Knowledge and practice of primary healthcare workers on the routine childhood immunization schedule in Osun State
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20251349Keywords:
Immunization, Primary healthcare workers, Knowledge-practice gapAbstract
Background: Despite global progress in immunization, Nigeria continues to face challenges in achieving adequate vaccination coverage. This study examined the knowledge and practices of primary healthcare workers regarding routine childhood immunization in Osun State, where coverage exceeds national averages but remains below global targets.
Methods: A descriptive cross-sectional study was conducted among 273 primary healthcare workers across 48 primary health centers in Osun State.
Results: There was a significant disparity between the knowledge (86.5%) and practice of routine childhood immunization (40.6%). Key gaps included inadequate vaccine storage (with 59% failing to maintain temperature records) and inconsistent caregiver communication (only 53.7% consistently obtained consent). Training deficiencies were evident, with 12.3% of staff lacking pre-service immunization training and 60% not having received refresher training within the previous six months.
Conclusions: These findings suggest that achieving better immunization outcomes requires more than just knowledge transfer. Health system strengthening should focus on improving cold chain infrastructure, implementing regular competency-based training, and strengthening supervision mechanisms. The study emphasizes the importance of ongoing support for healthcare workers to bridge the gap between knowledge and practice in routine immunization services.
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References
Lindstrand A, Cherian T, Chang-Blanc D, Feikin D, O’Brien KL. The World of Immunization: Achievements, Challenges, and Strategic Vision for the Next Decade. J Infect Dis. 2021;224(4):S45267. DOI: https://doi.org/10.1093/infdis/jiab284
World Health Organization (WHO). World Immunization Week 2025 - 24 to 30 April. 2025. Available at: https://www.who.int/news-room/ events/detail/2025/04/24/default-calendar/world-immunization-week-2025---immunization-for-all-is-humanly-possible. Accessed on 01 April 2025.
Barbazza E, Allen L, Abimbola S, Kringos D. PHC: definitions, terminology and frameworks. In: Implementing the Primary Health Care approach. 2024.
United Nations Children’s Fund (UNICEF). Child Mortality - UNICEF DATA. 2024. Available at: https://data.unicef.org/topic/child-survival/under-five-mortality/. Accessed on 10 February 2025.
Mohammed Y, Reynolds HW, Waziri H, Attahiru A, Olowo-Okere A, Kamateeka M, et al. Exploring the landscape of routine immunization in Nigeria: A scoping review of barriers and facilitators. Vaccine X. 2024;20:100563. DOI: https://doi.org/10.1016/j.jvacx.2024.100563
Federal Ministry of Health and Social Welfare of Nigeria (FMoHSW), ICF, National Population Commission (NPC) [Nigeria]. Nigeria Demographic and Health Survey 2023-24 Key Indicators. 2024. Available at: https://www.dhsprogram.com/pubs/ pdf/PR157/PR157.pdf. Accessed on 10 March 2025.
Fahmy K, Hasan Q, Sharifuzzaman M, Hutin Y. Analyzing Subnational Immunization Coverage to Catch up and Reach the Unreached in Seven High-Priority Countries in the Eastern Mediterranean Region, 2019–2021. Vaccines (Basel). 2024;12(3):285. DOI: https://doi.org/10.3390/vaccines12030285
Uwaibi NE, Erah FO. Assessment of healthcare workers’ implementation of childhood routine immunization in primary healthcare centers in Edo State, Nigeria: A mixed method survey. Ann Clin Biomed Res. 2021;21:2. DOI: https://doi.org/10.4081/acbr.2021.117
Douville LE, Myers A, Jackson MA, Lantos JD. Health Care Worker Knowledge, Attitudes, and Beliefs Regarding Mandatory Influenza Vaccination. Arch Pediatr Adolesc Med. 2010;164(1). DOI: https://doi.org/10.1001/archpediatrics.2009.252
Adebimpe WO, Adeoye OA. Knowledge and practice of vaccination logistics management among primary health care workers in Nigeria. Hum Vaccin Immunother. 2021;17(5):1490-5. DOI: https://doi.org/10.1080/21645515.2020.1827609
Adesanmi FO. Political Party, Voters’ Mobilization and Democratic Governance in Nigeria: Analysis of the 2018 Osun State Gubernatorial Election. NIU J Soc Sci. 2022;8(4). DOI: https://doi.org/10.58709/niujss.v8i4.1539
Brinkhoff T. Osun State, Nigeria - Population Statistics, Charts, Map and Location. citypopulation.de. 2022. Available at: https://city population.de/en/nigeria/admin/NGA030__osun/. Accessed on 04 April 2025.
Adewoye KR, Aremu SK, Adegbiji WA, Achebe CC. Awareness, knowledge, and factors that influenced the uptake of screening tests for prostate cancer among men aged 40 and older in Ido-Ekiti, Ekiti State, Nigeria. J Public Health Afr. 2023;14(4):2134. DOI: https://doi.org/10.4081/jphia.2023.2134
Azhar S, Rashid L, Islam T, Akhtar S, Hopkins KL, Sommers T, et al. Knowledge, attitudes, and practices of vaccinators about expanded programs on immunization: a cross-sectional study. Front Public Health. 2024;6:12. DOI: https://doi.org/10.3389/fpubh.2024.1366378
World Health Organization (WHO). Title of Section (TK) Global Vaccine Action Plan. 2013. Available at: www.who.int. Accessed on 10 December 2024.
Piedmont RL. Reliability Coefficient. In: Encyclopedia of Quality of Life and Well-Being Research. Cham: Springer International Publishing. 2023;5888-9. DOI: https://doi.org/10.1007/978-3-031-17299-1_2463
Mohamud AK, Ali IA, Ali AI, Dirie NI, Inchon P, Ahmed OA, et al. Assessment of healthcare workers' knowledge and attitude on Ebola virus disease in Somalia: a multicenter nationwide survey. BMC Public Health. 2023;23(1):1650. DOI: https://doi.org/10.1186/s12889-023-16562-2
Gibson E, Zameer M, Alban R, Kouwanou LM. Community Health Workers as Vaccinators: A Rapid Review of the Global Landscape, 2000-2021 Key Findings. Global Health: Science and Practice. 2023;11(1):e2200307. DOI: https://doi.org/10.9745/GHSP-D-22-00307
Ogundeji Y, Abubakar H, Ezeh U, Hussaini T, Kamau N, Love E, et al. An assessment of primary health care costs and resource requirements in Kaduna and Kano, Nigeria. Front Public Health. 2023;19:11. DOI: https://doi.org/10.3389/fpubh.2023.1226145
Jonathan JG, Victoria BB, Oyeninhun OA, Nathaniel OO, Iyabo DO, Mukhtar AB, et al. Health Providers’ Readiness for Immunization Services in Selected Primary Health Care Facilities in Kaduna State, Nigeria. Niger J Paediatr. 2024; 51(3):251-64. DOI: https://doi.org/10.4314/njp.v51i3.03
Abdulla E, Johnson J, Munir S, O’Dwyer R. Assessing primary health care nurses’ knowledge toward immunizations: A quantitative study. J Public Health Res. 2020;9(4):381-7. DOI: https://doi.org/10.4081/jphr.2020.1716
National Primary Health Care Development Agency (NPHCDA). Federal Republic of Nigeria National Routine Immunization Strategic Plan Intensifying Reaching Every Ward through Accountability. 2013. Available at: https://www.nitag-resource.org/sites/ default/files/2b302ead55915d61468ac747e2e437aee65871b1_1.pdf. Accessed on 10 November 2024.
Ali L, Eldessouki R. Assessment of safe injection awareness and practices among healthcare providers at primary healthcare facilities. J Egypt Public Health Assoc. 2022;97(1):1-8. DOI: https://doi.org/10.1186/s42506-022-00123-3
Tchoualeu DD, Fleming M, Traicoff DA. A systematic review of pre-service training on vaccination and immunization. Vaccine. 2023;41(20):3156-70. DOI: https://doi.org/10.1016/j.vaccine.2023.03.062