Immunization practices among mothers whose babies developed Neonatal Tetanus: Need for Review of the Nigerian National Policy on Immunization.
Keywords:Barriers, Implementation, National Policy, Tetanus Immunization, Practices, Pregnant Women, Nigeria
Objective: To identify the major problems encountered in the implementation of the policy on immunization of pregnant women against tetanus in Ibadan, Nigeria.
Methods: In a descriptive cross‐sectional study design, 140 mothers whose babies were admitted for neonatal tetanus into the major referral hospitals in the city of Ibadan over a 12‐month period were recruited into the study.
Results: Ante‐natal clinic (ANC) was attended by 121 (86.4%) of mothers but only 31 (25.6%) of these mothers received full immunization. Nearly three out of four mothers attended ANC for 5 to 20 times (mean = 8 times), indicating missed opportunities for immunization. The attendance by 74.3% of the mothers was spread over 2 or more months. Ignorance and lack of funds were the major reasons given by mothers for either not attending ANC or for not receiving full immunization. Age, 20 years or more
(p=0.003), parity of one or more (p=0.004), and formal education (p=0.02) are all significantly associated with having received one or two doses of tetanus toxoid (T.T).
Conclusions and Recommendations: This study shows that the national policy on tetanus immunization of women is poorly implemented. A shift of emphasis from immunizing pregnant women with two doses of TT at ANC to that of immunizing all women of child bearing age with the WHO recommended schedule of five doses of TT to give life‐long immunity is the suggested strategy to combat the present implementation problems.