1
10
should be more enlightenment campaign especially on
whether there is overdose of immunization or the impli-
cation for a child who receives the same immunization
at school and at church or health centre.”
in South Africa, in contrast, revealed a negative attitude
towards traditional medicine among caregivers of under
5s with the majori9ty believing that it cannot prevent
childhood illnesses.
“There should be incentives for mothers who bring their
babies for immunization e.g. giving them insecticide
treated nets or baby pampers (diapers).”
Apart from the appreciation of the benefit of immuniza-
tion, the respondents’ attitude left much to be desired.
About a third of them would not be willing to take their
children back for immunization if they developed com-
mon side effects of immunization such as mild fever and
soreness at the injection site. Significant proportions
would not take their child for immunizations for several
conditions that were not contraindications such as anti-
biotics use, recent recovery from illness, family history
of convulsions, mental challenges etc.
“Government should ensure that vaccines are available
at all times.”
The female participants identified more barriers to pa-
tronage: ignorance, fear of side effects, time consump-
tion, unwillingness to leave work and discouragement
when visits are made to the hospital without immuniza-
tion. They made similar recommendations as the male
participants.
Mothers in a semi-urban commu0 nity in India shared
1
some of these erroneous beliefs. Interestingly, almost
Discussion
all the respondents reported that their children had com-
pleted their immunization; this study however did not
ascertain age(s) of completion. The implication of this is
that children’s immunizations would be avoidably
missed and even if the schedule is completed it could be
at ages older than required because of missed opportu-
nity. These delays in immunization expose children to
VPDs. Over 40% of respondents would not allow their
children to be given supplemental polio vaccine during
National Immunization Days possibly because of a pref-
erence for routine immunization to mass immunization
Most (77.8%) of the respondents had correct under-
standing of the meaning of immunization and this could
be attributed to their high level of education. Similarly,
6
3.7% of mothers in a rural community in Edo state had
correct knowledge of the definition/purpose of immuni-
4
zation. Respondents in our study shared similar educa-
tional status with the Edo mothers. The respondents
were however not so knowledgeable about the different
types of immunization with measles being the most
commonly mentioned by a little more than half of re-
spondents. There were also some misconceptions identi-
fied among the female FGD participants regarding tim-
ing of polio vaccine and contraindications of immuniza-
tion. This underscores the need for health education in-
tervention to fill in the gaps in knowledge about
immunization. Health workers, being the most common
source of information in this survey will be useful in this
regard.
6
as was observed in Turkey or because they have not
been educated on the additional benefit it offers towards
herd immunity and the eradication of polio or because of
the fear of overdose. Limited acceptance coupled with
ongoing operational problems have resulted in low vac-
cination covera1ge and continued poliovirus transmission
1
in the country. We recommend that a lot more commu-
nity-based enlightenment programs should be carried
out among men and women to address misconceptions
and encourage the uptake of supplemental polio vaccine.
The respondents in this study perceived immunization to
be beneficial and this was similar to findings from the
Edo study and a qualitative research among
Mothers were entrusted with the sole responsibility of
immunization similar to findings in Turkey. The men
9
4
, 8
socio-economically challenged mothers in Turkey.
often supported with transportation money to the clinic.
It appears that gender roles in this setting may limit male
involvement in immunization; they identified laziness
on the part of the mothers as a barrier to accessing im-
munization services but did not identify non-
involvement of men as one. The implication of this is
that a mother in this community who does not appreciate
the benefit of immunization on her own may not take
her children for this service especially without the en-
couragement of her male partner. Interventions to im-
prove immunization uptake should thus include male
members of the community to ensure their active partici-
pation in childhood immunization.
Interestingly, the male FGD participants and not the
female felt that immunizations could also be disadvanta-
geous; they mentioned the possibility of side effects
such as fever and swelling and also more grievous con-
ditions such as paralysis or death. There appears to be
some mixing up of their knowledge with myths which
may adversely affect uptake of immunization if not ad-
dressed through health education. They seem to associ-
ate these negative conditions with poorly trained health
workers. Health workers need to be properly trained as
this not only ensures effective service delivery to the
populace but would also boost the confidence of end-
users of immunization services.
Apart from logistics issues, negative attitude of clinic
staff was emphasized as another barrier to accessing
services. There is a need for health workers to treat care-
givers and children properly and with the right amount
of respect so that they would willingly approach health
facilities for immunization.
The female FGD participants identified some traditional
means by which childhood illnesses were prevented n
the community other than immunization. Sometimes,
traditional methods are mixed with orthodox methods
because of strong ties with culture. A qualitative study