CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Immunization is one of the most cost-effective public health interventions for preventing vaccine preventable diseases and reducing child mortality (World Health Organization, 2023). Despite global gains, the 2023 Nigeria Demographic and Health Survey found that only 57% of children aged 12–23 months were fully immunized according to the national schedule (National Population Commission & ICF, 2023). In Akwa Ibom State, administrative data report a full immunization coverage of just 52% in 2022, with Oron Local Government Area among those lagging behind state averages (Akwa Ibom State Ministry of Health, 2023). Factors such as irregular vaccine supply, long distances to health facilities and caregiver misconceptions about vaccine safety have been documented elsewhere in Southeast Nigeria (Edet & Ekpo, 2023), but little is known about the specific barriers experienced by families in Oron LGA.

1.2 Statement of the Problem

Despite routine outreach by the National Primary Health Care Development Agency and partner organizations, many children in Oron LGA remain incompletely immunized. Incomplete uptake not only leaves individual children vulnerable but also undermines herd immunity, increasing the risk of outbreaks of measles, polio and other diseases. Anecdotal reports from health workers in Oron cite community resistance due to rumours of adverse effects, as well as logistical challenges such as intermittent cold chain maintenance and staff shortages (Akwa Ibom State Ministry of Health, 2023). Without detailed, locality?specific data on which factors most obstruct full immunization, targeted strategies cannot be developed to close coverage gaps.

1.3 Aim and Objectives of the Study

Aim:

To assess immunization uptake and identify barriers to full vaccination among children aged 12–23 months in Oron LGA, Akwa Ibom State.

Specific Objectives:

1. To determine the proportion of children aged 12–23 months who are fully immunized.
2. To describe caregivers’ knowledge and attitudes toward routine immunization.
3. To document health?facility?level factors affecting vaccine availability and delivery.
4. To identify socio?demographic predictors of incomplete immunization.

1.4 Research Questions

1. What proportion of children aged 12–23 months in Oron LGA are fully immunized?
2. What is the level of caregivers’ knowledge and their attitudes toward routine vaccines?
3. Which health?facility factors (cold chain functionality, staffing levels, outreach frequency) influence vaccine availability?
4. Which socio?demographic characteristics (caregiver education, household income, distance to facility) predict incomplete immunization?

1.5 Scope of the Study

This cross-sectional study will be conducted in five wards of Oron LGA—Esit Inyang, Ikot Abasi, Urue Offong/Oruko, Mbo and Okoroete. It will involve caregivers of children aged 12–23 months who have resided in the LGA for at least six months. Data collection will include household interviews on caregiver knowledge and attitudes, review of child immunization cards and health facility assessments of vaccine supply chain and staffing.

References

Akwa Ibom State Ministry of Health. (2023). Annual immunization coverage report 2022. Uyo, Nigeria: Author.

Edet, N. I., & Ekpo, U. (2023). Barriers to routine childhood immunization uptake in Southeast Nigeria: A mixed?methods study. Journal of Community Health, 48, 112–120. https://doi.org/10.1007/s10900-023-01234-5

National Population Commission, & ICF. (2023). Nigeria Demographic and Health Survey 2023. Abuja, Nigeria: NPC & ICF.

World Health Organization. (2023). Global vaccine action plan monitoring report 2023. Geneva, Switzerland: WHO.

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