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Impact of Polio Education on Routine Immunization Uptake among Mothers of Under-Five Children in Nigeria

Abstract

Poliomyelitis remains an important public health concern in Nigeria despite significant progress in polio eradication and routine childhood immunization. The disease is highly infectious and can cause permanent paralysis, particularly among children who are not adequately vaccinated. Routine immunization remains a critical strategy for protecting children against poliovirus and other vaccine-preventable diseases. Polio education provides mothers with information about poliovirus transmission, signs and symptoms, prevention, the importance of vaccination, routine immunization schedules, vaccine safety, and the consequences of incomplete immunization. Routine immunization uptake refers to the receipt of recommended childhood vaccines by eligible children according to the national immunization schedule. In Nigeria, inadequate knowledge, misconceptions about vaccines, misinformation, fear of adverse effects, missed vaccination opportunities, limited access to immunization services, and concerns about vaccine safety may contribute to incomplete routine immunization among children. Effective polio education may improve mothers' knowledge, confidence, and willingness to utilize routine immunization services for their children. Against this background, this study investigates the impact of polio education on routine immunization uptake among mothers of under-five children in Nigeria. The study is anchored on the Health Belief Model, Theory of Planned Behavior, and Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding mothers' decisions regarding childhood vaccination. The Theory of Planned Behavior explains how attitudes, subjective norms, and perceived behavioural control influence mothers' intentions and subsequent immunization practices. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and favourable attitudes resulting from polio education may influence routine immunization uptake. Collectively, these theoretical perspectives provide a suitable framework for explaining how polio education may influence routine immunization uptake among children in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from mothers or primary caregivers of under-five children in selected communities and healthcare facilities in Nigeria using a structured interviewer-administered questionnaire. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, households, and eligible mothers. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Mothers in the intervention group will receive structured polio education covering poliovirus transmission, symptoms and complications, prevention, the importance of routine immunization, recommended childhood vaccination schedules, vaccine safety, common misconceptions, the consequences of incomplete vaccination, and appropriate use of immunization services. Routine immunization uptake will be assessed based on children's vaccination records, receipt of age-appropriate routine vaccines, timeliness of vaccination, and completeness of recommended immunization. Where feasible, vaccination status will be verified using child health cards, immunization records, or healthcare facility records. Descriptive statistics will be used to summarize mothers' sociodemographic characteristics, polio knowledge, exposure to education, and children's immunization status. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple logistic regression analysis, will be used to determine the impact of polio education on routine immunization uptake. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that polio education has a significant positive impact on routine immunization uptake among mothers of under-five children in Nigeria. Mothers exposed to structured polio education are expected to demonstrate improved knowledge of poliovirus and greater confidence in childhood vaccination. Education may improve awareness of routine immunization schedules, reduce misconceptions and fears concerning vaccines, encourage timely attendance at immunization clinics, and reduce missed vaccination opportunities. However, education alone may not guarantee complete routine immunization because mothers may continue to face barriers such as distance to healthcare facilities, transportation difficulties, vaccine availability, competing household responsibilities, misinformation, concerns about vaccine safety, and inadequate access to reliable immunization services. Consequently, polio education is expected to be most effective when supported by reliable vaccine supply, accessible immunization services, community mobilization, reminder systems, effective follow-up, and strong routine immunization programmes. The study is expected to contribute to the literature on polio prevention, childhood immunization, vaccine education, maternal and child health, infectious disease prevention, and public health in Nigeria by providing empirical evidence on the impact of polio education on routine immunization uptake among mothers of under-five children. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), Nigeria Centre for Disease Control and Prevention (NCDC), National Primary Health Care Development Agency immunization programmes, state ministries of health, local government health authorities, primary healthcare facilities, community health workers, development partners, and policymakers regarding strategies for improving routine childhood immunization coverage. The study will also provide evidence-based recommendations for strengthening maternal and community-based polio education, improving vaccine communication, addressing misinformation and misconceptions, strengthening routine immunization services, reducing missed vaccination opportunities, improving immunization record systems, and promoting complete and timely routine immunization among under-five children across Nigeria.

Keywords: Polio education, routine immunization uptake, mothers, under-five children, childhood immunization, poliomyelitis prevention, vaccine education, maternal and child health, vaccine-preventable diseases, health promotion, public health, Nigeria.