Project – Factors Influencing Uptake of Routine Immunization Among Mothers/Caregivers in Sabon Gari Local Government Area, Kaduna State

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Routine immunization remains one of the most cost‑effective public health interventions for reducing childhood morbidity and mortality from vaccine‑preventable diseases such as measles, poliomyelitis, tuberculosis, diphtheria, pertussis, tetanus, hepatitis B, and yellow fever. Globally, immunization prevents an estimated 4–5 million deaths annually, yet millions of children—particularly in low‑ and middle‑income countries—remain partially immunized or unimmunized due to persistent health system, socio‑economic, cultural, and individual‑level barriers (World Health Organization [WHO], 2022).

In sub‑Saharan Africa, routine immunization coverage has improved over the past decades; however, progress has been uneven across and within countries. Nigeria continues to bear a disproportionate burden of vaccine‑preventable diseases despite having one of the largest immunization programs in Africa. National surveys have consistently shown suboptimal full immunization coverage, with marked regional disparities that disadvantage northern states, including Kaduna State (National Population Commission [NPC] & ICF, 2019).

Routine immunization services in Nigeria are delivered primarily through primary health care facilities and are offered free of charge under the National Programme on Immunization (NPI), now integrated into the National Primary Health Care Development Agency (NPHCDA). Despite the availability of these services, uptake remains influenced by multiple interacting factors. Maternal education, household socio‑economic status, access to health facilities, quality of service delivery, health worker attitudes, vaccine availability, and community trust in health systems have all been identified as key determinants (Antai, 2012; Favin et al., 2012).

Mothers and caregivers play a central role in childhood immunization decisions, as they are typically responsible for seeking preventive health services for their children. Their knowledge of immunization schedules, perceptions of vaccine safety and efficacy, cultural and religious beliefs, previous experiences with health services, and competing household demands significantly shape uptake. In some northern Nigerian communities, misconceptions about vaccines, gender dynamics that limit women’s autonomy, and security or mobility challenges further compound barriers to full immunization (Gavi, 2021).

Sabon Gari Local Government Area (LGA) of Kaduna State is an urban and peri‑urban area characterized by ethnic, religious, and socio‑economic diversity, with a high level of population mobility due to trade, education, and employment. While proximity to health facilities may be relatively better than in rural LGAs, routine immunization coverage remains inconsistent. Urban poor settlements, informal housing, and migrant populations may experience gaps in service utilization, missed opportunities for vaccination, and poor follow‑up for subsequent doses. Understanding context‑specific factors influencing routine immunization uptake among mothers and caregivers in Sabon Gari LGA is therefore critical for designing targeted and effective interventions.

1.2 Statement of the Problem

Despite national and state‑level efforts to improve routine immunization coverage, Kaduna State continues to report cases of vaccine‑preventable diseases and suboptimal completion of recommended immunization schedules. Evidence suggests that a significant proportion of children do not receive all age‑appropriate vaccines, or receive them late, thereby remaining vulnerable during critical periods of early childhood (NPC & ICF, 2019).

In Sabon Gari LGA, the presence of health facilities and immunization services has not consistently translated into optimal uptake among all population groups. Missed immunization appointments, incomplete vaccination schedules, and reliance on supplemental immunization activities indicate underlying challenges in routine service utilization. These challenges may stem from inadequate maternal knowledge of immunization benefits and schedules, negative perceptions or fears regarding vaccine safety, long waiting times at health facilities, poor communication by health workers, and socio‑economic constraints such as transportation costs and competing livelihood demands.

Furthermore, urban diversity in Sabon Gari LGA introduces additional complexities, including language barriers, cultural heterogeneity, and varying levels of trust in public health institutions. Without a clear understanding of the specific factors influencing mothers’ and caregivers’ decisions and behaviors regarding routine immunization in this setting, interventions may remain generalized and insufficiently responsive to local needs. This study therefore seeks to identify and analyze the factors influencing uptake of routine immunization among mothers and caregivers in Sabon Gari Local Government Area, Kaduna State, to inform evidence‑based strategies for improving coverage and child health outcomes.

1.3 Objectives of the Study

General Objective
To assess the factors influencing uptake of routine immunization among mothers and caregivers in Sabon Gari Local Government Area, Kaduna State.

Specific Objectives

1. To assess the level of uptake of routine immunization among children of mothers/caregivers in Sabon Gari LGA.
2. To determine mothers’/caregivers’ knowledge of routine immunization and immunization schedules.
3. To examine socio‑demographic factors influencing uptake of routine immunization.
4. To identify health system–related factors affecting routine immunization uptake.

1.4 Research Questions

1. What is the level of uptake of routine immunization among children in Sabon Gari LGA?
2. What is the level of knowledge of routine immunization among mothers/caregivers?
3. Which socio‑demographic factors influence routine immunization uptake in Sabon Gari LGA?
4. What health system factors affect uptake of routine immunization in the study area?

1.5 Research Hypothesis

H₁: There is a significant relationship between mothers’/caregivers’ level of knowledge and uptake of routine immunization among children in Sabon Gari Local Government Area, Kaduna State.

1.6 Significance of the Study

The findings of this study will provide empirical evidence on context‑specific factors influencing routine immunization uptake in Sabon Gari LGA. The results will be useful to policy makers, Kaduna State Ministry of Health, NPHCDA, and local health managers in designing targeted strategies to improve routine immunization services. Health workers may benefit from insights into caregiver perceptions and service delivery gaps, while researchers and students may use the study as a reference for further research on immunization uptake in similar settings.

1.7 Scope of the Study

This study focuses on mothers and primary caregivers of children aged 0–23 months residing in Sabon Gari Local Government Area, Kaduna State. It examines socio‑demographic, knowledge‑related, and health system factors influencing routine immunization uptake. The study does not assess the clinical effectiveness of vaccines.

1.8 Operational Definition of Terms

• Routine Immunization: The regular administration of recommended vaccines to children according to the national immunization schedule.
• Uptake: The extent to which children receive age‑appropriate routine immunization vaccines.
• Mothers/Caregivers: Women or other primary caretakers responsible for the health and wellbeing of children.
• Vaccine‑Preventable Diseases: Infectious diseases that can be prevented through vaccination.

Project – Factors Influencing Uptake of Routine Immunization Among Mothers/Caregivers in Sabon Gari Local Government Area, Kaduna State