SA) Agree (A) Neutral (N) Disagree (DA) Strongly Disagree (SD) DPT2 OPV2 Hepa.Questionnaires Part I.
FACTORS 1.g. facilities) 6. Lack of knowledge 3. Unavailability of health resources (e. Lack of information dissemination 4. 5 4 3 2 1 24 . health personnel. Lack of time 2. Others please Specify________________. Home distance from RHU 5.
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