Knowledge and awareness of parents about universal immunization program and optional vaccines : a cross-sectional study in Central India

Background: One of the most cost-effective health interventions for childhood illness prevention is immunization. Parental awareness and practice towards vaccination influences the immunization rate to a great extent. This study evaluates the knowledge and awareness about universal immunization program and optional vaccines among parents, to understand their perception towards immunization, to find out determinant factors for their knowledge in association with selected demographic variables and to identify solutions to address the knowledge gap. Methods: This cross-sectional study was conducted at a tertiary care hospital in central India from January 2017December 2017. Immunization knowledge and attitude among 500 parents was evaluated through a questionnaire. Results: Eighty percent of the parents were aware about Universal immunization program although most of them didn’t know the correct name and schedule of all vaccines.Seventy five percent of parents didn’t know about the optional vaccines which are not administered as per national program. Most of the parents are unaware of the newer vaccines being available and the disease prevented by them. Parents have misconceptions regarding vaccine efficacy, side effects, safety profile. Doctors were the main source of information (75%) and mass media (television, radio, newspaper) was also underutilized but to a lesser extent. Level of knowledge directly correlated with maternal literacy (P ≤ 0.05) and to a lesser extent with fathers’ literacy and advancing age was associated with better knowledge (P ≤ 0.05). Conclusions: There is good knowledge among parents regarding Universal immunization program but limited knowledge towards newer vaccines. Every opportunity of contact with the parents should be utilized by the doctors for imparting health education. It is prudent to target young parents and especially mothers. Vaccine awareness should be enhanced through the use of mass media. Government must include these newer vaccines in the national immunization program in a phase wise manner. INTRODUCTION Child’s total health includes physical, mental and social wellbeing. It is better to prevent disease than to allow morbidity and mortality. One of the most cost-effective health interventions for disease prevention is immunization. Protection through immunization against vaccine preventable diseases, disabilities and death is the birth right of every child. Awareness regarding vaccines is important for community acceptance of the vaccine and also for maintaining their confidence in the existing vaccines. (1) Effective awareness program should be in place to convey the benefits (and expected adverse events with explanation) as well as disadvantages of not being immunized to the parents. As the social benefits of immunization are extensive and well known; any deficiency in the knowledge, Indian Journal of Basic and Applied Medical Research; March 2018, Vol.-7, Issue2, P. 585-593 586 www.ijbamr. com P ISSN: 2250-284X , E ISSN : 2250-2858 attitude and practices that leave out large sections of the most deprived populations unimmunized are a cause for serious policy concern. It has been found that factors like birth order, belonging to a very orthodox family, those residing in rural areas, maternal education, parental age specifically maternal age, socioeconomic status and family size could influence immunization coverage. There is need for studies to understand the parent’s perception towards immunization. (2) This information should be utilized for taking corrective actions. In the present study we tried to assess the knowledge and awareness about universal immunization program and optional vaccines among parents, to understand their perception towards immunization, to find out determinant factors for their knowledge in association with selected demographic variables and to identify solutions to address the knowledge gap. METHODS The study was conducted at a tertiary care hospital in Bhopal, Madhya Pradesh, India. Children from all socioeconomic strata approach the hospital for different illnesses, immunizations and routine check-up. Study population included Parents/caretakers of children (0-5 years old) who visit the hospital out-patient clinic for any of the above purposes and Parents/caretakers of in-patient children. An automated software program was used to calculate the sample size required for this study. Considering a relative precision of 5% and 95% confidence interval, the estimated sample size was 500. This crosssectional study was conducted over a period of 1 year from January 2017 December 2017. The study protocol and consent form were reviewed and approved by Ethical Committee of the hospital. Parents/caretakers were explained regarding the study and only those who consent to participate in the study after proper description and rationale of the questionnaire were included in the study. Participants were asked to fill a questionnaire including 19 statements related to knowledge and attitude of parents visiting the clinic with their children. The questionnaire consisted of two parts Section A Demographic data of the child (name, age, gender, number of siblings and birth order) and demographic data of the parents (religion, age, employment and education of both parents). Section B Questions pertaining to knowledge and perception regarding UIP and optional vaccines. Fully filled proforma were analyzed. Incomplete or partially filled proforma were excluded. The following statistics were applied: Categorical variables were presented as bar diagrams, pie charts, frequency and percentage, to measure associations between nominal variables Chi-square test was used. Test was considered significant where p value is < 0.05. Level of significance was obtained using T test. RESULTS Demographic data : A total of 500 parents participated in the study. Out of them, majority of the fathers (59%) were undergraduates and majority of the mothers (52%) were graduates. 56% of the children were of 2nd birth order, 43% of children were of 1st order and the rest (1%) were of 3rd order. Comparing the parental age, majority of the parents including both father and mother were between ages of 25-35 years (Table 1). Indian Journal of Basic and Applied Medical Research; March 2018, Vol.-7, Issue2, P. 585-593 587 www.ijbamr. com P ISSN: 2250-284X , E ISSN : 2250-2858 Table 1: Demographics of parents charecteristics N(%), (n=500) Parental education