Sociodemographic determinants of maternal knowledge, attitude and uptake of routine immunization in ‘Sabo’ and ‘Non-Sabo’ communities in Awka, Nigeria

Chinomnso C. Nnebue, Chidebe O. Anaekwe, Adaeze N. Anaekwe


Background: Routine immunization coverage has been reportedly hampered by migration, and user characteristics, such as maternal knowledge and attitude. An understanding of these maternal variables could help modify preventive strategies. The objective of the present study was to assess and compare the Sabo and non-Sabo communities in Awka, Nigeria for sociodemographic determinants of maternal knowledge, attitude and uptake of routine immunization

Methods: A community based comparative study of 420 mothers and caregivers in Awka selected via multistage sampling technique, was conducted between July and October 2015. Data collection was by interview using semi-structured questionnaire, while analysis was done with Statistical Package for Social Sciences version 22.0. Chi-square, Fisher’s exact, Yates correction and student’s t tests were used to determine statistically significant associations between variables at p value of < 0.05.

Results: There was normal distribution of age groups of respondents for both communities. Married women (53.0%) in Sabo communities had better knowledge of routine immunization than (47.0%) in non-Sabo communities (p= 0.000). Self-employed women were the most knowledgeable in routine immunization 310 (74.0%) (p= 0.042). Married women in the Sabo communities (53.0%) had better attitude than (47.0%) (p= 0.000).in non-Sabo communities. The maternal uptake of routine immunization among the different communities, ethnic and religious groups were higher in non-Sabo, Igbo/others and Christian groups than the Sabo, Hausa/Fulani and Muslim groups. (p= 0.010).

Conclusions: This study found differences in baseline socio-demographic characteristics of the two communities, as well as better knowledge, attitude and uptake of routine immunization among the non-Sabo (Ibo/others and Christians) than the Sabo (Hausa/Fulani and Muslims). Addressing issues of factors identified to affect routine immunization will greatly assist in boosting uptake of routine immunization in both communities.


Attitude and uptake of routine immunization, Determinants, Knowledge, Sabo communities

Full Text:



World Health Organization (WHO). World TB Day, Health topic- immunization. Available at Accessed 24th March 2014.

Abdulkarim AA, Ibrahim RM, Fawi AO, Adebayo OA, Johnson A. Vaccine and Immunization: The past, present and the future in Nigeria. Nigerian J Pediatr. 2011;38(4):186-94.

World Health Organization (WHO). Health of migrants: the way forward, WHO report of a global consultation, Madrid, Spain. Available at URL: Accessed on 5th February 2015

Kiros GE, White MJ. Migration, community context, and child immunization in Ethiopia. Social Sci Med. 2004 Dec 1;59(12):2603-16.

Jegasothy K. Population and rural-urban environmental interactions in developing countries. Int J Social Economics. 1999 Jul 1;26:1027-55.

Smith LC, Ruel MT, Ndiaye A. Why is child malnutrition lower in urban than rural areas? Evidence from 36 developing countries. World Development. 2005;33:1285-1305.

Sastry N. What explains rural-urban differentials in child mortality in Brazil? Soc Sci Med. 1997;44:989-1002.

Biswas T, Mandal PK, Biswas S. Assessment of Health, Nutrition and Immunisation status amongst under -5 children in migratory brick klin population of periurban Kolkata, India. Sudanese J Public Health. 2011;6;7-11

Torun SD, Bakirci N. Vaccination coverage and reasons for non-vaccination in a district of Istanbul. BMC Public Health. 2006;6:125.

Anand S, Barnighausen T. Health workers and vaccination coverage in developing countries: an econometric analysis. Lancet. 2007;369:1277-85.

Williams IT, Milton JD, Farrell JB, Graham NM. Interaction of socioeconomic status and provider practices as predictors of immunization coverage in Virginia children. Pediatrics. 1995;96(3 Pt. 1):439-44.

Hutchins SS, Jansen HA, Robertson SE, Evans P, Kin-Farley RJ. Studies of missed opportunities for immunization in developing and industrialized countries. Bull World Health Org. 1993;71:549-60.

Bardenheier B, Gonzalez MI, Washington ML, Bell BP, Averhoff F, Massoudi MS. Parental knowledge, attitudes, and practices associated with not receiving Hepatitis A vaccine in a demonstration project in Butte County, California. Pediatrics. 2003;112:269-74.

Luman ET, McCauley MM, Stokley S, Chu SY, Pickering LK. Timeliness of childhood immunizations. Pediatrics. 2002;110:935-9.

Klevens R, Luman ET. US children living in and near poverty risk of vaccine-preventable diseases. Am J Prev Med. 2001;20(4 Suppl.):41-46.

Migration in India, 2007-2008, Ministry of Statistics and Programme Implementation. Government of India, June. 2010. Available at . Accessed 5th February 2015.

Anand S, Verma P, Sinha U, Mahawar P. Evaluation of primary immunization coverage in migratory versus non migratory labour population of urban area in Bhopal city. Pediatric On Call J. 2014 April-June; 11(2):35-8.

Singh P, Yadav RJ. Immunization status of children in BIMARU states. Indian J Pediatr. 2001;68:495-50.

National Family Health Survey (NFHS 2), India, 1998-99, Mumbai: International Institute for Population Sciences and ORC Macro. 2000:210.

Gulati SC, Bhatt PN, Sharma S. Rapid Household Survey, RCH project phase II, Agra, Uttar Pradesh, Population Research Center, University Enclave, New Delhi, 1999. Available at: Accessed 24th March 2014.

Ankrah V, Nwaigwe F. Immunization system review and training needs assessment in Ekiti State. February. Ado-Ekiti Ministry of Health. PATHS; 2005. Available at: Accessed 26th March 2014.

Nigeria Demographic and Health Survey 2013 - preliminary report. Available at: pg 23 Accessed 26 March 2014.

Nisar N, Mirza M, Qadri MH. Knowledge, Attitude and Practices of mothers regarding immunization of one year old child at Mawatch Goth, Kemari Town, Karachi. Pak J Med Sci. 2010;26(1):183-6.

Hamid S, Andrabi SA, Fazli A, Jabeen R. Immunization of Children in a Rural Area of North Kashmir, India: A KAP Study. Online J Health Allied Sci. 2012 Apr 15;11(1):153-6.

Federal Republic of Nigeria Official Gazette (15 May 2007) Legal Notice on Publication of the Details of the Breakdown of the National and State Provisional Totals 2006 census (PDF) Retrieved 2007-05-19. Available at: file:///C:/Users/indias/Downloads/Vol%2003%20Table%20DSx%20LGAPop%20by%20SDistrict-PDF.pdf

Anambra state, Nigeria. People, Local Government and Business opportunities in Anambra. Available at Accessed 6th February 2014.

Anambra State Government, Ministry of Health. Available at: Accessed 22nd August 2013.

Historical Society of Nigeria. Available at: Accessed 22nd August 2013.

Sabon Gari-Kano. Nigeria Available at Accessed 24th March 2014

World Health Organization (WHO). Immunization coverage cluster survey-reference manual. WHO/IVB/04.23 June 2005. Available at: Accessed 26th March 2014

Culture shock-UCI Study Abroad Center-University of California, Irvine. Available at: Accessed on 5th February 2015.

Wonodi C, Stokes-Prindle C, Aina M, Oni G. Landscape-Analysis of Routine Immunization in Nigeria. (NDHS 2008 National Immunization Cluster Survey 2010). Available at: Accessed 26th March 2014.

Smart Methodology. Sampling methods and sample size calculation for the SMART methodology, 2012 Available at: Accessed 22nd August 2013.

Statistical Package for Social Sciences (IBM SPSS) 22.0 version. Armonk NY: IBM United States. IBM Corp. 2013.

Glenda LL, Brynley, Craina M, Peter BM. Reasons for incomplete immunization among Australian children. Australian Fam Physician. 2004;33(7):13-19.

Bloom S, Wypij D, Das Gupta M. Dimensions of women’s autonomy and the influence of maternal health care utilization in a North Indian city. Neurography. 2001;38(1):67-78.

Bond L, Nolan T, Pattison P, Carlin J. Vaccine preventable diseases and immunisations: a qualitative study of mothers' perceptions of severity, susceptibility, benefits and barriers. Aust N Zs J Public Health. 1998;22:441-6.

Adeyinka DA, Oladimeji O, Adeyinka FE, Aimakhu C. Uptake of childhood immunization among mothers of under-five in Southwestern Nigeria. Internet J Epidemiol. 2009;7(2):1-5.

Brieger WR, Salami KK, Ogunlade BP. Catchment Area Planning and Action: Documentation of the community-based Approach in Nigeria. Arlington, Va.2004; BASIC 11 for USAID. Available at Accessed 22nd August 2013.

Basu AM, Stephenson R. Low levels of maternal education and the proximate determinants of childhood mortality: a little learning is not a dangerous thing. Social Sci Med. 2005;60(9):2011-23.

Parashar S. Moving beyond the mother-child dyad: Woman’s education, Child immunization and the importance of context in rural India. Social Sci Med. 2005;61(5):989-1000.

Muñoz-Laboy MA, Murray L, Wittlin N, Garcia J, Terto Jr V, Parker RG. Beyond faith-based organizations: using comparative institutional ethnography to understand religious responses to HIV and AIDS in Brazil. Am J Public Health. 2011 Jun;101(6):972-8.

Kaufmann JR, Feldbaum H. Diplomacy and the polio immunization boycott in Northern Nigeria. Health Affairs. 2009;28(4):1091-101.