Knowledge, attitude and practice regarding childhood immunization among mothers of under-five children: a hospital-based cross-sectional study from upper Assam, India

Mithun Roy; Rupam Das

doi:10.18203/2349-3291.ijcp20263309

Authors

Mithun Roy Department of Pediatrics, Assam Medical College and Hospital, Dibrugarh, Assam, India
Rupam Das Department of Pediatrics, Assam Medical College and Hospital, Dibrugarh, Assam, India https://orcid.org/0009-0005-8964-691X

DOI:

https://doi.org/10.18203/2349-3291.ijcp20263309

Keywords:

Childhood immunization, Knowledge, Attitude and practice, Vaccination coverage, Under-five children

Abstract

Background: Immunization is among the most cost-effective public health interventions, but awareness does not necessarily translate into timely completion of the schedule. This study assessed mothers' knowledge, attitude, and practice (KAP) regarding immunization of under-five children and factors associated with immunization status.

Methods: A hospital-based cross-sectional study was conducted at the pediatric outpatient department of Assam Medical College and Hospital, Dibrugarh, from June 2015 to May 2016. In all, 360 mothers of under-five children were interviewed using a predesigned, pretested proforma. Associations were tested using chi-square and Fisher exact tests, with p<0.05 considered significant.

Results: Overall, 322 mothers (89.44%) were aware of childhood immunization, the commonest source being health facilities (40.99%). Knowledge regarding the purpose of immunization (72.78%) and the correct starting age at birth (85%) was good; however, schedule-specific knowledge was weaker, notably the correct age for measles (46.67%) and the number of DPT doses (41.67%). Attitudes were largely favourable (86.11% considered immunization important). However, only 264 children (73.33%) were completely immunized; 51 (14.17%) were partially immunized and 45 (12.50%) unimmunized. Child sickness (46.88%) and lack of knowledge (39.58%) were the leading reasons for incomplete immunization, and lack of knowledge accounted for 62.38% of missed scheduled doses. Maternal literacy was associated with immunization knowledge, and immunization status with child sex and maternal religion (p<0.05).

Conclusions: A clear knowledge–practice gap was evident; awareness and attitudes were favourable, but about one in four children was incompletely immunized. Schedule-specific counselling, appropriate advice during childhood illness and reduction of access barriers may help convert favourable attitudes into timely immunization.

References

Andre FE, Booy R, Bock HL, Clemens J, Datta SK, John TJ, et al. Vaccination greatly reduces disease, disability, death and inequity worldwide. Bull World Health Organ. 2008;86(2):140-6.

World Health Organization. Immunization coverage. Fact sheet No. 378. Geneva: World Health Organization. 2013.

Park K. Park's textbook of preventive and social medicine. 23rd ed. Jabalpur: Banarsidas Bhanot. 2015.

Jheeta M, Newell J. Childhood vaccination in Africa and Asia: the effects of parents' knowledge and attitudes. Bull World Health Organ. 2008;86(6):419.

Siddiqi N, Siddiqi AE, Nisar N, Khan A. Mothers' knowledge about EPI and its relation with age-appropriate vaccination of infants in peri-urban Karachi. J Pak Med Assoc. 2010;60(11):940-4.

Kimmel SR, Burns IT, Wolfe RM, Zimmerman RK. Addressing immunization barriers, benefits, and risks. J Fam Pract. 2007;56(2):S61-9.

World Health Organization. Surveillance of adverse events following immunization: field guide for managers of immunization programmes. Geneva: World Health Organization. 1997.

Malkar VR, Khadilakar H, Lakde RN, Joge US, Choudhari SG. Assessment of sociodemographic factors affecting immunization status of children in the age group of 12-23 months in a rural area. Indian Med Gaz. 2013;147(5):164-70.

Mandal S, Basu G, Kirtania R, Roy SK. Caregivers' knowledge and practice on routine immunization among 12-23 months children in a rural community of West Bengal. IOSR J Dent Med Sci. 2013;6(6):105-11.

Bofarraj MAM. Knowledge, attitude and practices of mothers regarding immunization of infants and preschool children at Al-Beida City, Libya. Egypt J Pediatr Allergy Immunol. 2011;9(1):29-34.

Joseph J, Devarashetty V, Reddy SN, Sushma M. Parents' knowledge, attitude, and practice on childhood immunization. Int J Basic Clin Pharmacol. 2015;4(6):1201-7.

Asim M, Malik N, Yousaf H, Gillani I, Habib N. An assessment of parental knowledge, belief and attitude toward childhood immunization among minorities in rural areas of district Faisalabad, Pakistan. Mediterr J Soc Sci. 2012;3(11):153-9.

Awodele O, Oreagba IA, Akinyede A, Awodele DF, Dolapo DC. The knowledge and attitude towards childhood immunization among mothers attending antenatal clinic in Lagos University Teaching Hospital, Nigeria. Tanzan J Health Res. 2010;12(3):172-7.

Mapatano MA, Kayembe K, Piripiri L, Nyandwe K. Immunisation-related knowledge, attitudes and practices of mothers in Kinshasa, Democratic Republic of the Congo. S Afr Fam Pract. 2008;50(2):61-6.

Abidoye AO, Odeyemi KA. Knowledge, attitude and practice of mothers to childhood immunization in Kosofe Local Government Area of Lagos State, Nigeria. Int J Basic Appl Innov Res. 2013;2(4):66-72.

Chris-Otubor GO, Dangiwa DA, Ior LD, Anukam NC. Assessment of knowledge, attitudes and practices of mothers in Jos North regarding immunization. IOSR J Pharm. 2015;5(6):34-45.

Mahalingam S, Soori A, Ram P, Achappa B, Chowta M, Madi D. Knowledge, attitude and perceptions of mothers with children under five years of age about vaccination in Mangalore, India. Asian J Med Sci. 2014;5(4):52-7.

Al-Zahrani J. Knowledge, attitude and practice of parents towards childhood vaccination. Majmaah J Health Sci. 2013;1(1):23-32.

Hamid S, Andrabi SAH, Fazli A, Jabeen R. Immunization of children in a rural area of North Kashmir, India: a KAP study. Online J Health Allied Sci. 2012;11(1):10.

Nisar N, Mirza M, Qadri MH. Knowledge, attitude and practices of mothers regarding immunization of one-year-old child at Mawatch Goth, Kemari Town, Karachi. Pak J Med Sci. 2010;26(1):183-6.

Aslami AN, Athira TK, Salim AK, Pillai AV, Asha TJ, Bency S, et al. Assessment of knowledge about immunization of under-five children among mothers attending the outpatient department of pediatrics in a tertiary care hospital in Kollam, Kerala. J Evid Based Med Healthc. 2015;2(29):4191-200.

Angadi MM, Jose AP, Udgiri R, Masali KA, Sorganvi V. A study of knowledge, attitude and practices on immunization of children in urban slums of Bijapur city, Karnataka, India. J Clin Diagn Res. 2013;7(12):2803-6.

Nath B, Singh JV, Awasthi S, Bhushan V, Kumar V, Singh SK. KAP study on immunization of children in a city of North India-a 30-cluster survey. J Health Allied Sci. 2008;7(1):2.

Singh MC, Badole CM, Singh MP. Immunization coverage and the knowledge and practice of mothers regarding immunization in rural area. Indian J Public Health. 1994;38(3):103-7.

Yousif MA, Albarraq AA, Abdallah MAA, Elbur AI. Parents' knowledge and attitudes on childhood immunization, Taif, Saudi Arabia. J Vaccines Vacc. 2013;5(1):215.

Qidwai W, Ali SS, Ayub S. Knowledge, attitude and practice regarding immunization among family practice patients. J Dow Univ Health Sci. 2007;1(1):15-9.

Tagbo BN, Uleanya ND, Nwokoye IC, Eze JC, Omotowo IB. Mothers' knowledge, perception and practice of childhood immunization in Enugu. Niger J Paed. 2012;39(3):90-6.

Favin M, Steinglass R, Fields R, Banerjee K, Sawhney M. Why children are not vaccinated: a review of the grey literature. Int Health. 2012;4(4):229-38.