Predictors of Full Childhood Immunization Status in Owerri, Nigeria

Predictors of Full Childhood Immunization Status in Owerri, Nigeria by Osuala Kelvin MPH, University of Calabar, 2008 BS, University of Nigeria, 1996 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University March 2015 Abstract Full (complete) childhood immunization against tuberculosis, poliomyelitis, diphtheria, tetanus, hepatitis B, yellow fever, measles, and the maternal retention of immunization documentation are the most cost-effective interventions against vaccine-preventable childhood diseases. The full childhood immunization rate in Nigeria has not reached the expected target level of compliance at 90%. Using the social ecological model, this study investigated the influence of maternal satisfaction with postnatal services and paternal support on full childhood immunization status; it also examined the association between maternal factors and the maternal retention of immunization documentation in Owerri, Nigeria. The hypotheses were that maternal satisfaction with postnatal services and paternal support were associated with full childhood immunization status. This study was a quantitative, cross-sectional survey design that included validated modified WHO/EPI-30 cluster immunization survey information from the cluster sample of 560 mothers of children between the ages of 12 and 23 months old. The multivariate logistic regression analysis (at the .05 level) indicated that the odds of full childhood immunization status were lower for participants who indicated no maternal satisfaction with postnatal services compared with those who indicated satisfaction with postnatal services. Public health workers and policymakers should invest more resources in maternal and child health care resources to increase maternal satisfaction with postnatal services. The study outcomes may help to evolve a system that may increase childhood immunization status and reduce vaccine-preventable diseases in Owerri, and serve as a model for other countries.Full (complete) childhood immunization against tuberculosis, poliomyelitis, diphtheria, tetanus, hepatitis B, yellow fever, measles, and the maternal retention of immunization documentation are the most cost-effective interventions against vaccine-preventable childhood diseases. The full childhood immunization rate in Nigeria has not reached the expected target level of compliance at 90%. Using the social ecological model, this study investigated the influence of maternal satisfaction with postnatal services and paternal support on full childhood immunization status; it also examined the association between maternal factors and the maternal retention of immunization documentation in Owerri, Nigeria. The hypotheses were that maternal satisfaction with postnatal services and paternal support were associated with full childhood immunization status. This study was a quantitative, cross-sectional survey design that included validated modified WHO/EPI-30 cluster immunization survey information from the cluster sample of 560 mothers of children between the ages of 12 and 23 months old. The multivariate logistic regression analysis (at the .05 level) indicated that the odds of full childhood immunization status were lower for participants who indicated no maternal satisfaction with postnatal services compared with those who indicated satisfaction with postnatal services. Public health workers and policymakers should invest more resources in maternal and child health care resources to increase maternal satisfaction with postnatal services. The study outcomes may help to evolve a system that may increase childhood immunization status and reduce vaccine-preventable diseases in Owerri, and serve as a model for other countries. Predictors of Full Childhood Immunization Status in Owerri, Nigeria by Osuala Kelvin MPH, University of Calabar, 2008 BS, University of Nigeria, 1996 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Public Health Walden University March 2015 Dedication To God Almighty through our Lord Jesus Christ I dedicate this dissertation. I thank God for using early missionaries to establish schools in my village, Addi, Abaja, Nigeria, where I commenced my primary education. My darling wife, Mrs. Roseline Osuala, who has been supportive to my academics and make life joyful for me, I thank you. I also appreciate my son, Titus, and other family members whose contributions are constructive to the realization of my educational dreams. Acknowledgments I have to commend the ingenuity of the founders and employees of Walden University for creating the opportunity for busy individuals to study for higher degrees. I have to express my heartfelt indebtedness to Dr. Tammy Root for her effort in ensuring that my dissertation process experience is rewarding. I am grateful to my chair, Dr. James Rohrer for his patience, commitment and high display of professionalism and hard work in guiding my dissertation process. I can say he is the epitome of a mentor per excellence. My committee members: Dr. Mark White and Dr. David Segal are excellent mentors too. I appreciate their invaluable professional review and inputs to my dissertation. Dr. Kelly Chermack, my editor also did a great work, I am grateful to him. I would like to express my sincere gratitude to Dr. Mike Anibueze and Dr. Mansur Kabir, chairmen of the Board of the West Africa Health Examination for the immense support to me in this study. My thanks go to the West Africa Health Examination Board, members of the Board and staff for the support they gave to my study at Walden University. At this moment, I will like to remember all my teachers at all levels and my fellow learners, they are all great men and women. I thank you all.