Assessment of Parents’ Perceptions of Childhood Immunization: A Cross-Sectional Study from Pakistan
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Site, Setting
2.2. Sample Size and Sampling Procedure
2.3. Data Collection Tool and Its Development
2.4. Reliability and Validity of the Tool
2.5. Data Analysis
3. Results
3.1. Socio-Demographic Characteristics of the Respondents
3.2. Parents’ Perceptions about Immunization of Their Children under Two Years of Age
3.3. Parents’ Perceptions Regarding Immunization Services and Factors Responsible for Delay in the Immunization of Their Children
3.4. Knowledge of Parents Regarding Immunization and Its Schedule for Their Children under Two Years of Age
3.5. Parents’ Satisfaction with Immunization Services Offered in Pakistan
3.6. Measures to Be Taken for the Improvement of Immunization Services in Pakistan
3.7. Comparison of Parents’ Knowledge Scores about the Immunization of Their Children under Two Years of Age by Demographic Characteristics
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | Rawalpindi n (%) | Islamabad n (%) | Composite n (%) | |
---|---|---|---|---|
Gender | Male | 71 (18.58) | 142 (37.17) | 213 (55.76) |
Female | 76 (19.89) | 93 (24.34) | 169 (44.24) | |
Age, yrs | Less than 20 | 2 (0.5) | 2 (0.5) | 4 (1.05) |
21–30 | 56 (14.65) | 110 (18.79) | 166 (43.45) | |
31–40 | 73 (19.10) | 88 (23.03) | 161 (42.14) | |
More than 40 | 13 (3.4) | 38 (9.94) | 51 (13.35) | |
Education | No formal education | 2 (0.5) | 5 (1.3) | 7 (1.83) |
Primary education | 8 (2.09) | 6 (1.57) | 14 (3.66) | |
Secondary education | 28 (7.32) | 31 (8.11) | 59 (15.44) | |
Higher secondary education | 4 (1.05) | 16 (4.18) | 20 (5.23) | |
Graduate | 51 (13.35) | 94 (24.60) | 145 (37.95) | |
Master’s degree | 51 (13.35) | 86 (22.51) | 137 (35.86) | |
Monthly income, Rs | Less than 10,000 | 5 (1.30) | 8 (2.09) | 13 (3.40) |
10,000–20,000 | 24 (6.28) | 36 (9.42) | 60 (15.70) | |
20,000–30,000 | 9 (2.35) | 27 (7.06) | 36 (9.42) | |
30,000–40,000 | 17 (4.45) | 36 (9.42) | 53 (13.87) | |
40,000–50,000 | 14 (3.66) | 30 (7.85) | 44 (11.51) | |
More than 50,000 | 27 (7.06) | 63 (16.49) | 90 (13.56) | |
No income source | 48 (12.56) | 38 (9.94) | 86 (22.51) | |
Occupation | Governmental | 11 (2.87) | 32 (8.37) | 43 (11.25) |
Healthcare professional | 10 (2.6) | 20 (5.23) | 30 (7.85) | |
Private employee | 24 (6.28) | 50 (13.08) | 74 (19.37) | |
Business | 11 (2.8) | 34 (8.9) | 45 (11.78) | |
Engineers | 8 (2.09) | 7 (1.83) | 15 (3.93) | |
Academia | 20 (5.23) | 47 (12.30) | 67 (17.54) | |
Blue collar | 6 (1.57) | 6 (1.57) | 12 (3.14) | |
Homemaker | 48 (12.56) | 38 (9.94) | 86 (22.51) | |
Banker/other professional | 4 (1.04) | 4 (1.04) | 8 (2.10) | |
Number of children | One | 40 (10.47) | 65 (17.01) | 105 (27.48) |
Two | 46 (12.04) | 81 (21.20) | 127 (33.25) | |
Three | 29 (7.59) | 53 (13.87) | 82 (21.46) | |
More than three | 29 (7.59) | 39 (10.20) | 68 (17.80) |
Questions | Islamabad | Rawalpindi | Composite | ||||||
---|---|---|---|---|---|---|---|---|---|
Strongly Agree/ Agree n (%) | Neutral n (%) | Strongly Disagree/ Disagree n (%) | Strongly Agree/ Agree n (%) | Neutral n (%) | Strongly Disagree/ Disagree n (%) | Strongly Agree/ Agree n (%) | Neutral n (%) | Strongly Disagree/ Disagree n (%) | |
Do you think childhood immunization is important? | 228 (59.68) | 10 (2.62) | Nil | 142 (37.17) | 2 (0.52) | Nil | 370 (96.85) | 12 (3.14) | Nil |
Do you think childhood immunization is beneficial? | 219 (57.33) | 14 (3.66) | 5 (1.30) | 129 (33.77) | 13 (3.40) | 2 (0.52) | 366 (95.81) | 27 (7.06) | 7 (1.83) |
Do you think immunization is safe for children? | 226 (59.16) | 12 (3.14) | Nil | 140 (36.65) | 3 (0.78) | 1 (0.26) | 348 (91.1) | 15 (3.92) | 1 (0.26) |
Is immunization prohibited by your religion? | 26 (6.81) | 30 (7.85) | 182 (47.64) | 26 (6.81) | 16 (4.18) | 102 (26.70) | 98 (25.65) | 56 (14.65) | 284 (74.34) |
Do you think the timing of vaccinations matters? | 185 (48.42) | 33 (8.63) | 20 (5.24) | 121 (31.67) | 14 (3.66) | 9 (2.35) | 306 (80.09) | 47 (12.29) | 29 (7.59) |
Questions | Islamabad | Rawalpindi | Composite | ||||||
---|---|---|---|---|---|---|---|---|---|
Strongly Agree/ Agree n (%) | Neutral n (%) | Strongly Disagree/ Disagree n (%) | Strongly Agree/ Agree n (%) | Neutral n (%) | Strongly Disagree/ Disagree n (%) | Strongly Agree/ Agree n (%) | Neutral n (%) | Strongly Disagree/ Disagree n (%) | |
Do you think the immunization services offered by the government are satisfactory? | 162 (42.40) | 31 (8.11) | 45 (11.78) | 93 (24.34) | 26 (6.80) | 25 (6.54) | 255 (66.74) | 57 (14.91) | 70 (18.32) |
Do you think fear of temporary side effects are a hurdle in adoption of vaccination? | 108 (28.27) | 49 (12.82) | 81 (21.20) | 77 (20.15) | 30 (7.85) | 37 (9.68) | 185 (48.42) | 79 (20.67) | 118 (30.88) |
Do you think an awareness campaign about childhood immunization is effective for the community? | 214 (56.02) | 19 (4.97) | 5 (1.30) | 121 (31.67) | 14 (3.66) | 3 (0.78) | 335 (87.69) | 33 (8.63) | 12 (3.13) |
Do you think an awareness campaign about childhood immunization is active in Pakistan? | 181 (47.38) | 25 (6.54) | 32 (8.37) | 98 (25.65) | 20 (5.23) | 26 (6.80) | 279 (73) | 45 (11.77) | 58 (15.17) |
Questions | Islamabad | Rawalpindi | Composite | ||||||
---|---|---|---|---|---|---|---|---|---|
Strongly Agree/ Agree n (%) | Neutral n (%) | Strongly Disagree/ Disagree n (%) | Strongly Agree/Agree n (%) | Neutral n (%) | Strongly Disagree/ Disagree n (%) | Strongly Agree/ Agree n (%) | Neutral n (%) | Strongly Disagree/ Disagree n (%) | |
Affordability | 144 (37.69) | 17 (4.45) | 77 (20.15) | 76 (19.89) | 17 (4.45) | 51 (13.35) | 220 (57.58) | 34 (8.9) | 128 (33.5) |
Unavailability of vaccines | 129 (33.77) | 35 (9.16) | 74 (19.37) | 74 (19.37) | 13 (3.40) | 57 (14.92) | 202 (53) | 48 (12.56) | 131 (34.29) |
Non-cooperative attitude of staff | 91 (23.82) | 47 (12.30) | 100 (26.17) | 52 (13.61) | 34 (8.90) | 58 (15.18) | 143 (37.43) | 81 (21.2) | 158 (41.35) |
Long waiting times | 102 (26.70) | 31 (8.11) | 105 (27.48) | 59 (15.44) | 22 (5.75) | 63 (16.49) | 161 (42%) | 53 (13.89) | 168 (43.97) |
Lack of awareness regarding immunization timing | 190 (49.73) | 15 (3.92) | 33 (8.63) | 108 (28.27) | 12 (3.14) | 24 (6.28) | 298 (78) | 27 (7.06) | 57 (14.91) |
Lack of access to immunization centers | 133 (34.81) | 33 (8.63) | 72 (18.84) | 91 (23.82) | 17 (4.45) | 36 (9.42) | 224 (58.63) | 50 (13.08) | 108 (28.26) |
Immunization Schedule | Islamabad | Rawalpindi | Composite | |||
---|---|---|---|---|---|---|
Correct n (%) | Incorrect n (%) | Correct n (%) | Incorrect n (%) | Correct n (%) | Incorrect n (%) | |
Vaccine given at birth | 26 (6.80) | 210 (54.97) | 16 (4.18) | 128 (33.50) | 42 (10.98) | 338 (88.46) |
Vaccines given at 6 weeks | 22 (5.75) | 216 (56.54) | 18 (4.71) | 126 (32.98) | 40 (10.46) | 342 (89.5) |
Vaccines given at 10 weeks | 21 (5.49) | 217 (56.80) | 11 (2.88) | 133 (34.81) | 31 (8.37) | 350 (91.6) |
Vaccines given at 14 weeks | 17 (4.45) | 221 (57.85) | 15 (3.92) | 129 (33.77) | 32 (8.37) | 350 (91.6) |
Vaccines given at 9 months | 27 (7.08) | 210 (54.97) | 19 (4.97) | 125 (32.72) | 46 (12) | 335 (87.67) |
Vaccines given at 12 months | 28 (7.33) | 210 (54.97) | 25 (6.54) | 119 (31.15) | 53 (13.87) | 329 (86.1) |
Do you know about the immunization day | 81 (21.20) | 157 (41.09) | 88 (23.03) | 72 (18.84) | 169 (44.23) | 229 (59.93) |
Do you know about the age up to which immunization is given to your children | 134 (35.07) | 104 (27.22) | 76 (19.89) | 68 (17.80) | 210 (54.96) | 172 (44.99) |
Have you ever experienced any adverse event with your child due to immunization | 80 (20.94) | 158 (41.36) | 61 (15.96) | 83 (21.72) | 142 (37) | 241 (63.07) |
Have you ever heard about mobile immunization team | 174 (45.55) | 64 (16.75) | 91 (23.82) | 53 (13.87) | 265 (69.37) | 117 (30.6) |
Immunization Schedule | Islamabad | Rawalpindi | Composite | |||
---|---|---|---|---|---|---|
Correct n (%) | Incorrect n (%) | Correct n (%) | Incorrect n (%) | Correct n (%) | Incorrect n (%) | |
Are you satisfied with the services provided by a mobile immunization team? | 140 (36.64) | 98 (25.65) | 73 (18.36) | 71 (18.58) | 214 (56) | 168 (44) |
Are you satisfied with the immunization provided at hospital centers? | 174 (45.55) | 64 (16.77) | 107 (28.01) | 37 (9.68) | 282 (73.56) | 100 (26.44) |
Are immunization services provided to children free of cost? | 144 (38.22) | 92 (24) | 97 (25.39) | 47 (12.30) | 243 (64) | 139 (36) |
Suggestions | Islamabad Answer ‘Yes’, n | Rawalpindi Answer ‘Yes’, n | Composite n (%) |
---|---|---|---|
Promotion of awareness and training of parents regarding the immunization of children | 63 | 22 | 85 (26.17) |
Easy availability and accessibility to immunization centers regulatory enforcement | 14 | 8 | 22 (5.75) |
Regulatory enforcement | 6 | 5 | 11 (3.40) |
Proper vaccine management system/health system | 11 | 8 | 19 (8.90) |
Not satisfied with service | 3 | 2 | 5 (1.30) |
Computerized vaccination system/tele-health/vaccination reminder | 5 | 2 | 14 (3.91) |
Cheaper/free of cost vaccine | 27 | 0 | 27 (7.06) |
Improve the services of the mobile immunization team, the availability, and involvement of the mobile immunization team | 12 | 10 | 22 (6.54) |
Involvement of religious scholars | 9 | 2 | 11 (2.87) |
Cooperative staff | 9 | 6 | 15 (3.92) |
Not responded | 43 | 54 | 97 (27.22) |
Satisfied | 6 | 4 | 10 (2.61) |
Promotion of awareness, improvement of immunization services | 10 | 5 | 15 (3.92) |
Variable | |||
---|---|---|---|
Gender | n | Knowledge Score (14–28) Mean Ranks | p-Value |
Male | 231 | 195.56 | 0.201 |
Female | 169 | 181.77 | |
City: Islamabad | 144 | 189.35 | 0.811 |
Rawalpindi | 238 | 192.80 | |
Occupation: Government employee | 53 | 146 | 0.121 |
Healthcare professional | 49 | 110 | |
Private employee | 74 | 140 | |
Businessman | 95 | 155.80 | |
Engineer | 25 | 141.80 | |
Academic staff | 86 | 125.95 | |
Age, y: Less than 20 | 4 | 160.62 | 0.418 |
Between 20 and 30 | 166 | 196.58 | |
Between 30 and 40 | 161 | 181.61 | |
More than 40 | 51 | 202.97 | |
Qualification: No formal education | 7 | 304.50 | 0.002 |
Primary education | 14 | 240.49 | |
Secondary education | 59 | 215.84 | |
Higher secondary education | 20 | 209.52 | |
Education up to graduation | 145 | 181.21 | |
Education up to master’s level | 137 | 177.28 | |
Monthly income in Rs: Less than 10,000 | 53 | 182.77 | 0.021 |
10,000–20,000 | 60 | 175.77 | |
20,000–30,000 | 42 | 131.97 | |
Rs 30,000–40,000 | 73 | 145.42 | |
40,000–50,000 | 64 | 134.90 | |
More than 50,000 | 90 | 138.49 | |
Number of Children: 1 | 105 | 182.99 | 0.851 |
2 | 127 | 191.29 | |
3 | 82 | 192.85 | |
4 | 68 | 199.71 |
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Hussain, A.; Zahid, A.; Malik, M.; Ansari, M.; Vaismoradi, M.; Aslam, A.; Hayat, K.; Gajdács, M.; Jamshed, S. Assessment of Parents’ Perceptions of Childhood Immunization: A Cross-Sectional Study from Pakistan. Children 2021, 8, 1007. https://doi.org/10.3390/children8111007
Hussain A, Zahid A, Malik M, Ansari M, Vaismoradi M, Aslam A, Hayat K, Gajdács M, Jamshed S. Assessment of Parents’ Perceptions of Childhood Immunization: A Cross-Sectional Study from Pakistan. Children. 2021; 8(11):1007. https://doi.org/10.3390/children8111007
Chicago/Turabian StyleHussain, Azhar, Anam Zahid, Madeeha Malik, Mukhtar Ansari, Mojtaba Vaismoradi, Adeel Aslam, Khezar Hayat, Márió Gajdács, and Shazia Jamshed. 2021. "Assessment of Parents’ Perceptions of Childhood Immunization: A Cross-Sectional Study from Pakistan" Children 8, no. 11: 1007. https://doi.org/10.3390/children8111007