Mothers' Knowledge and Attitudes Towards Child Immunization

ASSESSMENT OF KNOWLEDGE, ATTITUDES AND PRACTICES OF MOTHERS REGARDING IMMUNIZATION
TO CHLDREN 0 – 12 MONTHS IN BONASSAMA HEALTH DISTRICT.
CHAPTER ONE: INTRODUCTION
1.1 Background
The World Health Organization (WHO) has defined immunization as the

process whereby a person is made immune or resistant to an infectious disease, typically by the
administration of a vaccine. These vaccines help to stimulate the body’s own immune system to
protect the person against subsequent infection or disease (WHO, 2013). Immunization therefore
depicts the ability to develop immunity. Immunity being the state of having sufficient biological
defenses to avoid infection, disease, or other unwanted biological invasion (Gherardi E, 2013).
Immunity also depicts the capability of the body to resist harmful microbes from gaining access
into it.
Immunization is considered as one of the biggest achievements of the twentieth century and as
one of the most cost effective measures in the prevention of childhood diseases (Muhsen K et al,
2012). In 1974, the World Health Organization (WHO) launched a worldwide vaccination
program known as the Expanded Program of Immunization (EPI), which has been considered
one of the major public health interventions aimed at reducing infant morbidity and mortality
(Bos E et al, 2000). During the launching of the EPI in 1976, only about 5% of infants
throughout the world were protected against six diseases (diphteria, measles, pertussis,
poliomyelitis, tetanus, and tuberculosis). By 2013, the number of protected infants was more
than 80% in many countries. It is estimated that vaccination helps to prevent 2 to 3 million infant
deaths each year (WHO, 2016).
The Expanded Program of Immunization started in Cameroon in 1976 as a pilot project and
targeted infants from 0 to 11 months. Initially it targeted 6 diseases (diphtheria, measles,
pertussis, poliomyelitis, tetanus, and tuberculosis), and other vaccines were gradually introduced;
the last to be introduced in the EPI was IPV in 2015. Presently, it has vaccines against the
following diseases: tuberculosis, diphteria, tetanus, poliomyelitis, pertussis, viral hepatitis B,
type b Hemophilus influenza infections, pneumococcal infections, diarrhoea caused by rotavirus,
measles, yellow fever, and rubeola. An infant is completely immunized when he or she has
received all the vaccines in the EPI. Ensuring that all the doses are not only administered, but
Written and presented by ERIC EPAH et al.

1
given at the appropriate ages, is of crucial importance in ensuring the efficacy of the vaccine in
disease prevention (Lernout T et al, 2014). An infant is correctly vaccinated when he or she has
received all the vaccines at the recommended ages. Many infants still do not complete their
vaccination schedules or are vaccinated after the recommended ages (Ba Pouth SFB et al 2014).
Given the importance of vaccination in reducing morbidity and mortality in children, we decided
to assess the knowledge, attitudes and practices of mothers regarding immunization to chldren 0
– 12 months in Bonassama Health District of the Littoral region of Cameroon. This will
ultimately improve the vaccine coverage and reduce obstacles which might hinder effective
implementation of vaccination strategies.
1.2 RESEARCH PROBLEM
The Expanded Program on Immunization (EPI) was introduced in Cameroon in 1976 (Ba Pouth
SFB et al 2014). Since 2010, the national targets have been to achieve a national coverage of
80%, and 90 % at the level of health districts (Bofarraj AMM, 2008). To achieve these
objectives, several vaccination strategies have been adopted, and recommended to be used in
health facilities. These strategies includes; organizing vaccination at fixed posts, outreach
vaccinations, mobile and supplementary vaccination activities (Barreto TV et al, 1992).
Despite adoption of these strategies, in an attempt to achieve a universal coverage in the EPI,
access of populations to vaccination services remains low. In fact, based on the WHO definition,
only 53 % of children aged between 12 and 23 months were completely vaccinated, 5 % did not
receive any antigen of the EPI, 42 % were only partially vaccinated and 5 out of the 9 antigens
had national coverage rates lower than 80 %, far below the national targets (Chidiebere ODI et
al, 2014).
1.3 RESEARCH QUESTION
Do mothers of children of vaccination age have adequate knowledge and good practices with
regards to immunization? Why is vaccination coverage rate in Bonassama Health District hardly
100 percent?

2
1.4 RESEARCH HYPOTHESIS
HA: Mothers of children of vaccination age (0 – 12 months) have adequate knowledge posses
good attitude and exhibit practices with respect to Immunization.
Ho: Mothers of children of vaccination age (0 – 12 months) have inadequate knowledge, posse’s
improper attitude and exhibit inappropriate practices with respect to Immunization.
1.5 RESEARCH OBJECTIVES
1.5.1 GENERAL OBJECTIVE
To assess knowledge, attitude and practices of mothers towards immunization of children 0 – 12

months of age in Bonassama Health District.
1.5.2 SPECIFIC OBJECTIVES
1. To assess knowledge of mothers of children 0 – 12 months old regarding immunization.
2. To assess the attitude of mothers of children 0 – 12 months of age with respect to

immunization.
3. To assess the practices of mothers of children 0 – 12 months towards immunization.
4. To establish a correlation between mother’s educational level and knowledge of children

vaccinations.
1.6 SCOPE OF THE STUDY
This research was carried out extensively in the Bonassama Health District in Douala, with
participants being representative of most of the major communities in Bonaberi. The findings
from this research can reflect results of Douala in particular and the national territory.
1.7 SIGNIFICANCE OF THE STUDY
• This research will help increase awareness and inculcate positive attitude and practices of
the target population thereby increasing vaccination coverage, thus reducing the
prevalence rate of vaccine preventable diseases.
3
• Results from this research will help the ministry of public health to improve and develop
strategies geared towards sensitization of parents about immunization.
• Increase awareness will increase vaccination coverage rate. This will lead to increased
herd immunity.
• From the research, a health sensitization module will be developed to be used for health
campaign in the community.
1.8 CONTEXTUAL DEFINITION OF TERMS
Assessment: - It is the organized systematic and continuous process of collecting data

from mother of children 0 – 12months regarding vaccination.
Knowledge: - It denotes the awareness or information that the mothers posses regarding
vaccination.
Attitude: - Refers to opinion of mothers towards vaccination.
Mothers: - Mothers of children 0 – 12 months, who resides within the land surface
area covered by Bonassama Health District and who participated in the
research.
Child immunization: The World Health Organization (WHO) has defined immunization as the
process whereby a person is made immune or resistant to an infectious disease, typically by the
administration of a vaccine.
1.9 ASSUMPTION
The study assumes that,
i. Mothers play an active role in preventing child hood infections by immunization of

their children.
ii. Mothers will have some knowledge; possess positive attitude and practices regarding
immunization.
iii. Health education module will help the mothers to gain knowledge regarding
importance of immunization.

4
CHAPTER TWO
LITERATURE REVIEW
2.1 HITORICAL BACKGROUND
World Health Organization (WHO) initiated the Expanded Program on Immunization (EPI) in
May1974 with the objective to vaccinate children throughout the world (World Health
Organization; 1993). A major goal for the World Health Organization is the global control of
certain infectious diseases (World Health Organization, 1997). The main strategies for the
prevention of infection are to eliminate or diminish the amount of infecting microorganism from
circulation, to enhance the host immune response and to treat the infected host. These strategies
are achieved by two of immunization types i.e. active and passive. (World Health Organization.
the Jakarta Declaration, 1997).
In Cameroon, the National Primary Health Care Development Agency has the Expanded
Program for Immunization (EPI). Included within this policy is the Immunization Schedule
which is designed to include all children 0-1 year who shall receive one dose of (Bacille-
Calmette Guerin) BCG against tuberculosis, one dose of Yellow Fever vaccine, 3 doses of
Diphtheria, Pertussis, Tetanus (DPT), 3 doses of Haemophilus influenza (Hib) vaccines, 3 doses
of Hepatitis B vaccines 4 doses of (Oral Poliomyelitis Vaccine) OPV and one dose of Measles
vaccine before the age of one.

5
Table 2.1: Immunization Schedule for Vaccines used in Cameroon

Minimum
Route of
Contact Target age Type of Vaccine Dosage Site
administration
of child
Right Upper
BCG 0.05ml Intra dermal
1st At Birth Arm
OPV0 2 drops Oral Mouth
Antero-lateral
Pentavalent1(DPT,
0.5ml Intramuscular aspect of
2nd 6 weeks HBV and Hib)
thigh
Antero-lateral
Pentavalent2(DPT,
3rd 10 weeks HBV and Hib)
thigh
Antero-lateral
Pentavalent3(DPT,
4th 14 weeks HBV and Hib)
thigh
Left Upper
Measles 0.5ml Subcutaneous
Arm
5th 9 months
Left Upper
Yellow fever 0.5ml Subcutaneous
Arm
Sourced from National Primary Health Care Development Agency (NPHCDA, 2009)
Achieving this goal has been faced with so many challenges, some of which include inadequate
sensitization and lack of awareness and knowledge to parents to comply with the strategies put in
place to achieve this W.H.O goal. Most research work has been published on related topics,
assessing the knowledge, attitude and practice of parents of children of vaccination age.
1. An institutional based cross-sectional study was conducted from March 1st to April 1st,
2013. This study was aimed to assess Knowledge, Attitude and Practice of mothers regarding
infant immunization and their associated factors in immunization clinic in health centers at
Addis Ababa, Ethiopia. Multi stage sampling technique was used for participant selection.
Participants were interviewed with structured questionnaire for different variables. It was found
out that only 55.0%, 53.8%, and 84% of respondents had good knowledge, positive attitude, and
good practice towards immunization of infants, respectively. Mothers’ education and mothers
who had infants’ aged from 2-3 months were significantly association with favorable attitude

6
towards immunization of infants. Good infant immunization practice was significantly

associated with mothers who heard information about vaccination, mothers who know correctly
the time when infants should begin immunization, know the number of sessions needed, and
know the time when infants should complete immunization and place of delivery. The study
concluded that Knowledge and attitude of mothers’ about infant vaccination was not adequate.
Despite inadequate knowledge and attitude of mothers towards infant immunization, 84.0% of
mothers found in Addis Ababa had good practice of infants’ immunization. Health education to
promote knowledge and attitude based immunization practice is recommended.
2. In another study published in January 2018, Esra Saleh et Al had an aim to assess
parental knowledge and attitudes on childhood immunization among Saudi parents in Riyadh,
Saudi Arabia. This was a cross sectional prospective study. Pretested well designed
questionnaires were distributed during March 2017 to parents with children of 0-12 years old
who were invited to answer the questionnaires. Out of a total of 731 parents recruited,
672(91.9%) of parents had good knowledge on aspects related to the general role of vaccination
in prevention of some infectious diseases. However, poor knowledge was documented among
parents in other aspects like the importance of administration of multiple doses of the same
vaccine to child immunity (41.6%), administration of multiple vaccines at the same time have
no negative impacts on child immunity (37.1%), vaccination of children against seasonal
influenza (45.7%) and contraindication to vaccination (39.3%). This study concluded that
although parents had good knowledge and positive attitudes on some aspects related childhood
immunization, gaps in both studied domains were identified. Educational interventions are
needed to upgrade parent’s knowledge with special emphasis on less educated and residents of
rural areas.
3. Another study was carried out Jos, Nigeria by Chris-Otubor et al, to assess the
knowledge, attitudes and practices of mothers regarding immunization. A household multi-stage
sampling 48-item questionnaire study design was used. Mothers with children born between 0 –
12 months were targeted with a sample size of 232. Though only 2.6% had excellent knowledge
on vaccine preventable diseases, 89.6% had an overall good knowledge while 5.2% each had
fair and poor knowledge. Less than 60% reported for vaccination at the stipulated time and less
than 3% had negative attitude towards immunization. The education of the mother, marital
status, religion, geopolitical zone and her and/or the father of the child been immunized as

7
children significantly influenced their knowledge (p<0.05). These findings call for health
promotion.
4. The purpose of this other study was to determine the mother’s knowledge towards
childhood immunization and examining the reasons for incomplete immunization carried out by
Vinodkumar Mugada et al in East Godavari District in India. Information regarding socio-
demographic variables, gender disparity ratio, urban and rural inequality ratio and causes for
incomplete immunization, knowledge of immunization was collected from 377 mothers bearing
children of age 3 years. Around 115 (30.50%) children were partially immunized. Unavailability
of vaccine was considered to be the major reason for incomplete immunization. The association
between gender and immunization status (p=0. 027), mother’s education and knowledge score
(p=0. 005) and area of residence and knowledge score towards immunization (p=0. 001) was
found to be statistically significant. Mother’s education and area of residence were found to get
associated with knowledge of immunization. However, knowledge towards immunization and
immunization status was not significantly associated. Gender disparity in immunization was
observed in the study. No association was found between the children’s immunization status and
area of residence, birth order or mother’s education. Area of residence and mother’s education
and was found to get associated with knowledge of immunization.
5. Another research study was conducted to determine parental hesitancy toward
vaccination inside Erbil city, Iraq, and to find associations between the parents’ position towards
vaccination and the outcome of immunization. A descriptive study was done during the period
from 1st of January 2014 till 1st of July 2015. The data were collected through a self-
administered questionnaire. Parental position in respect to immunization of their child revealed
that 65.3% were unquestioning acceptors, 20.6% were cautious acceptors, 9.9% were hesitant,
3.5% were late or selective vaccinator and only 0.7% were refusal. Immunization behaviors of
parents among different groups showed that, 20.9% postponed their child’s vaccination for
causes other than sickness or sensitivity, while 73% were provided with immunization on time.
More than two thirds (65.9%) were completely sure that, it is a good idea to follow the schedule
of immunization for their child and only 26.6% were not sure. This study showed that parents
had some positive aspects related to vaccination and defects in some domains were recognized.
Identifying these parents is important in order to implement the necessary measures to maintain
and improve the vaccines uptake.

8
6. This other study was designed by Muhammad Asim et al in Rural Areas of District
Faisalabad, Pakistan to explore the gap toward health facilities and assess the parental
knowledge, belief and attitude toward childhood immunization. A sample of 160 Christian
minorities was selected conveniently from District Faisalabad through multistage sampling
techniques. Majority of the respondents 95% were aware of child immunization, and 81.3%
respondents agreed that child immunization were impotent for the children for their healthy
future. 85% of the respondents were in the opinion that childhood immunization is more
beneficial than harmful, and 90% of the respondents confessed that child immunization is not
prohibited in our religion

9
CHAPTER THREE
MATERIALS AND METHOD
3.1 STUDY AREA
The study is a community based research carried out in some chosen communities which form
part of the Bonassama Health District. These communities will include:
• Mabanda
• Centre Caise
• Grand Hangar
• Ngwelle
• Ndobo
• Bonassama
Similar amount of sample were collected in all the chosen communities so that results obtained
after analysis will reflect the result of most of the mothers with regards to immunization of
children 0-12 months of age in Bonassama Health District.
3.2 STUDY AND STUDY DESIGN

This study is a cross-sectional descriptive study design use on women having children of age
between 0-12 months and care givers of children 0-12 months in Bonassama Health District.
3.3 TARGET POPULATION
The target population was all the mothers of children between 0 – 12 months, children of active
vaccination age.
3.4 SAMPLE AND SAMPLE SIZE CALCULATION

The sample size (N) was determined using the Cochran formula as follows:
N = z2 p (1- p)
e2
Where z is the significance threshold; 1.96 for a 95% confidence level, d is the margin of error;
5%, and p; 64.3%, is the prevalence of vaccine completeness from the study of Ba Pouth et al in
the Djoungolo Health District in 2012.
N= sample size
Confident Interval 95% (z) = 1.96
10
Margin of error (e) =0.05

Prevalence (p) of 64.3%, =0.643
Substituting these on the formula gives:
1.962(0.643) (1- 0.643)/ 0.052
= (3.8416) (0.643) (0.357)/ 0.0025= 0.111744/ 0.0025
= 0.881831216 / 0.0025
= 352
Non response rate of 10% will give 35.2
Estimated sample size is 352+35=387
(n=387) mothers of children aged 0 – 12 months will be chosen for the study from the various
communities. In order to reduce the margin of error, the sample size shall be increased to 400.
3.5 SAMPLING TECHNIQUE

The sample of mothers having children aged 0 – 12 months will be selected by using convenient
sampling technique.
3.6 RECRUITMENT OF PARTICIPANTS
3, 6, 1 INCLUSION CRITERIA
1. Mothers/caregivers who are having children between 0 and 12 months
2. Mothers/caregivers who are attending the immunization clinic in any private or
public health units within Bonassama Health District.
3. Mothers/caregivers who are willing to participate in the study.
4. Mothers/caregivers who speak French, English or Pidgin language.
3.6.2 EXCLUSION CRITERIA

1. Mothers/caregivers who are unable to understand and read French or English.
2. Mothers/caregivers who are not willing to participate in the study.
3. Mothers/caregivers who are not available at the time of data collection.
4. Mother/caregivers whose children are more than 12 months of age.
3.7 STUDY VARIABLES
Dependent variable: Knowledge, attitude and practice of mothers of children 0 – 12 months.
Attributing variable: Demographic data of mothers including age, religion, education,

occupation, family income and number of children.
11
3.8 SAMPLE AND SAMPLING TECHNIQUES.

Participants will be recruited using the convenient sampling technique.
3.9 DATA COLLECTION METHOD.

Data will be collected through interview and self-administered questionnaires.
3.10 DATA COLLECTION TOOLS AND MATERIALS.

Data collection tool is the questionnaires. Materials to be used will include A4 papers,
calculators, pens and pencils, rulers. The questionnaire will be made up of the information sheet,
the informed consent sheet and the question sheet. The question will be made up of four sections;
Section A: Proforma for collecting demographic data.
Section B: Consist of questions to assess the knowledge of mothers regarding immunization.
Section C: Consists of a series of questions to assess attitude of mothers regarding immunization.
Section D: Consist of a series of questions which aims to assess practices of mothers regarding
immunization.
3.11 DATA MANAGEMENT AND STATISTICAL PLAN

Data collected through questionnaires will be then entered using Epi data version 3.53 (Center
for Disease Control and Prevention of the United State of America (CDC). It will be transported
to SPSS version 21s.0.
Descriptive analysis will be used to determine the knowledge, attitude and practices (KAP) of
immunization of children from 0-12 month’s children. KAP will be assessed as a proportion of
participant who has adequate knowledge, favorable attitude and good practice of vaccination.
The level of significance will be at P<0.005 for statistical significance.
The result will be analyzed and will be presented in chapter 4 using methods of simple
percentages OR with their 95% confident interval.
a.Descriptive statistics.
Frequency and Percentage will be used to describe the distribution of mothers
according to demographic characteristics.
Mean, Mean score percentage and Standard deviation will be used to assess
the knowledge and attitude scoring of mothers.

12
Linear correlation will be worked out to find the relation between knowledge
and attitude of mothers of children 0 – 12 months.
b. Inferential Statistics
Chi-Square test will be used to determine the association of knowledge and
attitude of mothers with demographic characteristics.
3.12 ETHICAL CONSIDERATIONS
Prior to carrying out this study, administrative authorization and ethical clearance will be
obtained from the AHID ethical committee and the Faculty of Medicine and Biomedical
Sciences of the University of Douala respectively. A written consent form was signed by each
mother or caretaker who accepted to be enrolled and participate in the study and for those who
could not read and write verbal consent was sought after receiving information on the study.
Participants in the study were informed on any missed vaccine and any other information
concerning the child’s vaccinations.
Table 3.1: activity time line

Activities time line 1 2 3 4 5 6 7 8 9 10
Oct Nov Dec Jan Feb Mar Apr May Jun Jul
Phas1:conception x
Phase2: Literaturereview x X x x X x X
Phase3:Protocol development X x
and defense
Phase4:Development,pretest X x X
of data collection
Phase5:Data collection x X x
Phase6: Data analysis X x

Report write up x
Research defense x

13
PROJECTED BUDGETING
NO ITEMS QUANTITY UNIT COST TOTAL

COST
1 Materials / Pens, 5 100 500
Equipment’s Pencils, 1 6000 6000
Calculator, 1
pkt papers,
2 Personal motivation 1 20000 20000

and development
3 Logistics 1 30000 30000
4 Ethical Clearance and 1 25000 25000

authorization from
different agencies and
public authorities
5 Data management and 1 30000 30000
analysis
6 Sum Total (B1 + B2 + 6500+20000+30000+25000+ 111500
B3+ B4 + B5 + B6) 30000
7 Institutional and 1 25000 25000
miscellaneous cost
8 Grand Total 111500+25000 135500

14
CHAPTER FOUR
DATA PRESENTATION AND ANALYSIS
Three hundred and ninety - eight, 42-item questionnaires were prepared for data collection by
interview method through trained research assistants between April and May 2019. Two hundred
and thirty two were correctly filled and returned by the time of analysis. Six were improperly
filled. Thus the non response rate was 1.50%.
Results from survey of mothers in Bonassama Health District.
4.1 SECTION A: SOCIO – DEMOGRAPHIC CHARACTERISTICS OF THE STUDIED

PARENTS AND CHILDREN
Figure 4.1: showing the sex of children sample in the study.

Sex of child Frequency Parentage
Males 201 51.3
Females 191 48.7
Total 392 100
The table above shows that out of a total of 392 questionnaires that were returned correctly
filled, more males 201(51.3%) than females 191(48.7%) were sampled.
Table 4.2: illustrates age of children chosen for the study

Age (Months) Frequency Percentage
<1 month
76 19.3
1 – 3 months
64 16.3
4 – 6 months
38 9.6
7 – 9 months
106 27.0
10 – 12 months
108 27.6
Total
392 100
The ages of children under study ranged from 0 – 12 months. Although their mean age was about
6 months, a greater number 108(27.5%) had their ages ranging between 10 and 12 months.

15
Figure 4.1:: Distribution of the age of mothers sampled
Frequency
200
150
100 174 Frequency

120
50 83
15
0
<25 years 25 - 30 31 - 40 >40
This table depicts that the mothers were largely between the ages of 25-30years
25 174(44.4%)
which is the reproductive period for most women. Only about 4% were above 40 years of age.
The mean age of participant was 27.
Table 4.3:: Marital Status of the mothers

status Frequency Percentage
Single/separated/divorced/widowed 29 7.3
married 363 92.7
Total 392 100.0
Table 4 shows that almost 93% of the mothers were married while all single mothers (separated,
divorced or widowed) constituted only 7.3%.
Table 4.4:: Mothers’ education

Education Frequency Percentage
Primary 47 12.1
Secondary 222 56.5
Tertiary 108 27.6
None 15 3.9
Total 392 100.0
The table above reveals that most of the mothers have had some form of secondary education,
this accounted for over 56%. However, 3.9% never had any formal education.

16
Figure 2:: Distribution of mothers by their chosen communities
70 78
Grand Hangar
59 Centre caise
61
Mabanda
Bonassama
64 60 Ngwele
Bonadale
As shown on the table above, slightly more mothers 78 (20%) were resident at Grand Hangar.
Other women represented other communities as follows; Centre caise 61 (16%), Mabanda 60
(15%), Bonassama 64(17%), Ngwele 59(15%) and Bonandale 70 (18%).
Table 4.5:: Religion of mothers surveyed

Religion Frequency Percentage
Christianity 363 92.7
Islam 29 7.3
Total 392 100.0
Table 7 above shows that almost 363 of the sampled mothers were Christians as compared to
only 29 that were Muslims.

17
Table 4.6:: Mothers’ occupation

Occupation Frequency Percentage
Employed 41 10.4
Non employed 297 75.8
Student 54 13.8
Total 392 100.0
This table is portraying that most women 297 (75.8%) were unemployed, although most of them
run private businesses. Only 41(10.4%) were employed by the public service and other corporate
organizations. 13.8% were current students.
arental immunization at infancy

Figure 4.3: History of parental
328
350
300
236
250
Yes
200
135 No
150 I don’t know
100
40
50 24 21
0
Mothers Fathers
From figure 2 above, it was observed that majorities (83.6%) of mothers were immunized as
children but 6.0% were not. Unlike mothers, 60.3% of fathers were immunized as children and
5.2% were not. About 34.5% of fathers could not determine whether they were vaccinated in
childhood.

18
4.2 SECTION B: ASSESSMENT OF MOTHER’S KNOWLEDGE ON IMMUNIZATION.
Table 4.7: assessement of mother’s knowledge on immunization
NO I DON’T
YES N (%) KNOW
N (%) N (%)
Heard about immunization 389 (99.2) 2(0.4) 2(0.4)

Immunization prevents childhood
368 (94.0) 9(2.2) 15(3.9)
disease
It stops children from developing
16 (4) 337 (86) 39 (10)
properly
Vaccines are important to your
384(98) 2(0.3) 6(1.7)
child’s health
Sources of information for Mass media 343 Interpersonal
Never head 8 (2)
vaccination (62) 141 (36)
Vaccination reduces probability of
death or illness to a child from 361 (92) 24(4.1) 15 (3.9)
infectious diseases
Does immunization has a role on a
341 (87) 24(6) 27(7)
child’s health
Vaccines are different and given at
212(54) 149(38) 31 (8)
different ages
Vaccines may be accompanied by
263(67) 125(32) 4(1)
side effects such as fever
Low grade fever and diarrhea are
278 (71) 44(12) 67 (17)
contraindication for vaccination
Even healthy children need to be
349(87) 8(2) 35(9)
vaccinated
Vaccines are administered to
47(12) 310(79) 35(9)
children once every month
BCG is given at six weeks after birth 39(10) 341 (87) 12 (3)
If your child develops fever after
taking a vaccine, stop vaccinating 70(18) 306(78) 15(4)
your child
Some vaccine are administered after
9months of age which are out of EPI 251 (64) 31(8) 110 (28)
vaccination program
Table above reveals that overall; most mothers were able to give correct answers to questions
on immunization and were generally able to demonstrate mastery of the different schedules of
the vaccination calendar of a child less than one year. Eighteen mothers (4.59%) however

19
showed excellent knowledge about vaccination and were able to identify the different vaccines
with respect to age of the child in the vaccination calendar.
Table 4.8: Cumulative assessment of knowledge
Knowledge Frequency Percentage
Good 208 89.6
Fair 12 5.2
poor 12 5.2
Total 232 100.0
Table 4.8 above summarizes the outcomes of knowledge assessment by scoring and categorizing
the respondents into three. The first group was rated “good” when the mothers scored between 8
and 15 questions correctly. The second group was rated “fair” if they scored between 5 and 7
points while the third group was rated “poor” if they scored less than 5 points. The overall
knowledge of sampled women was good as almost 90% had a good knowledge of immunization
even though an equal percentage of 5.2 had fair and poor knowledge respectively.

20
4.3 SECTION C: ASSESSEMENT OF ATTITUDE OF MOTHERS TOWARDS

IMMUNIZATION
Table 4.9: Assessment of mother’s attitude towards vaccination
NO I DON’T KNOW
YES N (%) N (%)
N (%)
Have you given your child
mandatory vaccines with respect 370 (94.38) 16(4.08) 6(1.53)
to her age?
Do you respect the EPI
vaccination calendar for your 371(94.6) 15(3.8) 6(1.5)
child and catch all appointment?
How do you feel after a vaccine is
Secured 357 (91%) Afraid 31 (8%) Nothing 4(1%)
administered to your child?
Do you advice your friends and
relatives to vaccinate their 206(52.5) 48(12.3) 138(35.2)
children?
What is your assessment of your I don’t know 50
Good 342 (87.4%)
child’s vaccination? (12.6%)
Are you keen to complete all doses
of vaccination when there is more 361 (92) 24(4.1) 15 (3.9)
than one dose?
Do you always make up time to
accompany your son/daughter at
331 (84.4) 45(11.4) 16(4.2)
vaccination center on the days of
their appointment?
Did you stop vaccination when
your child developed fever from 12(3) 380(97) 0 (0)
previous vaccine?
What usually remind you of the
Vaccination My husband I don’t know
next appointment date of your
calendar 334(85.2) 47(12) 11(2.8)
child’s vaccine?
Go for the vaccine Skip that dose
What do you do if you miss a I don’t know
Immediately 304 of vaccine
vaccination session? 68(17.3)
(77.5) 20(5.2)

21
Table 4.10 Reasons for negative attitudes toward immunization

Of the 14 children that were only partially immunized after 9 months of age, the reasons for
missed vaccination sessions were sampled as shown on the table below.
Reason Frequency Percentage
Mother was too busy 3 21.4
There was a family problem 1 7.1
The vaccine was not available 2 14.2
Wasn’t aware of the need for a second or third dose 1 7.1
Child was ill and was not brought 2 14.2
Did not know the place and time for immunization 1 7.1
Long queue and waiting time 3 21.4
Lack of money 1 7.1
Total 14 100
Prominent among these were mothers busy schedule, long queue and waiting time and ill
health of children on the day of vaccination.
4.4 SECTION D: ASSESSEMENT OF PRACTICES OF MOTHERS TOWARDS CHILD

IMMUNIZATION
Table 4.11: assessment of practices of mothers towards vaccination
YES NO I DON’T
N (%) N (%) KNOW
N (%)
D o you adhere to your child's 363(82.6) 11(2.8) 18(14.6)
immunization schedule?
How do you confirm that a child has Observing BCG I don’t know
been administered BCG? mark 361(92) 31(8)
Do you have the EPI vaccination card 328(83.6) 48 (12.2) 16(4.2)
for your child?
Have you been taking your Tetanus 372(95) 6(1.5) 14(3.5)
Toxoid vaccination during pregnancy?
Immunization status of infants (age <9 A. Take all B. Not taken all
months) vaccines vaccines
appropriate appropriate
for child’s for age
age 11(3)
381(97)
Immunization status of infants (age > 9 A. Fully B. Partially
months) immunized immunized
378(96.4) 14(3.6)

22
Table 4.11: Assessments of practices (N=108 i.e. children at 10 months and above).
Vaccine A B C D E
BCG 70 (65.3) 13 (12.2) 9 (10) 3(3.1) 13 (8.4)
DPT 44 (40.5) 20 (17.7) 33(31.0) 8 (7.8) 3 (3.0)
Hepatitis 43 (39.7) 16(15.1) 35 (32.3) 11(9.9) 3(3.0)
OPV 43 (40.1) 17(15.9) 35(32.3) 9(8.6) 4(3.0)
Measles 54 (50.0) 8 (7.8) 35(32.8) - 11 (9.5)
Yellow fever 52 (48.3) 9(8.2) 36(32.8) - 11(10.7)
Note: DPT and Hepatitis were taken as single vaccines or as in PENTA

Key:
A- Vaccinated at the stipulated time
B- Vaccinated but not at the stipulated time
C- Mothers history
D- Incomplete doses
E- E- Not vaccinated
After the vaccination cards of all children of age 10 months and above, table 14 classifies
children and their level of immunization depicting the practice of their mothers. In terms of
receiving the vaccine at the stipulated time; for BCG, those that had taken it by two weeks fell
into this group along with those that had taken the other vaccines within one month of the due
date.
About 70, 44and 43 mothers vaccinated their children within the stipulated time for BCG, DPT
and hepatitis vaccines respectively. There were also cases of incomplete dosage for DPT (7.8%),
hepatitis (9.9%) and OPV (8.6%). However, some children were not presented for vaccination at
all; yellow fever had the highest prevalence (10.7%)

23
Table 4.12: Influence of socio demographic characteristics on knowledge (*P<0.05)
Characteristics knowledge Chi - P value

square
Good Fair Poor
N=352 N=20 N=20
Sex 0.486 0.784
Female 169(88.5) 12(6.2) 10(5.3)
Male 182(90.8) 9(4.2) 10(5.0)
Mother’s age(yrs) 3.722 0.714
<25 71(85.7) 5(6.1) 7(8.2)
25 – 30 159(91.3) 7(3.9) 8(4.9)
31 – 40 108(90.1) 9(7.0) 3(2.8)
>40 13(88.9) 0(0.0) 2(11/1)
Mother’s marital status 14.766 0.001
Single/separated/divorced/widow 19(64.7) 7(23.5) 3(11.8)
Married 333(91.6) 13(3.7) 17(4.7)
Mother’s education 22.846 0.001
None 10(66.6) 0(0.0) 5(33.3)
Primary 37(78.6) 7(14.3) 3(11.8)
Secondary 203(91.6) 12(5.3) 7(3.1)
University 101(93.8) 2(1.6) 5(4.7)
Resident community 46.747 0.000
Grand Hangar 71(91.4) 4(4.6) 3(4.0)
Centre caise 17(28.6) 9(14.3) 35(55.1)
Mambanda 44(75.0) 8(12.5 8(12.5)
Bonassama 21(33.3) 21(33.3) 21(33.3)
Ngwele 59(100) 0(0.0) 0(0.0)
Bonanale 65(92.0) 5(8.0) 0(0.0)
Mother’s occupation 14.540 0.069
Employed 33(80.0) 2(5.5) 6(14.5)
Non employed 283(94.8) 14(3.1) 14(3.1)
Student 50(92.3) 4(7.7) 0(0.0)
Religion 24.324 0.000
Christian 334(92.0) 17(4.7) 12(3.3)
Muslim 17(58.8) 3(11.8) 9(29.4)
Mother’s immunized 31.933 0.000
Yes 302(92.3) 15(4.6) 11(3.1)
No 12(50.0) 4(14.3) 8(35.7)
I don’t know 36(91.7) 2(4.2) 0(0.0)
Father’s immunizatiom 27.757 0.000
Yes 226(95.7 5(2.1) 5(2.1)
No 11(50.0) 5(25.0) 5(25.0)
I don’t know 115(85.0) 11(7.5) 9(6.5)

24
Table 4.12. portrayed that the level of education was significantly associated with how
knowledgeable mothers were on immunization and vaccine preventable diseases, the higher the
level of education, the higher the knowledge. Other factors that significantly associated with
knowledge were marital status, resident community, religion, mothers being immunized as
children as well as fathers.

25
CHAPTER FIVE
DISCUSSION, CONCLUSION AND RECOMMENDATIONS
5.1 DISCUSSION
5.1.1 Knowledge of mothers on immunization
This study was an analytical epidemiological study, seeking to determine whether immunization
can improve or decrease the quality of life of an individual. It had as its main objective to assess
mother’s knowledge, attitudes and practices towards immunization.
This study revealed that a greater majority 389(99.2%) of mothers reported that they have heard
about immunization. About 368 (94.0%) also reported that they knew that immunization is
meant to prevent childhood diseases rather than cause harm to the children. This knowledge
therefore accounts for the overall „good knowledge rated among the sampled women 208
(89.6%). It was alarming however that only 18 (4.59%) of mothers however showed excellent
knowledge about vaccination and were able to identify the different vaccines with respect to age
of the child in the vaccination calendar. This discovery calls for targeted information, education
and communication. While 70 mothers (18%) revealed that vaccination should be stopped if a
child develops fever after being administered a vaccine, 141 (36%) didn’t know that other
vaccines are programmed after nine months of age.
Poor knowledge of mothers on VPDs is detrimental in achieving a high percentage of coverage
during immunization. When mothers are not properly educated with regards to the diseases their
children are meant to be immunized against, they may not realize the necessity of the vaccines.
One of the Millennium Developmental Goals (MDGs) is to reduce child mortality and this would
not be achieved significantly if mothers are not aware of these VPDs. This lack of knowledge
also extends to the appropriate time for each vaccine to be taken.
5.1.2 Attitude of mothers towards immunization

Only a small percentage of women (less than 3%) gave reasons for their failure in making their
children available for immunization. The most popular reasons given were: Prominent among
these were mothers busy schedule, long queue and waiting time and ill health of children on
the day of vaccination. The least reasons given by mothers were: wasn’t aware of the need for a

26
second or third dose, family problem and lack of money. Most of the reasons mentioned by the
women only show the lack of education on the part of women. If mothers were better educated
on the importance of immunization and the need for it to be taken at the right time, they probably
would not have excuses for not showing up for immunization. Proper information needs to be
passed on to the women. It is also important to note that lack of money should not so much as
be an issue in Douala because the economic capital has good road network and boost of different
means of transportation instituted to facilitate movement. This further stresses the fact that
ignorance is a major reason for mothers not immunizing their children. Health education must be
utilized to promote health protection through vaccination in order to prevent these childhood
killer diseases.
5.1.3 Practice of mothers as regards immunization
In terms of showing up for immunization at the right time (within one month of the expected
date) it was observed that almost 60% of mothers brought their children promptly for the first
immunization- BCG. This high turnout could be attributed to the fact that women who give birth
in hospitals, clinics or maternity homes are usually given this vaccine immediately or advised to
go to approved centers. Antai (2009) had also stated that the proportion of mothers that delivered
in a hospital setting is a predictor of child immunization uptake. Further noting that hospital
delivery is one of the most important preventive measures against maternal and child health
outcomes, and an important determinant of full immunization. Still in relation to this reason,
most women 372(95%) have taken their Tanus toxoid vaccine as compared just 6% that did not
take it. A closer observation of the vaccination cards reveal vaccination drop out at various levels
of schedule. Many reasons could be postulated for this high rate of dropout such as moving to
another area, changing the place used for immunization, death of the child or ignorance on the
part of the mother. Health education is greatly required in this regard. Sadoh and Eregie (2009)
state that to achieve maximal protection against vaccine-preventable diseases, a child should
receive all immunizations within recommended intervals. One of the health indicators of
achieving reduction in child mortality is to increase the proportion of one year olds that have
been immunized against measles. From this study, only 50% of the children were immunized
promptly against measles and 9.5% were yet to be immunized even after one year of age.

27
5.1.4 Influence of socio demographic characteristics on knowledge
Some demographic factors were observed to have significant effects on the knowledge of
mothers. One of such factors was marital status of the mothers. Married women were observed to
have a significantly higher knowledge of immunization (p=0.001) than their
single/divorced/widowed or separated counterparts. This is unlike the study conducted by
Odusanya et al., (2008) were the marital status of the mother was not found to significantly
affect their level of knowledge on immunization. The marital status of a mother may enhance her
knowledge in the sense that those that are married may have more access to education compared
to those that are single mothers who may generally have more responsibility and would tend to
put aside education in order to seek for a means to cater for their children. The supportive role of
their partners may also enhance her knowledge if both partners jointly seek for ways to better the
health status of their offspring. The level of education of mothers was observed to be very
significant (p=0.001) to their knowledge on immunization. The higher the level of education of
the mothers, the greater their knowledge on immunization. This has been similarly reported by
Angellilo et al., (1999) and Odusanya et al., (2008) who stated that the level of knowledge about
mandatory vaccinations for infants correlated significantly with level of education. This expected
because those with higher educational standards would have greater ability to process
information generally than those who are not.
5.2 CONCLUSION
Within the limits of this study it can be said that though there seems to be a high level of
knowledge among mothers in Bonassama Health District generally, this knowledge is not
reflected in their practices. Knowledge of mothers in Bonassama Health District was also found
to be significantly affected by education, marital status, religion, resident community and the
mother and/or father been immunized as a child. Health promotion in the form of health
education is still lacking in some areas making adherence to the immunization schedule a
challenge for some mothers. There is a need to properly counsel them on disease prevention and
health protection. Some mothers were observed to still have negative attitudes towards
immunization which calls for periodic health promotion and education.

28
5.3 RECOMMENDATIONS
1. There will be a need to create more jingles on air in English and other dialects to promote
knowledge on the immunization schedule and the various vaccines that should be taken.
2. Fliers and billboards with relevant information on immunization should be produced and
widely distributed.
3. Traditional birth attendants in various localities should be reached and educated on
immunization as a disease prevention and health protection tool. Health protection in the
area of preventing sepsis during child birth through tetanus toxoid vaccines can be taught
also.
4. The Government should make it mandatory for children to present their immunization
cards before being admitted into public and private schools.
5. Similar studies should be conducted in various local governments, published and the
results forwarded to their Chairmen for action.
6. Areas that have poor access roads should be considered and given adequate attention to
ensure better immunization coverage.

29
References
Muhsen K, Abed El-Hai R, Amit-Aharon A, Nehama H, Gondia M, Davidovitch N, et al. Risk
factors of underutilization of childhood immunizations in ultraorthodox Jewish communities in
Israel despite high access to health care services. Vaccine. 2012;30(12):2109–2115. doi:
10.1016/j.vaccine.2012.01.044. [PubMed] [CrossRef] [Google Scholar]
2Bos E, Batson A. Using immunization coverage rates for monitoring health sector performance:
measurement and interpretation issues. 2000 [cited 2016 Jan 18]; Available from:
http://agris.fao.org/agris-search/search.do?recordID=US2014600832.
WHO | Together we can close the immunization gap. [Internet].[cited 2016 Jan 13]. Available
from: http://www.who.int/mediacentre/commentaries/vaccine-preventable-diseases/en/.
Lernout T, Theeten H, Hens N, Braeckman T, Roelants M, Hoppenbrouwers K, et al. Timeliness
of infant vaccination and factors related with delay in Flanders, Belgium. Vaccine.
2014;32(2):284–289. doi: 10.1016/j.vaccine.2013.10.084. [PubMed] [CrossRef] [Google
Scholar]
Ba Pouth SFB, Kazambu D, Delissaint D, Kobela M. Immunization coverage and factors
associated with drop-out in children 12 to 23 months in Djoungolo-Cameroon Health District in
2012. Pan Afr Med J. 2014;4:17. [PMC free article] [PubMed] [Google Scholar]
Hu Y, Chen Y, Guo J, Tang X, Shen L. Completeness and timeliness of vaccination and
determinants for low and late uptake among young children in eastern China. Hum Vaccin
Immunother. 2014;10(5):1408–1415. doi: 10.4161/hv.28054. [PMC free article] [PubMed]
[CrossRef] [Google Scholar]
Torun SD, Bakırcı N. Vaccination coverage and reasons for non-vaccination in a district of
Istanbul. BMC Public Health. 2006;6:125. doi: 10.1186/1471-2458-6-125. [PMC free article]
[PubMed] [CrossRef] [Google Scholar]
Bofarraj AMM. Knowledge, attitude and practices of mothers regarding immunization of infants
and preschoo l children at al-Beida City, Libya 2008. J. Pediatr Allergy Immunol. 2011;9(1):29–
34. [Google Scholar]
Barreto TV, Rodrigues LC. Factors influencing childhood immunisation in an urban area of
Brazil. J Epidemiol Community Health. 1992;46(4):357–361. doi: 10.1136/jech.46.4.357. [PMC
free article] [PubMed] [CrossRef] [Google Scholar]

30
Chidiebere ODI, Uchenna E, Kenechi OS. Maternal sociodemographic factors that influence full
child immunisation uptake in Nigeria. SAJCH. 2014;8(4):138–142. doi: 10.7196/sajch.661.
[CrossRef] [Google Scholar]
Antai, D., (2009) Inequitable childhood immunization uptake in Nigeria: a multilevel analysis of
individual and contextual determinants. BMC Infectious Diseases, 9: 181
Gherardi E. The Concept of Immunity. History and Applications. Immunology course Medical
School, University of Pavia. http://en.wikipedia.org/wiki/Immunity_(medical)#cite_ref
Silverstein_2-0 Accessed 2nd August 2013
World Health Organization (1991) The Expanded Programme on Immunization (EPI)
SurveyWHO/EPI/MLM/91.10http://www.who.int/immunization_monitoring/routine/EPI_covera
ge_su vey.pdf
World Health Organization (WHO) (2013) Immunization. www.who.int/topics/immunization/en
Assessed February 19th 2013.
Angelillo I.F., Ricciardi G., Rossi P., Pantisano P., Langiano E. & Pavia M.(1999) Mothers and
vaccination: knowledge, attitudes, and behaviour in Italy. Bulletin of the World Health
Organization, 77 (3): 225-228

31
DATA COLLECTION INSTRUMENT

PART 1: INFORMATION SHEET FOR OFFICIAL PARTICIPATION
1- Who is the researcher?
The researcher is called ERIC Epah.
2- Who supervises the work?
The work is being supervised by Mr. MBINTA Fenibe JAMES
3- Where and for how long will the study take place?
The study will take in the selected communities in Bonassama Health District. These
communities include Mabanda, Bonassama, Grand Hangar, Ngwelle, Centre Caise and
Ndobo from April to July 2019.
4- What is the purpose of the study?
To assess mothers knowledge, attitude and practices of mothers towards immunization of
children 0 – 12 months of age in Bonassama Health District.
5- Why was your community chosen for this study?
Environmental conditions favors the spread of infectious diseases which can be prevented
by vaccination.
6- What type of information will be collected?
Demographic information which includes; age, sex, marital status and religion. Also
information on their knowledge, qttitute and practice with regards to immunization.
7- What will happen to the data collected?
It will be kept confidential
8- How much of your time will be needed for the interview?
Approximately 30 minutes
9- Who approved your study?
The study was approved by Alpha Higher Institute Douala.
10- What will the participants benefit?
Data collected and result from the study will be used to develop a health module
That will be used to give health talk in the communities involved
11- What will be the inconveniences of the participation?
Time constrain, language and the sensitive nature of the topic.
12- What should you do in case of any worries about the study?
Ask the researcher to explain things to you so you can better understand.

32
PART 2: INFORMED CONCERN FORM
Do you agree taking part in the study?
After reading and understanding the context and content of the research, I agree to take part in
the study titled Assessment of mother’s knowledge, attitude and practices of mothers towards
immunization of children 0 – 12 months of age in Bonassama Health District.
Name of Participant Signature of principal investigator
……………………………………….. ……………………………………….
Signature of participant Date
………………………………………… ………………………………………

33
QUESTIONNAIRE
Dear respondent,
I am …...... a student from ………... I am carrying out a research on the topic …………
You have conveniently been chosen to participate in this study. This work is a purely for
academic purpose. All information provided is strictly confidential. I will appreciate your just
and honest responses.
SECTION A: SOCIO-DEMOGRAPHIC CHARACTERS OF THE

STUDIED PARENTS AND CHILDREN,
Childs age group (months) A. 0-3 months, B. 4-6months,
C. 7-10month, D. 11-12months
Sex of child A. Male, B. Female
Marital status of participant A. Married, B. Single, C. Divorced,
D. Widow
Fathers educational level A. Illiterate B. Primary,
B. C. Secondary, D. University
Mothers educational level A. Illiterate B. Primary,
C. Secondary, D. University
Number of children A. 1, B. 2, C. 3, D. 4, E. 5+
Mothers age group (Years) A. <20, B. 20-30, C. 31-40, D. 41+
Fathers age group (Years) A. 20-30, B. 31-40, C. 40-50,
D. 50+
Mothers occupation A. Employed, B. Not employed,
C. student
Fathers occupation
A. Employed, B. Not employed,
C. student
Religion of participant A. Muslim, B. Christian, C. Non
Ethnicity of participant
Living status A. Own home , B. Rent home,
C. Other
Residence of participant with respect to chosen a) Mabanda B. Grand Hangar,
community C. Ngwelle D. Ndobo
E. Centre Caise, F. Bonassama
Immunization status of parents Mother: A. Yes, B. No

Father: A. Yes, B. No

34
SECTION B: ASSESSMENT OF MOTHERS’ KNOWLEDGE ON IMMUNIZATION
Have you ever heard about immunization? A. Yes, B. No, C. I don’t know
Where did you get information about A. Mass media (TV, Radio,
vaccination? Literature/Poster, News paper, internet)
B. Interpersonal (Health workers, family
members and relatives, school
teacher/development worker)
Are you sure that vaccines are important to A. Yes, B. No, C. I don’t know
your child
Do you think immunization reduces the A. Yes, B. No, C. I don’t know
probability of death or illness to a child?
Do you think vaccination reduces the number A. Yes, B. No, C. I don’t know
of infectious diseases?
Does immunization have a role on a child’s A. Yes, B. No, C. I don’t know
health?
Do you know that vaccines are different and A. Yes, B. No, C. I don’t know
are administered with respect to age?
Are you aware that vaccination is accompanied A. Yes, B. No, C. I don’t know
with side effects such as fever?
Are you sure that low grade fever and diarrhea A. Yes, B. No, C. I don’t know
are contraindications for vaccines?
Do you think even healthy children need A. Yes, B. No, C. I don’t know
vaccination?
Immunization stops children from developing A. Yes, B. No, C. I don’t know
properly
With respect to the EPI calendar,
Vaccines are administered to children once A. Yes, B. No, C. I don’t know
every month
BCG is administered at six weeks after birth A. Yes, B. No, C. I don’t know
A total of five appointments are given within 9 A. Yes, B. No, C. I don’t know
months after birth
If your child has fever after being administered A. Yes, B. No, C. I don’t know
a vaccine, stop vaccinating your child
Do you know that some vaccines are A. Yes, B. No, C. I don’t know
administered after nine months of age and
which are out of the EPI vaccination program?

35
SECTION C: ASSESSMENT OF ATTITUDE OF MOTHERS TOWARDS

IMMUNIZATION
Have you given your child mandatory vaccines A. Yes, B. No, C. I don’t know
with respect to his/her age?
Do you respect the EPI vaccination calendar for A. Yes, B. No, C. I don’t know
your child and respect all appointment dates?
How do you feel after a vaccine is administered A. Secured, B. Fear
to your child?
Do you advice your friends and relatives to A. Yes, B. No, C. I don’t know
vaccinate their children?
What is your assessment of your child’s A. Not important B. Important
vaccination? C. Very important
Are you keen to complete all doses of vaccination A. Yes, B. No, C. I don’t know
when there is more than one dose?
Do you always make up time to accompany your
son/daughter at vaccination center on the days of
their appointment?
Did you stop vaccination when your child
developed fever from previous vaccine?
What usually remind you of the next appointment
date of your child’s vaccine?
What do you do if you miss a vaccination
session?
SECTION D: ASSESSING PRACTICES OF MOTHERS TOWARDS CHILD

IMMUNIZATION.
Do you adhere to immunization schedule? A. Yes, B. No, C. I don’t know

How do you confirm that a child has been
administered BCG?
Do you have the EPI vaccination card for your A. Yes, B. No, C. I don’t know
child?
Have you been taking your Tetanus Toxoid A. Yes, B. No, C. I don’t know
vaccination during pregnancy?
Immunization status of infants (age <9 A. Took all vaccines appropriate for the
months) age
B. Not took all vaccines appropriate for
the age
Immunization status of infants (age > 9 months) A. Fully immunized
B. Partially immunized

36
Examine and complete the table by filling in the blank spaces
Vaccines Appointment date for Actual date for vaccination

vaccination
BCG
DPT
Hepatitis
OPV
Measles
Yellow fever
What are the reasons for missed vaccination sessions?
a) Mother was too busy

b) There was a family problem
c) The vaccine was not available
d) The time for immunization was not convenient
e) I postponed it to another time
f) The child was ill, was brought but not immunized
g) The child was ill, was not brought
h) Wasn’t aware of the need for a second or third dose
i) don’t believe in the vaccine
j) Was not aware of the need for immunization.
k) Heard bad things about immunization
l) Did not know the place and time for immunization
m) Long queue and waiting time
n) Strike (industrial action by health workers)
Thanks a lot for your time and kind participation/

37

38

Mothers' Knowledge and Attitudes Towards Child Immunization

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Mothers' Knowledge and Attitudes Towards Child Immunization

Uploaded by

Copyright:

Available Formats

ASSESSMENT OF KNOWLEDGE, ATTITUDES AND PRACTICES OF MOTHERS REGARDING IMMUNIZATION

TO CHLDREN 0 – 12 MONTHS IN BONASSAMA HEALTH DISTRICT.

CHAPTER ONE: INTRODUCTION

The World Health Organization (WHO) has defined immunization as the

Written and presented by ERIC EPAH et al.

1.2 RESEARCH PROBLEM

1.3 RESEARCH QUESTION

Written and presented by ERIC EPAH et al.

1.4 RESEARCH HYPOTHESIS

1.5 RESEARCH OBJECTIVES

1.5.1 GENERAL OBJECTIVE

To assess knowledge, attitude and practices of mothers towards immunization of children 0 – 12

1.5.2 SPECIFIC OBJECTIVES

1. To assess knowledge of mothers of children 0 – 12 months old regarding immunization.

2. To assess the attitude of mothers of children 0 – 12 months of age with respect to

3. To assess the practices of mothers of children 0 – 12 months towards immunization.

4. To establish a correlation between mother’s educational level and knowledge of children

1.6 SCOPE OF THE STUDY

1.7 SIGNIFICANCE OF THE STUDY

1.8 CONTEXTUAL DEFINITION OF TERMS

Assessment: - It is the organized systematic and continuous process of collecting data

Attitude: - Refers to opinion of mothers towards vaccination.

The study assumes that,

i. Mothers play an active role in preventing child hood infections by immunization of

Written and presented by ERIC EPAH et al.

Written and presented by ERIC EPAH et al.

Table 2.1: Immunization Schedule for Vaccines used in Cameroon

Written and presented by ERIC EPAH et al.

towards immunization of infants. Good infant immunization practice was significantly

Written and presented by ERIC EPAH et al.

Written and presented by ERIC EPAH et al.

Written and presented by ERIC EPAH et al.

3.2 STUDY AND STUDY DESIGN

3.3 TARGET POPULATION

3.4 SAMPLE AND SAMPLE SIZE CALCULATION

Margin of error (e) =0.05

3.5 SAMPLING TECHNIQUE

3.6.2 EXCLUSION CRITERIA

3.7 STUDY VARIABLES

Dependent variable: Knowledge, attitude and practice of mothers of children 0 – 12 months.

Attributing variable: Demographic data of mothers including age, religion, education,

3.8 SAMPLE AND SAMPLING TECHNIQUES.

3.9 DATA COLLECTION METHOD.

3.10 DATA COLLECTION TOOLS AND MATERIALS.

3.11 DATA MANAGEMENT AND STATISTICAL PLAN

Written and presented by ERIC EPAH et al.

3.12 ETHICAL CONSIDERATIONS

Table 3.1: activity time line

Phase6: Data analysis X x

Written and presented by ERIC EPAH et al.

NO ITEMS QUANTITY UNIT COST TOTAL

2 Personal motivation 1 20000 20000

4 Ethical Clearance and 1 25000 25000

Written and presented by ERIC EPAH et al.

DATA PRESENTATION AND ANALYSIS

Results from survey of mothers in Bonassama Health District.

4.1 SECTION A: SOCIO – DEMOGRAPHIC CHARACTERISTICS OF THE STUDIED

Figure 4.1: showing the sex of children sample in the study.

Table 4.2: illustrates age of children chosen for the study

Written and presented by ERIC EPAH et al.

Figure 4.1:: Distribution of the age of mothers sampled

100 174 Frequency

Table 4.3:: Marital Status of the mothers