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THE EFFECT OF ROUTINE IMMUNIZATION DEFAULT AMONG WOMEN OF CHILD BEARING AGE

ABSTRACT

This study examined the effect of routine immunization default among women of childbearing age. The study was motivated by concerns over the increasing rate of missed or incomplete routine immunization schedules, which contribute significantly to the prevalence of vaccine-preventable diseases among children. Routine immunization remains one of the most effective public health interventions for reducing childhood morbidity and mortality; however, defaulting from immunization schedules continues to pose a major challenge in many developing countries. The study aimed to assess the prevalence of immunization default among women of childbearing age, identify the factors responsible for defaulting, and examine its effects on child health outcomes. The study adopted a descriptive survey research design. The population comprised women of childbearing age attending selected healthcare facilities and communities within the study area. Data were collected through structured questionnaires and interviews administered to eligible respondents. Secondary data were obtained from health records, government publications, World Health Organization reports, textbooks, and relevant scholarly literature. The collected data were analyzed using descriptive statistics such as frequencies, percentages, mean scores, and inferential statistical techniques. Findings revealed that routine immunization default remains a significant public health concern among women of childbearing age. The study identified factors such as lack of awareness, low educational level, long distance to health facilities, vaccine stock-outs, financial constraints, cultural beliefs, fear of side effects, poor health worker attitudes, and inadequate family support as major contributors to immunization default. The findings further showed that immunization default increases the risk of vaccine-preventable diseases, childhood illnesses, disability, and mortality, while also placing additional burdens on families and healthcare systems. The study also found that women with higher levels of education and better access to health information were more likely to complete their children's immunization schedules. The study concluded that routine immunization default among women of childbearing age negatively affects child health and undermines public health efforts aimed at disease prevention. The study recommended intensified health education campaigns, improved accessibility to immunization services, regular vaccine availability, community mobilization programs, and strengthened follow-up mechanisms by healthcare workers to encourage complete adherence to routine immunization schedules.

Keywords: Routine Immunization, Immunization Default, Women of Childbearing Age, Vaccine-Preventable Diseases, Child Health, Maternal Health, Public Health, Immunization Coverage.

CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

Routine immunization is one of the most effective public health strategies for preventing infectious diseases and reducing illness and death among mothers and children worldwide (World Health Organization [WHO], 2023). Immunization helps protect women of childbearing age against vaccine preventable diseases that may affect their health during pregnancy and can also protect their newborns through the transfer of maternal antibodies (WHO, 2022). Despite the availability of vaccines and ongoing efforts by governments and health organizations, many women still fail to complete recommended immunization schedules, leading to routine immunization default (United Nations Children's Fund [UNICEF], 2023).

Routine immunization default refers to the failure of an individual to receive scheduled vaccine doses within the recommended period after initially enrolling in an immunization program (WHO, 2023). Among women of childbearing age, immunization default remains a significant public health concern, especially in low and middle income countries where access to healthcare services may be limited (Gavi, 2024). Factors such as inadequate knowledge of vaccine benefits, fear of side effects, poor access to health facilities, financial constraints, and lack of family support have been identified as major contributors to immunization default among women (UNICEF, 2023).

The consequences of routine immunization default among women of childbearing age can be serious for both mothers and children. Women who fail to receive recommended vaccines may be at increased risk of contracting infectious diseases that can lead to pregnancy complications, maternal illness, and adverse birth outcomes (WHO, 2022). In addition, low immunization coverage among women can weaken community immunity and increase the likelihood of disease outbreaks within communities (WHO, 2024).

In many developing countries, efforts have been made to improve immunization coverage through health education, community outreach programs, and strengthening primary healthcare services (Gavi, 2024). However, routine immunization default continues to affect the success of these interventions, particularly among women who face social, cultural, and economic barriers to healthcare access (UNICEF, 2023). Understanding the effect of routine immunization default among women of childbearing age is therefore important for designing effective interventions that will improve vaccine uptake, enhance maternal health, and reduce preventable diseases among women and their children (WHO, 2024).

1.2 Statement of the Problem

Routine immunization plays an important role in protecting women of childbearing age from vaccine preventable diseases. Despite the availability of immunization services in many health facilities, a significant number of women fail to complete their recommended vaccination schedules. This situation has continued to create concerns among healthcare providers and public health authorities because incomplete immunization reduces the effectiveness of disease prevention efforts and increases vulnerability to infections.

The persistent occurrence of routine immunization default among women of childbearing age may lead to poor maternal health outcomes, increased risk of disease transmission, and reduced community immunity. Although several interventions have been introduced to improve vaccine uptake, default rates remain a challenge in many communities. Therefore, there is a need to investigate the effect of routine immunization default among women of childbearing age in order to provide evidence that can support effective strategies for improving immunization coverage and maternal health outcomes.

1.3 Objectives of the Study

Main Objective

The main objective of this study is to determine the effect of routine immunization default among women of childbearing age.

Specific Objectives

      i.         To evaluate the impact of routine immunization default on the health status of women of childbearing age.

    ii.         To determine the factors responsible for routine immunization default among women of childbearing age.

   iii.         To find out how routine immunization default affects maternal and child health outcomes.

1.4 Research Questions

      i.         What is the impact of routine immunization default on the health status of women of childbearing age?

    ii.         What are the factors responsible for routine immunization default among women of childbearing age?

   iii.         How does routine immunization default affect maternal and child health outcomes?

1.5 Research Hypotheses

Hypothesis I

H0: There is no significant impact of routine immunization default on the health status of women of childbearing age.

H1: There is a significant impact of routine immunization default on the health status of women of childbearing age.

Hypothesis II

H0: There is no significant relationship between identified factors and routine immunization default among women of childbearing age.

H2: There is a significant relationship between identified factors and routine immunization default among women of childbearing age.

Hypothesis III

H0: There is no significant effect of routine immunization default on maternal and child health outcomes.

H3: There is a significant effect of routine immunization default on maternal and child health outcomes.

1.6 Significance of the Study

This study will be beneficial to healthcare workers by providing information on the factors associated with routine immunization default among women of childbearing age. The findings will assist health professionals in developing effective health education programs and intervention strategies aimed at improving vaccine uptake and reducing default rates among women.

The study will also be useful to government agencies, policy makers, and public health organizations in planning and implementing policies that promote immunization coverage. Furthermore, the findings will contribute to existing knowledge and serve as a reference material for future researchers interested in maternal health, immunization programs, and public health interventions.

1.7 Scope of the Study

This study focuses on the effect of routine immunization default among women of childbearing age. The study will examine the impact of immunization default on women's health, identify factors responsible for defaulting immunization schedules, and assess the effects on maternal and child health outcomes.

The study is limited to women of childbearing age who are eligible for routine immunization services within the selected study area. It does not cover immunization practices among children, elderly individuals, or other population groups outside the target population.

1.8 Limitations of the Study

One limitation of this study may be the inability of some respondents to provide complete and accurate information due to forgetfulness or poor record keeping regarding their immunization history. This may affect the accuracy of some responses obtained during data collection.

Another limitation may be time and financial constraints, which could restrict the number of participants involved in the study. In addition, limited access to some respondents and health facilities may affect the scope of data collection and the generalization of the findings.

1.9 Definition of Terms

Routine Immunization: The regular administration of vaccines according to approved schedules to protect individuals against vaccine preventable diseases.

Immunization Default: Failure to receive scheduled vaccine doses within the recommended period after beginning an immunization program.

Women of Childbearing Age: Women who are within the reproductive age group, generally between 15 and 49 years.

Vaccine Uptake: The acceptance and receipt of recommended vaccines by eligible individuals.

Maternal Health: The health condition of a woman during pregnancy, childbirth, and the postnatal period.

Health Outcome: The result or effect of healthcare services or interventions on an individual's health status.

Primary Healthcare: Basic healthcare services provided at the community level to promote health and prevent diseases.

Vaccine Preventable Diseases: Diseases that can be prevented through the administration of vaccines.

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