Project – The Role of Immunization in the Reduction of Childhood Mortality in Nigeria. A study of Selected Health Centres in Kaduna South LGA.

CHAPTER ONE
INTRODUCTION

1.1 Background to the Study

Childhood mortality remains one of the most critical public health challenges in developing countries, particularly in sub-Saharan Africa, where preventable diseases continue to claim the lives of millions of children under the age of five. According to the World Health Organization (WHO, 2022), over 5 million children under five years died globally in 2021, with a significant proportion of these deaths resulting from vaccine-preventable diseases such as measles, pneumonia, and polio. Immunization has been recognized as one of the most effective and cost-efficient public health interventions for reducing child mortality and preventing communicable diseases (UNICEF, 2021).

Immunization involves administering vaccines to stimulate the immune system against specific diseases, thus preventing illness, disability, and death. Through routine immunization programs, diseases that previously caused widespread mortality have been significantly reduced or eradicated in many parts of the world. The Global Alliance for Vaccines and Immunization (GAVI, 2020) estimates that immunization prevents between 2 to 3 million deaths annually worldwide. In Nigeria, immunization plays a vital role in reducing the incidence of deadly diseases among children under five, including polio, diphtheria, tetanus, whooping cough, and measles (National Primary Health Care Development Agency [NPHCDA], 2021).

Despite its proven benefits, Nigeria continues to record high rates of child mortality, partly due to low immunization coverage, poor vaccine accessibility, inadequate health infrastructure, and limited parental awareness (Adeyemi & Bello, 2022). The 2018 Nigeria Demographic and Health Survey (NDHS, 2019) revealed that only 31% of children aged 12–23 months were fully immunized, far below the global target of 90%. Inadequate vaccine supply, weak cold chain systems, and socio-cultural factors contribute to the persistence of vaccine-preventable diseases (NPC & ICF, 2019).

Kaduna State has made notable progress in immunization coverage through various health campaigns supported by government and development partners, including WHO and UNICEF. However, disparities still exist across local government areas (LGAs). In Kaduna South LGA, several health centres continue to report outbreaks of preventable diseases such as measles and meningitis among unvaccinated children (Kaduna State Ministry of Health, 2021). Parental ignorance, religious misconceptions, and logistical challenges in vaccine delivery remain key obstacles to achieving full immunization coverage (Usman et al., 2021).

The reduction of childhood mortality through effective immunization coverage is essential for achieving Sustainable Development Goal (SDG) 3, which aims to end preventable deaths of newborns and children under five years by 2030 (United Nations, 2020). Therefore, evaluating the role of immunization in reducing childhood mortality is not only crucial for public health planning but also for improving the quality of life of Nigerian children.

This study seeks to assess the effectiveness of immunization programs in reducing child mortality in Nigeria, focusing on selected health centres in Kaduna South Local Government Area. It will analyze the relationship between immunization coverage, vaccine accessibility, parental awareness, and the mortality rate among children under five years.

1.2 Statement of the Problem

Nigeria remains one of the countries with the highest child mortality rates globally, despite the availability of free immunization services at public health facilities. According to WHO (2022), Nigeria accounts for nearly 15% of global under-five deaths, many of which are caused by diseases that could have been prevented through timely vaccination. The persistence of such preventable deaths raises critical questions about the effectiveness of immunization campaigns and the accessibility of vaccines in local communities.

In Kaduna South LGA, periodic health reports indicate that many children still suffer from diseases such as measles, tetanus, and pneumonia due to incomplete or non-existent vaccination (Kaduna State Ministry of Health, 2021). Factors such as poor health infrastructure, vaccine stock-outs, and low parental awareness continue to hinder the full success of immunization programs. Moreover, cultural and religious misconceptions sometimes lead parents to reject immunization, leaving children vulnerable to preventable diseases (Usman et al., 2021).

While the Nigerian government and international partners have intensified efforts through programs such as the Expanded Programme on Immunization (EPI), the coverage remains inconsistent across regions and communities. The persistence of childhood deaths from preventable diseases underscores the need to critically assess how immunization initiatives have impacted mortality rates and to identify barriers limiting their effectiveness. This study, therefore, investigates the role of immunization in reducing childhood mortality in Kaduna South LGA, with emphasis on vaccine accessibility, parental awareness, and health service delivery.

1.3 Objectives of the Study

The main objective of this study is to evaluate the role of immunization in reducing childhood mortality in Nigeria, using selected health centres in Kaduna South Local Government Area as a case study.

The specific objectives are to:

1. Assess the level of immunization coverage among children under five years in Kaduna South LGA.

2. Examine the accessibility and availability of vaccines in selected health centres.

3. Determine the level of parental awareness and attitudes toward child immunization.

4. Analyze the relationship between immunization coverage and the rate of childhood mortality in Kaduna South LGA.

1.4 Research Questions

1. What is the level of immunization coverage among children under five years in Kaduna South LGA?

2. How accessible and available are vaccines in the selected health centres?

3. What is the level of parental awareness and attitude toward immunization in Kaduna South LGA?

4. What is the relationship between immunization coverage and childhood mortality in Kaduna South LGA?

1.5 Research Hypothesis

H₀: There is no significant relationship between immunization coverage and the reduction of childhood mortality in Kaduna South Local Government Area.

1.6 Significance of the Study

This study is significant for several reasons. Firstly, it provides empirical evidence on the role of immunization in reducing child mortality, particularly within the context of Kaduna South LGA. The findings will help policymakers and health practitioners identify gaps in immunization coverage and develop strategies to enhance vaccine accessibility and parental education.

Secondly, the study contributes to academic knowledge and public health literature by providing insights into how immunization impacts child survival in a developing country context. It will serve as a valuable reference for future researchers, students, and development partners working on immunization and maternal-child health issues.

Thirdly, for health administrators and community leaders, the study highlights practical recommendations for improving immunization campaigns, addressing vaccine hesitancy, and strengthening the delivery of primary health care services. The results will also guide the Kaduna State Ministry of Health and related agencies in implementing targeted interventions aimed at reducing child mortality and achieving SDG 3.

1.7 Scope of the Study

This study focuses on the role of immunization in reducing childhood mortality in Nigeria, with a specific focus on selected health centres in Kaduna South Local Government Area. The research examines key variables such as immunization coverage, vaccine accessibility, parental awareness, and child mortality rates. It will involve mothers or caregivers of children under five years and health personnel working in immunization units within the selected centres. The findings, while based on Kaduna South LGA, may reflect similar trends across other regions in Nigeria.

1.8 Operational Definition of Terms

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

• Vaccine Accessibility: The ease with which individuals can obtain vaccines from health centres, including physical availability and affordability.

• Immunization Coverage: The proportion of children who have received the recommended vaccines for their age group.

• Parental Awareness: The knowledge, attitudes, and beliefs of parents or caregivers regarding the importance of child immunization.

• Childhood Mortality: The death of children under the age of five, often measured per 1,000 live births within a population.

1.9 Organization of the Study

This research is organized into five chapters. Chapter One presents the introduction, statement of the problem, objectives, research questions, hypothesis, significance, scope, and definition of terms. Chapter Two reviews relevant literature on immunization and childhood mortality. Chapter Three discusses the research methodology adopted for the study. Chapter Four presents data analysis and interpretation, while Chapter Five provides the summary, conclusion, and recommendations

Project – The Role of Immunization in the Reduction of Childhood Mortality in Nigeria. A study of Selected Health Centres in Kaduna South LGA.