Factors affecting the use of immunization among urban settlement dwellers in Papua New Guinea

Abstract

This paper examines the importance of selected social factors in the acceptance of childhood immunization in urban settlements in Port Moresby, Papua New Guinea. The study found that the provision of information to mothers on when to start immunization and how often the child should be immunized were key factors in determining immunization status. Maternal education was found to be positively associated with knowledge of immunization, but was not significantly associated with actual immunization practice. Over 70% of the women studied found out when to attend for immunization from the local maternal and child health (MCH) staff, hence emphasizing their importance in disseminating information. If coverage is to be increased further in urban settlements with mobile populations, maximal use must be made of local community organizations to disseminate the key immunization information and for follow-up of newborns and infants new to the community. Efforts to encourage mothers to deliver under supervision should also continue as this is an important point of first contact for immunization.

PIP: A community-based study was carried out between July 30 and August 13, 1990, in order to assess the level of immunization coverage in 11 Port Moresby urban settlements and to examine selected social factors in the completion of the immunization. The population comprised women living in urban settlements with children under the age of 2 years. Multistage sampling was used to select the sample. A sample size of 323 children was derived on an expectation of 70% coverage, with an allowance for 5% error. 345 mothers were interviewed in Melanesian Pidgin by trained interviewers and 345 children were included in the survey. Of the mothers, only 154 had ever attended school and only 128 (37%) had completed more than 4 years of school. Maternal education was positively associated with residence in planned settlements (p 0.01). Only 189 (55%) of mothers were able to explain the preventive effects of immunization. 58% did not know when immunizations should commence and 48% did not know how many times the child should be immunized in the first year of life. When asked what prevented them from attending immunization clinics, lack of money to pay the bus fare was the most common reason given (n = 24), followed by indifference (n = 23) and sickness in the family (n = 8). Longer maternal education was associated with knowledge of when to start childhood immunizations (p 0.001), and of the number of times that children should be immunized (p 0.001). Mothers' education was also associated with the ability of mothers to name the diseases which immunization prevents (p 0.001). Among 232 (79%) of 293 children more than 1 year old, the immunization coverage was 93.5% for bacillus Calmette-Guerin, 85.3% for third dose of tetanus and oral poliomyelitis virus, and 82.8% for measles vaccine. 77.6% of children had received all antigens. The knowledge of mothers of when to start immunization was positively associated with actual immunization practice (p 0.01), as was the knowledge of the number of times that a child should be immunized (p 0.006).