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Effect of Immunization Education on Childhood Vaccination Uptake among Mothers in Nigeria

Abstract

Childhood immunization is one of the most effective public health interventions for preventing vaccine-preventable diseases, reducing childhood morbidity and mortality, and promoting population health. Despite the availability of routine childhood vaccination programmes, gaps in vaccination coverage continue to exist in Nigeria, particularly among children living in underserved communities and households facing barriers to healthcare access. Immunization education provides mothers and caregivers with accurate information about the benefits of vaccination, recommended immunization schedules, vaccine-preventable diseases, possible mild side effects, contraindications, and the importance of completing all recommended vaccine doses. Mothers play an important role in childhood vaccination because they are frequently responsible for decisions concerning children's healthcare and attendance at immunization services. However, inadequate knowledge, misconceptions about vaccine safety, fear of adverse effects, misinformation, religious and cultural beliefs, limited access to health information, and concerns about the quality of vaccines may influence mothers' decisions regarding childhood vaccination. In addition, practical barriers such as distance to health facilities, transportation costs, inconvenient clinic schedules, and vaccine availability may affect vaccination uptake even when mothers have adequate knowledge. Effective immunization education may improve mothers' understanding of vaccination and encourage timely and complete utilization of routine immunization services. Against this background, this study investigates the effect of immunization education on childhood vaccination uptake among mothers in Nigeria. The study is anchored on the Health Belief Model (HBM), Theory of Planned Behavior (TPB), and Knowledge-Attitude-Practice (KAP) 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 to vaccinate their children. The Theory of Planned Behavior proposes that attitudes, subjective norms, and perceived behavioural control influence intentions and subsequent vaccination behaviours. The Knowledge-Attitude-Practice framework provides a basis for examining how immunization education may improve knowledge and attitudes and consequently influence vaccination practices. Collectively, these theoretical perspectives provide a comprehensive framework for explaining how immunization education may influence childhood vaccination uptake among mothers in Nigeria. The study adopts a quantitative cross-sectional 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, and eligible mothers. Immunization education will be measured using mothers' knowledge of vaccine-preventable diseases, recommended childhood vaccination schedules, vaccine benefits, vaccine safety, possible adverse events, contraindications, and the importance of completing recommended vaccine doses. Childhood vaccination uptake will be assessed using vaccination records, immunization cards where available, and maternal reports, with emphasis on receipt of age-appropriate routine vaccines and completion of recommended doses. Descriptive statistics will be used to summarize mothers' sociodemographic characteristics, immunization knowledge, exposure to education, and children's vaccination status. Inferential statistical techniques, including chi-square tests, correlation analysis, and multiple logistic regression analysis, will be employed to determine the effect of immunization education on childhood vaccination uptake. Where appropriate, vaccination records will be compared with maternal reports to improve the accuracy of vaccination-status assessment. Diagnostic tests will also be conducted to assess multicollinearity, model specification, goodness of fit, and the robustness of the findings. The study anticipates that immunization education will have a significant positive effect on childhood vaccination uptake among mothers in Nigeria. Mothers who receive accurate and comprehensive immunization education are expected to demonstrate better knowledge of vaccine-preventable diseases, recommended vaccination schedules, vaccine benefits, and the importance of completing childhood immunization. Improved knowledge may reduce misconceptions and fears surrounding vaccines and encourage mothers to attend routine immunization sessions and ensure that their children receive age-appropriate vaccine doses. However, immunization education alone may not guarantee complete vaccination because mothers may continue to face barriers such as distance to healthcare facilities, transportation costs, inconvenient clinic schedules, vaccine stock-outs, poor healthcare experiences, misinformation, and limited household resources. Consequently, the effectiveness of immunization education is expected to be greater when educational interventions are combined with accessible, reliable, affordable, and consistently available vaccination services. This study is expected to contribute to the literature on childhood immunization, maternal health education, vaccine uptake, health promotion, and public health in Nigeria by providing empirical evidence on the relationship between immunization education and childhood vaccination uptake among mothers. The findings will provide useful information for the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), National Emergency Management Agency (NEMA), state ministries of health, primary healthcare facilities, community health workers, immunization programme managers, development partners, and policymakers regarding strategies for improving routine childhood vaccination coverage. The study will also provide evidence-based recommendations for strengthening maternal immunization education, improving community-based vaccine communication, addressing vaccine misinformation, promoting accurate understanding of vaccination schedules, strengthening reminder and follow-up systems, improving vaccine availability, and integrating immunization education into routine maternal and child healthcare services across Nigeria.

Keywords: Immunization education, childhood vaccination, vaccination uptake, mothers, routine immunization, vaccine-preventable diseases, maternal health education, vaccine acceptance, child health, public health, Nigeria.