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Effect of Measles Prevention Education on Childhood Measles Vaccination Uptake among Mothers in Nigeria

Abstract

Measles remains a highly contagious vaccine-preventable disease and continues to pose a public health challenge in Nigeria, particularly in communities with low immunization coverage. Childhood measles infection can result in serious complications, including pneumonia, diarrhoea, malnutrition, encephalitis, and death, especially among young and inadequately immunized children. Routine measles vaccination is an important intervention for preventing measles infection, reducing transmission, and protecting children and communities from outbreaks. Measles prevention education provides mothers with information about measles transmission, symptoms, complications, risk factors, vaccination schedules, vaccine benefits, vaccine safety, and the importance of completing recommended childhood immunization. Childhood measles vaccination uptake refers to the receipt of the recommended measles-containing vaccine by eligible children according to the applicable national immunization schedule. In Nigeria, low vaccination uptake may be associated with inadequate knowledge, misconceptions about vaccines, fear of adverse effects, misinformation, limited access to immunization services, missed vaccination opportunities, and concerns about vaccine safety. Effective measles prevention education may improve mothers' knowledge, confidence, and willingness to utilize routine immunization services for their children. Against this background, this study investigates the effect of measles prevention education on childhood measles vaccination uptake among mothers 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 measles vaccination. The Theory of Planned Behavior explains how attitudes, subjective norms, and perceived behavioural control influence mothers' intentions and subsequent vaccination practices. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and favourable attitudes resulting from measles prevention education may influence childhood vaccination practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how measles prevention education may influence measles vaccination 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 eligible 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 measles prevention education covering measles transmission, signs and symptoms, complications, prevention, recommended measles vaccination, vaccine benefits and safety, management of common concerns about vaccination, immunization schedules, the importance of completing recommended doses, and appropriate healthcare-seeking practices. Childhood measles vaccination uptake will be assessed based on children's vaccination status, receipt of recommended measles-containing vaccine doses, timeliness of vaccination, and completion of the applicable immunization schedule. 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, measles knowledge, exposure to prevention education, and children's vaccination 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 effect of measles prevention education on childhood measles vaccination 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 measles prevention education has a significant positive effect on childhood measles vaccination uptake among mothers in Nigeria. Mothers exposed to structured measles prevention education are expected to demonstrate improved knowledge of measles transmission and complications, greater confidence in measles vaccination, and increased utilization of routine immunization services for their children. Education may reduce misconceptions and fears concerning vaccination, improve awareness of vaccination schedules, reduce missed vaccination opportunities, and encourage timely completion of recommended measles vaccination. However, education alone may not guarantee complete vaccination because mothers may continue to face barriers such as distance to immunization centres, transportation difficulties, vaccine stock-outs, competing household responsibilities, misinformation, concerns about vaccine safety, and inadequate access to healthcare services. Consequently, measles prevention education is expected to be most effective when supported by reliable vaccine availability, accessible immunization services, effective community mobilization, reminder systems, and strong routine immunization programmes. The study is expected to contribute to the literature on childhood immunization, measles prevention, vaccine education, infectious disease prevention, maternal and child health, and public health in Nigeria by providing empirical evidence on the effect of measles prevention education on childhood measles vaccination uptake among mothers. 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), state ministries of health, local government health authorities, primary healthcare facilities, immunization programmes, community health workers, development partners, and policymakers regarding strategies for improving measles vaccination coverage. The study will also provide evidence-based recommendations for strengthening maternal and community-based measles education, improving vaccine communication, addressing misinformation and misconceptions, strengthening routine immunization services, reducing missed vaccination opportunities, improving vaccination record systems, and promoting timely childhood measles vaccination across Nigeria.

Keywords: Measles prevention education, childhood measles vaccination, vaccination uptake, mothers, childhood immunization, measles prevention, vaccine education, maternal and child health, infectious disease prevention, health promotion, public health, Nigeria.