Project – Evaluation of Immunization Coverage and Challenges Among Children Under Five in Jos North LGA, Plateau State

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Immunization is one of the most cost-effective public health interventions, preventing millions of deaths worldwide from vaccine-preventable diseases (WHO, 2022). Vaccines protect children from infectious diseases such as measles, polio, tuberculosis, diphtheria, pertussis, and hepatitis B, thereby reducing childhood morbidity and mortality (UNICEF, 2021). Despite global progress in immunization, sub-Saharan Africa, including Nigeria, continues to experience suboptimal immunization coverage, contributing to preventable childhood illnesses and deaths.

In Nigeria, approximately 30% of children under five years of age remain partially immunized or unimmunized, exposing them to high risks of vaccine-preventable diseases (National Primary Health Care Development Agency [NPHCDA], 2022). Plateau State, located in North-Central Nigeria, faces similar challenges. Jos North Local Government Area (LGA) is a densely populated urban center with diverse socio-economic and cultural groups, which influence health-seeking behaviors, including immunization uptake (Yakubu et al., 2020).

Several factors have been identified as influencing immunization coverage, including caregiver knowledge and awareness, socio-economic status, accessibility of health facilities, vaccine stock-outs, cultural beliefs, and perceptions about vaccine safety (Adejoh et al., 2021). Additionally, conflicts and internal displacement in certain parts of Plateau State have disrupted healthcare service delivery, further impacting immunization programs (Gumel et al., 2019).

High immunization coverage is essential not only for individual protection but also for achieving herd immunity and reducing the risk of outbreaks of preventable diseases. The Nigerian government, through the National Primary Health Care Development Agency (NPHCDA), has implemented routine immunization programs and campaigns to reach children under five. However, despite these efforts, immunization coverage remains uneven, and preventable disease outbreaks continue to occur in communities like Jos North LGA (NPHCDA, 2022).

Understanding the coverage and barriers to immunization among children under five is crucial for targeted interventions. Evaluating these factors will provide insights into gaps in service delivery, community perceptions, and logistical challenges that impede optimal vaccine uptake. Such information is vital for policymakers, healthcare providers, and NGOs to strengthen routine immunization programs and achieve the Sustainable Development Goal (SDG) target of reducing child mortality (UNICEF, 2021).

1.2 Statement of the Problem

Despite national and local immunization programs, Jos North LGA continues to experience suboptimal vaccination coverage among children under five years of age. Low immunization rates have been linked to persistent outbreaks of preventable diseases such as measles, polio, and whooping cough, which contribute significantly to childhood morbidity and mortality (Yakubu et al., 2020).

Challenges affecting immunization coverage in Jos North include inadequate access to health facilities, vaccine stock-outs, poor caregiver knowledge, misconceptions about vaccines, cultural and religious beliefs, and logistical issues in vaccine distribution (Adejoh et al., 2021; Gumel et al., 2019). Furthermore, intermittent conflicts and population movements in Plateau State have disrupted routine immunization services, leaving some children partially vaccinated or entirely unimmunized.

There is limited empirical data assessing the current immunization coverage and identifying specific barriers affecting vaccine uptake in Jos North LGA. Without such evidence, public health interventions may remain insufficiently targeted, leading to continued vulnerability of children under five to preventable diseases. Therefore, it is imperative to evaluate immunization coverage and challenges among children under five in Jos North LGA to inform strategies that enhance vaccine uptake and improve child health outcomes.

1.3 Research Objectives

The general objective of this study is to evaluate immunization coverage and identify challenges affecting vaccine uptake among children under five in Jos North LGA, Plateau State. The specific objectives are to:

1. Assess the current immunization coverage among children under five in Jos North LGA.

2. Determine the level of caregiver knowledge and awareness regarding routine immunization.

3. Identify socio-economic, cultural, and logistical factors influencing immunization uptake.

4. Examine the availability and accessibility of immunization services in the LGA.

1.4 Research Questions

1. What is the current level of immunization coverage among children under five in Jos North LGA?

2. How knowledgeable are caregivers regarding routine immunization schedules and benefits?

3. What socio-economic, cultural, and logistical factors influence immunization uptake in Jos North LGA?

4. How accessible and available are immunization services in the area?

1.5 Research Hypothesis

H₀: There is no significant relationship between socio-economic, cultural, and logistical factors and immunization coverage among children under five in Jos North LGA.
H₁: There is a significant relationship between socio-economic, cultural, and logistical factors and immunization coverage among children under five in Jos North LGA.

1.6 Significance of the Study

This study will provide empirical evidence on immunization coverage and the challenges affecting vaccine uptake in Jos North LGA. Findings will assist public health authorities, policymakers, healthcare providers, and NGOs in designing targeted interventions to improve routine immunization services, reduce the incidence of preventable diseases, and promote child health. Additionally, the study will contribute to academic literature on immunization practices in urban Nigerian communities.

1.7 Scope of the Study

The study will focus on children under five years of age residing in Jos North LGA, Plateau State, and their caregivers. It will examine immunization coverage, caregiver knowledge, and factors influencing vaccine uptake, including socio-economic, cultural, and logistical aspects. While the study is limited to Jos North LGA, findings may be relevant to other urban communities facing similar challenges in Nigeria.

1.8 Definition of Terms

1. Immunization: The process by which a person is made immune or resistant to an infectious disease, typically through the administration of a vaccine (WHO, 2022).

2. Immunization Coverage: The proportion of children under five who have received the recommended vaccines according to national schedules (NPHCDA, 2022).

3. Caregiver: An individual, usually a parent or guardian, responsible for the care and health of a child.

4. Vaccine-Preventable Diseases (VPDs): Infectious diseases that can be prevented through the administration of vaccines, such as measles, polio, and tuberculosis (UNICEF, 2021).

5. Routine Immunization: Regularly scheduled vaccination services provided at health facilities or outreach programs to prevent common childhood diseases.

6. Logistical Factors: Issues related to the availability, distribution, storage, and delivery of vaccines to healthcare facilities and communities (Adejoh et al., 2021).

Project – Evaluation of Immunization Coverage and Challenges Among Children Under Five in Jos North LGA, Plateau State