Abstract

This study assesses mothers’ knowledge of infant vaccination schedules in Bwitingi Community, Buea. Vaccination is essential for preventing childhood diseases, and adherence to recommended vaccination schedules is critical to building immunity in infants. However, knowledge gaps regarding the schedule can lead to missed vaccinations, delayed immunization, and reduced vaccine effectiveness. This study investigates the extent of mothers’ understanding of infant vaccination timelines, identifies common misconceptions, and examines factors that may affect adherence to these schedules.

A descriptive cross-sectional survey was conducted, targeting mothers with infants aged 0–24 months within the Bwitingi Community. Data collection involved structured questionnaires with sections on demographic information, awareness of specific vaccines, timing of doses, sources of vaccination information, and perceived importance of adhering to the schedule. Factors such as accessibility to healthcare facilities, socio-economic status, and the influence of healthcare providers on vaccination knowledge were also assessed to provide a comprehensive analysis of adherence challenges.

Results showed that 65% of mothers were aware of the recommended vaccination schedule, with the majority understanding the timing of major vaccines like BCG, polio, and measles. However, 35% of mothers were either unaware of or confused about the timing of certain vaccines, particularly for newer vaccines such as rotavirus and pneumococcal conjugate vaccines. Sources of information primarily included healthcare providers (75%) and community health campaigns (20%), while 5% relied on informal sources like family advice. Socio-economic factors, such as income and educational background, influenced knowledge levels; mothers with higher education levels or regular access to healthcare information demonstrated better adherence to the schedule. Additionally, the availability of nearby healthcare facilities significantly impacted adherence, as mothers with easier access were more likely to follow the schedule consistently.

The study highlights the importance of enhancing mothers’ understanding of the infant vaccination schedule through targeted education efforts. Recommendations include increasing healthcare provider engagement with mothers to discuss vaccination schedules at each clinic visit, implementing community-based informational sessions, and distributing educational materials. Efforts should also be made to improve healthcare accessibility, particularly in more remote areas, to minimize missed doses due to distance. These measures could help reduce knowledge gaps, promote timely vaccination, and improve overall health outcomes for infants in Bwitingi.

Keywords: Infant vaccination, maternal knowledge, immunization schedule, Bwitingi Community, healthcare access, vaccine adherence.

CHAPTER ONE

 INTRODUCTION

1.0 Introduction /Background of study.

    Childhood vaccination almost guarantees protection from many major diseases. It prevents 2 million deaths per year worldwide and is widely considered to be ‘overwhelmingly good’ by the scientific community (WHO, 2005).   However, 2.5 million deaths a year continue to be caused by vaccine preventable diseases, mainly in Africa and Asia among children less than 5 years old (WHO, 2005). The prevention of diseases is important in ensuring public health and in reducing maternal and child mortality. It is widely believed among clinicians that the occurrence of disease is prevented than curing them. Vaccination is one of the best means of protection against contagious diseases. Vaccination is a way of creating immunity to certain diseases by using small amounts of a killed or weakened microorganism that causes the particular disease (Centre for Disease Control and Prevention (CDC), 2015).

      Vaccination is considered as one of the biggest achievements of the twentieth century and as one of the most cost-effective measures in the prevention of childhood diseases (Davidovitch, et al., 2012). In 1974, the World Health Organization (WHO) launched a worldwide vaccination program known as the Expanded Program of Immunization (EPI), which has been considered one of the major public health interventions aimed at reducing infant morbidity and mortality (Bos & Batson, 2000). During the launching of the EPI in 1976, only about 5% of infants throughout the world were protected against six diseases (diphtheria, measles, pertussis, poliomyelitis, tetanus, and tuberculosis). By 2013, the number of protected infants was more than 80% in many countries. It is estimated that vaccination helps to prevent 2 to 3 million infant deaths each year (WHO, 2016).

       Chiabi et al., (2017) stated that the Expanded Program of Immunization started in Cameroon in 1976 as a pilot project and targeted infants from 0 to 11 months. Initially it targeted 6 diseases (diphtheria, measles, pertussis, poliomyelitis, tetanus, and tuberculosis), and other vaccines were gradually introduced; the last to be introduced in the EPI was IPV in 2015. Presently, it has vaccines against the following diseases: tuberculosis, diphtheria, tetanus, poliomyelitis, pertussis, viral hepatitis B, type b Hemophilus influenza infections, pneumococcal infections, diarrhea caused by rotavirus, measles, yellow fever, and rubella. An infant is completely vaccinated when he or she has received all the vaccines in the EPI. Ensuring that all the doses are not only administered, but given at the appropriate ages, is of crucial importance in ensuring the efficacy of the vaccine in disease prevention (Hoppenbrouwers, et al., 2014). An infant is correctly vaccinated when he or she has received all the vaccines at the recommended ages. Many infants still do not complete their vaccination schedules or are vaccinated after the recommended ages (Ba Pouth, Kazambu, Delissaint, & Kobela, 2014).

       Vaccination has been regarded as the most cost-effective intervention for child health promotion by the World Health Organization. Vaccinating the children significantly decreases the percentage of treating diseases which may possibly occur in the future, thus; this will provide the children a healthy childhood and reducing poverty and suffering. The Millennium Development project 2009 emphasizes that, reducing child morbidity in a nation ensures a healthy and robust generation contributing to society. In an international project’s report, Sub-Saharan Africa is the lowest performing region in terms of Millennium Development Goal (MDG) 4 – reducing child mortality and, Ethiopia is one of the lowest performers in all MDGs. The Expanded Programmed on Immunization (EPI) was created with the purpose of expanding immunization services beyond smallpox to the following six preventable diseases: diphtheria, measles, pertussis, poliomyelitis, tetanus and tuberculosis . The EPI was introduced in Cameroon in 1976 (Ministry of Public Health of Cameroon, 2002). According to the 2011 Cameroonian Demographic Health Survey (DHS) (Institut National de la Statistique (Yaoundé, Cameroun) et ICF International (Calverton, Maryland, USA), 2011), the coverage of the nine EPI vaccines in children aged 12–23 months was 57 % at the national level, and 59.3 % in the West Region. When it became clear in the late 1990s that this goal would not be achieved globally, some supportive initiatives arose, including the Global Alliance for Vaccines and Immunization (GAVI), which contributes to an impressive increase in new funding for immunization. GAVI is a public-private partnership committed to improving access to routine vaccines and to introducing new vaccines for children in low-income countries (Martin & Marshal, 2003).

       Vaccine preventable diseases outbreaks are linked to inadequate levels vaccination coverage (WHO, 2013). Several factors are associated with poor vaccination coverage in resources-limited countries. A multilevel analysis involving 24 African countries (International Federation of Red Cross and Red Crescent Societies, 2013) showed that breaks in childhood vaccination are linked, at the contextual level. High community illiteracy rates, high country fertility rates, and living in urban areas, while, at the individual level, they are linked to poorest households, uneducated parents, parents with no access to media and/or with low health seeking behaviors. The relative effect of the above factors may significantly vary according to the geographical area (International Federation of Red Cross and Red Crescent Societies, 2013). Uptake of vaccination services is dependent not only on provision of the services but also on other factors including knowledge and attitude of mothers and density of health workers (Anand & Bärnighausen, 2017). The opportunity costs (such as lost earnings or time) incurred by parents may also have an important impact on uptake

 (Nath et al 2018).

     Cultural receptivity to perceived modernity and education, as well as trust in health workers, were considered to be the most important factors influencing attitudes (Mull, Anderson & Mull, 2011). In short, knowing little about vaccination does not necessarily translate into negative attitudes towards it. factors such as trust (e.g., in health-care providers) and culture may be more influential. The impact of high levels of knowledge on subsequent attitudes towards vaccination is unknown. The fundamental question is whether or not resources should be invested in improving parents’ knowledge of and attitudes towards vaccination. Although the evidence is unclear, it is commonly believed, though some disagree, that strengthening advocacy, communication and social mobilization will enhance informed and willing participation in vaccination programme and that vaccination strategies are likely to be more successful if they are based on an understanding of sociocultural behavior (Streefland, 2015).

This study benefits from the Health Promotion Model (HPM) Nola J. Pender (2012). This theory focused on health promotion directed at increasing a client’s level of well-being. It also describes the multi-dimensional nature of persons as they interact within their environment to pursue health. The model focuses on following three areas: (1) Individual characteristics and experiences, (2) Behavior – specific cognitions and affect, and (3) Behavioral Outcomes (Pender, 2012). The health promotion model notes that each person has unique personal characteristics and experiences that affect subsequent actions.

1.1 Problem Statement

In Africa, a more detailed and comprehensive information at district level is necessary in order to develop and implement appropriate strategies for improving vaccination coverage. In Cameroon, there are few studies, conducted at the primary level on, assessing mother’s knowledge, attitude, and practices on the vaccination of children. With the growing importance of vaccination to fight against diseases by preventing the diseases yet they are recurring traces of common epidemic diseases found within the communities. It is against this backdrop that the researcher seeks to embark on the research study in order to assess the knowledge, attitude, and practices of vaccination in children in the Bwitingi community of Buea Municipality in the South West Region of Cameroon.

1.2 Research Hypothesis

Mothers in the Bwitingi community do not have adequate knowledge, attitude and practices in vaccination of children.

1.3 General Objective

To assess mother’s knowledge, attitude, practices and challenges in vaccination of children in the Bwitingi Community.

1.4 Specific Objective

Specifically, the study seeks:

• To assess the knowledge of mothers living in Bwitingi of vaccination in children .
• To assess attitude of mothers living in Bwitingi towards vaccination in children
• To find out if mothers in the Bwitingi community comply with the vaccination of their children.
• To determine the challenges faced by mothers in Bwitingi in the vaccination of children.

1.5 Research questions

• What is mothers’ knowledge of vaccination in children in the Bwitingi community?
• What is the attitude of mothers towards the vaccination of children in the Bwitingi community?
• How do mothers ensure they practice vaccination of children in the Bwitingi community?
• What are the challenges encountered in the vaccination of children in the Bwitingi community?