Project – Evaluation of Immunization Coverage and Determinants of Vaccine Uptake in Primary Health Centres in Abeokuta South LGA, Ogun State

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Immunization is one of the most cost-effective public health interventions for preventing infectious diseases and reducing child morbidity and mortality worldwide. It involves the administration of vaccines to stimulate the immune system to develop protection against vaccine-preventable diseases such as measles, diphtheria, pertussis, tuberculosis, hepatitis B, and polio. The World Health Organization (WHO) emphasizes that immunization currently prevents an estimated 3.5–5 million deaths annually across the globe (WHO, 2023).

Globally, significant progress has been made in expanding immunization coverage through initiatives such as the Expanded Programme on Immunization (EPI), established in 1974. Despite these gains, disparities still exist between high-income and low- and middle-income countries. In many developing regions, vaccine-preventable diseases remain a major cause of child mortality due to low immunization coverage, vaccine hesitancy, inadequate health infrastructure, and uneven access to healthcare services.

In Sub-Saharan Africa, immunization coverage remains below global targets, with several countries struggling to achieve full vaccination for children under five years. Factors such as geographical barriers, insecurity, poor health education, cultural beliefs, and weak health systems contribute to suboptimal vaccine uptake. These challenges undermine efforts to achieve Sustainable Development Goal 3, which aims to ensure healthy lives and promote well-being for all at all ages.

In Nigeria, immunization services are delivered through the National Primary Health Care Development Agency (NPHCDA) in collaboration with state and local governments. Despite ongoing efforts, Nigeria continues to rank among the countries with a high number of zero-dose children—children who have not received any routine vaccines. According to WHO and UNICEF estimates, Nigeria accounts for a significant proportion of global unvaccinated children, indicating persistent gaps in immunization coverage.

In Ogun State, immunization services are provided through primary health centres (PHCs) and outreach programmes. However, coverage levels vary across local government areas due to differences in access, awareness, and health service delivery capacity. One of such areas is Abeokuta South Local Government Area, where primary health centres serve as the first point of contact for maternal and child health services, including routine immunization.

Despite the availability of vaccines in these facilities, anecdotal evidence suggests that full immunization coverage is not yet achieved. Some children miss scheduled doses, while others do not complete the immunization schedule. This situation raises concerns about the determinants influencing vaccine uptake, including maternal education, distance to health facilities, cultural beliefs, fear of side effects, and health worker attitudes.

Understanding immunization coverage and the determinants of vaccine uptake is critical for improving child health outcomes and preventing outbreaks of vaccine-preventable diseases. Therefore, this study seeks to evaluate immunization coverage and identify the key factors influencing vaccine uptake in primary health centres in Abeokuta South LGA, Ogun State.

1.2 Statement of the Problem

Immunization remains a fundamental strategy for reducing child mortality and controlling infectious diseases. However, despite the availability of effective vaccines and government-led immunization programmes, full vaccine uptake is yet to be achieved in many parts of Nigeria.

In Abeokuta South Local Government Area, primary health centres are expected to provide routine immunization services to children under five years. Nevertheless, reports from health facilities and community observations indicate that a significant number of children either miss scheduled immunization appointments or fail to complete the full vaccination schedule.

This situation poses a serious public health concern because incomplete immunization increases the risk of outbreaks of preventable diseases such as measles, whooping cough, and polio. It also weakens herd immunity within communities, making vulnerable populations more susceptible to infection.

Several factors may contribute to low immunization uptake in the area. These include long waiting times at health facilities, inadequate availability of vaccines, poor awareness among mothers and caregivers, cultural and religious misconceptions, distance to health centres, and negative attitudes of some healthcare workers. However, the extent to which these factors influence vaccine uptake in Abeokuta South LGA has not been sufficiently documented.

Furthermore, there is limited localized empirical evidence on immunization coverage levels within specific primary health centres in the area. Without such data, it becomes difficult for policymakers and health administrators to design targeted interventions aimed at improving vaccine uptake and achieving full immunization coverage.

It is against this background that this study evaluates immunization coverage and the determinants of vaccine uptake in primary health centres in Abeokuta South Local Government Area, Ogun State.

1.3 Objectives of the Study

The main objective of this study is to evaluate immunization coverage and determinants of vaccine uptake in primary health centres in Abeokuta South LGA, Ogun State.

Specifically, the study aims to:

1. Assess the level of immunization coverage among children under five years in Abeokuta South LGA.
2. Identify the determinants influencing vaccine uptake among caregivers.
3. Examine the relationship between socio-demographic factors and immunization completion rates.
4. Determine the challenges affecting effective immunization delivery in primary health centres.

1.4 Research Questions

1. What is the level of immunization coverage in primary health centres in Abeokuta South LGA?
2. What factors influence vaccine uptake among caregivers?
3. Is there a relationship between socio-demographic characteristics and immunization completion?
4. What challenges affect immunization delivery in the study area?

1.5 Research Hypothesis

H₀: There is no significant relationship between socio-demographic factors and vaccine uptake in primary health centres in Abeokuta South Local Government Area, Ogun State.

H₁: There is a significant relationship between socio-demographic factors and vaccine uptake in primary health centres in Abeokuta South Local Government Area, Ogun State.

1.6 Significance of the Study

This study is significant in several ways. First, it will provide updated empirical data on immunization coverage in Abeokuta South LGA, which can guide health planning and resource allocation. Second, it will help policymakers and public health authorities identify key barriers to vaccine uptake and design targeted interventions. Third, the findings will assist healthcare workers in improving service delivery and community engagement strategies. Finally, the study will contribute to academic literature on immunization coverage and child health in Nigeria.

1.7 Scope of the Study

This study is limited to primary health centres in Abeokuta South Local Government Area, Ogun State. It focuses on immunization coverage among children under five years and the determinants of vaccine uptake among caregivers, including socio-demographic, cultural, and health system-related factors.

1.8 Operational Definition of Terms

Immunization Coverage: The proportion of eligible children who have received all recommended vaccines within a defined period.

Vaccine Uptake: The acceptance and administration of vaccines by caregivers for their children according to the recommended schedule.

Primary Health Centre: A basic healthcare facility that provides preventive, promotive, and curative services at the community level, including immunization services.

Determinants: Factors that influence or affect the uptake of vaccines, including socio-economic, cultural, and health system-related variables.

Project – Evaluation of Immunization Coverage and Determinants of Vaccine Uptake in Primary Health Centres in Abeokuta South LGA, Ogun State