COMPLETE SCHOOL PROJECT TOPICS & MATERIALS :
CHAPTERS: Chapter 1-5
|
DOC FORMAT: MS WORD/PDF
|
PRICE: ₦5,000
EVALUATION OF PEER-LED HEALTH EDUCATION INTERVENTIONS ON MATERNAL ATTITUDES TOWARD ROUTINE VACCINATIONS (A Case Study of Maternal and Child Health Clinics in Port Harcourt City Local Government Area, Rivers State)
Abstract
Peer-led health education interventions leverage trusted community networks to address vaccine hesitancy, particularly among mothers navigating cultural and informational barriers to routine vaccinations. This study evaluates their impact on maternal attitudes in Maternal and Child Health (MCH) clinics of Port Harcourt City Local Government Area (LGA), Rivers State, Nigeria, where coverage lags despite accessible services. Through a quasi-experimental design involving pre- and post-intervention surveys, focus groups with 200 mothers of children aged 0-23 months, and clinic record reviews, the research measures shifts in knowledge, perceptions, and compliance. Expected outcomes include a 25-35% improvement in positive attitudes toward vaccine safety and timeliness, highlighting peer educators’ role in dispelling myths. The findings inform scalable models for South-South Nigeria, enhancing equity in immunization programs and supporting national efforts to reduce zero-dose children.
1.1 Background of the Study
Childhood immunization has prevented over 154 million deaths worldwide in the last 50 years, yet global coverage for the third dose of diphtheria-tetanus-pertussis (DTP3) vaccine plateaued at 85% in 2024, leaving nearly 20 million infants under-vaccinated and 14.3 million as zero-dose children. The World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) note that while 89% of infants received at least one DTP dose—up slightly from 2023—this masks stark inequities, with sub-Saharan Africa accounting for 58% of zero-dose cases amid outbreaks like measles affecting 10 million children annually. Maternal attitudes, shaped by misinformation on safety and efficacy, contribute significantly to hesitancy, underscoring the need for targeted education that builds trust through relatable channels.
In Nigeria, routine immunization coverage remains critically low, with the 2024 Nigeria Demographic and Health Survey (NDHS) reporting 39% of children aged 12-23 months fully vaccinated against basic antigens (BCG, three DTP-HepB-Hib, three polio, and one measles dose), and only 20% completing the full national schedule. The country harbors 2.5 million zero-dose children yearly, with regional disparities evident: the South-South zone, including Rivers State, achieves 39% basic antigen coverage in Rivers LGA, better than the North’s 31% but far from the 90% Immunization Agenda 2030 goal. Factors like urban congestion in Port Harcourt and economic pressures exacerbate dropout rates, yet maternal education levels—higher at 62% secondary attainment in Rivers—offer leverage for interventions.
Port Harcourt City LGA, an oil-rich urban hub serving over 1 million residents, exemplifies these tensions in its MCH clinics, where full immunization hovers at 45-50% per 2024 audits, despite positive baseline attitudes among 80% of mothers. Studies in nearby Emohua LGA reveal poor knowledge (e.g., only 40% aware of full schedules) but strong favorable views toward vaccines, influenced by age, education, and religion. Recent campaigns, like the October 2025 integrated measles-rubella-polio drive targeting 106 million children nationally, highlight Rivers’ proactive stance, yet hesitancy persists due to myths about infertility or spiritual harm, particularly among multiparous mothers juggling work and childcare.
Peer-led health education, where trained mothers deliver tailored sessions on vaccine benefits, has proven effective in low-resource settings, fostering attitude shifts through social proof and cultural resonance. In Nigeria, initiatives like the Routine Immunization Buddy System (RIBS) empower unemployed mothers via peer groups and vocational support, reducing hesitancy by 30% in Kaduna pilots by addressing gender dynamics and financial barriers. Similarly, community volunteer-driven models in rural Rivers have boosted coverage by 25% through myth-busting dialogues, aligning with global evidence from LMICs where peer interventions enhance uptake by 20-40%. In Port Harcourt’s clinics, integrating such approaches could capitalize on high maternal clinic attendance (70%) to sustain gains.
1.2 Statement of the Problem
Despite Rivers State’s 39% basic immunization coverage and generally positive maternal attitudes, Port Harcourt City LGA’s MCH clinics report 25-30% dropout rates post-initial doses, driven by persistent knowledge gaps and hesitancy—e.g., 35% of mothers citing safety concerns—leading to elevated zero-dose prevalence at 12%. Conventional top-down education fails to engage urban mothers amid busy lifestyles, perpetuating inequities and contributing to national shortfalls, as seen in the 2024 NDHS’s 31% unvaccinated children. Without evaluating peer-led interventions to transform attitudes into sustained compliance, these clinics risk inefficient resource use and heightened outbreak vulnerability, undermining efforts like the 2025 MNCH Week.
1.3 Objective of the Study
General Objective:
To evaluate the impact of peer-led health education interventions on maternal attitudes toward routine vaccinations in Maternal and Child Health clinics of Port Harcourt City Local Government Area, Rivers State.
Specific Objectives:
1. To assess baseline maternal knowledge and attitudes regarding routine childhood vaccinations in the study area.
2. To determine the changes in maternal attitudes following exposure to peer-led health education sessions.
3. To identify the factors influencing the effectiveness of peer-led interventions in shaping positive vaccination attitudes.
1.4 Significance of the Study
This evaluation equips Rivers State Ministry of Health and the National Primary Health Care Development Agency (NPHCDA) with evidence to scale peer-led models, potentially raising Port Harcourt’s coverage from 45% to 70%, averting 2,000+ annual zero-dose cases and aligning with the 2025 Child Survival Action Plan. By quantifying attitude shifts—e.g., via validated scales—it guides training for 500+ community peers, reducing hesitancy costs estimated at ₦1 billion yearly in South-South outbreaks and promoting gender-equitable health decisions.
Theoretically, it enriches health behavior models like the Health Belief Model with Nigerian urban contexts, informing curricula at University of Port Harcourt and fostering replicable frameworks for LMICs. For clinic mothers, it empowers peer networks that halve misinformation exposure, enhancing family resilience and contributing to SDG 3 through community-owned immunization advocacy.
1.5 Research Questions
- What are the baseline levels of maternal knowledge and attitudes toward routine childhood vaccinations in Port Harcourt City LGA?
- What changes occur in maternal attitudes following peer-led health education interventions?
- What factors influence the effectiveness of peer-led interventions in improving maternal attitudes toward vaccinations?
1.6 Hypothesis
H1: There is no significant difference in baseline maternal knowledge and attitudes toward routine vaccinations before peer-led interventions in Port Harcourt City LGA.
H2: Peer-led health education interventions have no significant positive effect on changing maternal attitudes toward routine vaccinations.
H3: There are no significant factors influencing the effectiveness of peer-led interventions on maternal vaccination attitudes in the study area.
1.7 Scope of the Study
The study is delimited to mothers of children aged 0-23 months attending MCH clinics in Port Harcourt City LGA, Rivers State, over five months in 2026. It focuses on peer-led education’s impact on attitudes toward routine vaccinations (e.g., DTP, measles), excluding paternal roles or non-routine vaccines, with data from three major clinics via surveys and groups.
1.8 Definition of Terms
Peer-Led Health Education Interventions: Community-based programs where trained mothers facilitate group sessions on vaccination benefits, using relatable narratives to influence peers (Okafor et al., 2025).
Maternal Attitudes: Mothers’ beliefs, perceptions, and intentions regarding vaccine safety, efficacy, and necessity, assessed via Likert scales (Mustapha et al., 2025).
Routine Vaccinations: Standard schedule antigens for infants, including BCG, DTP-HepB-Hib, OPV, and measles, per NPHCDA guidelines (NDHS, 2024).
References
Mustapha, M. A., et al. (2025). Knowledge, attitude and practice on routine immunization in the Northeast of Nigeria. Open Journal of Nursing, 15(5), 1-15. https://www.scirp.org/journal/paperinformation?paperid=144346
Nigeria Demographic and Health Survey (NDHS). (2024). Nigeria 2024 Demographic and Health Survey Summary Report. The DHS Program. https://dhsprogram.com/pubs/pdf/SR294/SR294.pdf
Okafor, C. E., et al. (2025). Culturally tailored women’s empowerment strategies to improve immunization uptake: Formative research using a human-centered design approach. Frontiers in Public Health, 13, 1258498. https://pmc.ncbi.nlm.nih.gov/articles/PMC12584986/
Olaniran, O., et al. (2024). Vaccination decision-making among mothers of children 0–12 months old in Nigeria: A qualitative study. Human Vaccines & Immunotherapeutics, 20(1), 2355709. https://www.tandfonline.com/doi/full/10.1080/21645515.2024.2355709
World Health Organization (WHO) & United Nations Children’s Fund (UNICEF). (2025, July 15). Global childhood vaccination coverage holds steady, yet over 14 million infants remain unvaccinated. https://www.who.int/news/item/15-07-2025-global-childhood-vaccination-coverage-holds-steady-yet-over-14-million-infants-remain-unvaccinated-who-unicef
Yakubu, A., et al. (2024). Interventions addressing routine childhood immunization and its enablers in low- and middle-income countries: A scoping review. Frontiers in Public Health, 12, 1364798. https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1364798