Vaccines Other Than Specified in National Immunization Schedule among Parents of under- five Children
Ritu Yadav
Lecturer, Faculty of Nursing, SGT University, Gurgaon
*Corresponding Author Email:
ABSTRACT:
Vaccination is the basic right of every child. This is the only way by which we can prevent many serious and communicable diseases in children. Parents are also willing to prevent these diseases in their children. A present study was a Quasi Experimental Study to Evaluate the Effectiveness of Planned Teaching Program Regarding Knowledge about Vaccines Other Than Specified in National Immunization Schedule among Parents of Under- five Children in a Selected Hospital at Gurgaon, Haryana. The main objective of the present study is to evaluate the effectiveness of planned teaching program on vaccines other than specified in national immunization schedule among parents of under five children in Aarvy hospital Gurgaon. The researcher used convenient sampling technique for selecting the samples. Total sample size was 60 out of that 30 were in experimental group and 30 were in comparison group. The data was obtained through structured knowledge questionnaire for assessing knowledge of parents about vaccines other than specified in national immunization schedule such as rotaviras vaccine, MMR vaccine, meningococcal vaccine, Japanese encephalitis vaccine etc. The finding reveals that the knowledge of parents of under five children about vaccines other than specified in national immunization schedule in pre test was 48.03% which is average knowledge and in post test it was 81.47% which falls in good category of knowledge according to set criteria. The present study found that post test knowledge level of parents of under five children has no significance with the selected socio demographic variables.
KEY WORDS: Effectiveness, planned teaching programme, Vaccination, National Immunization schedule, parents of under five children, vaccine other than specified in national immunization schedule.
INTRODUCTION:
World Health Organization (WHO) states that “health is a state of complete physical, mental and social well being not merely the absence of disease or illness”1. It is affected by a wide range of spectrum of physical, mental, social and political factors2. All these factors are responsible for better health condition and quality of life as these are related to each other if one is hampered it affects other also. It has been reported that 5 million children were dying each year and another 5 million were disabled by infectious diseases3.
Children, with their weaker immune systems, are especially vulnerable to infections. Therefore they are at an increased risk for contracting infections and vaccine preventable diseases like mumps, rubella, typhoid and rotavirus etc. Immunizing child is one way of guarding against some serious diseases4.
Apart from these there are a few vaccines recommended by IAP (the national body of Paediatricians) other than specified in national immunization schedule at this point of time. Vaccines other than specified in national immunization schedule are: Rotavirus vaccine, Haemophilus influenzae b (Hib) vaccine, Influenza vaccine, Varicella (Chickenpox) vaccine, Typhoid vaccine, Meningococcal vaccine, Japanese encephalitis vaccine, Pneumococcal vaccine, MMR vaccine5.
NEED FOR THE STUDY:
Immunization is one of the most cost-effective interventions for disease prevention6. The vaccines for the six killer diseases are already included in the National Immunization Schedule of the country7. But in view of the severity of other infectious diseases during the past several decades, the Government of the developing countries like India is trying to include new vaccines viz. Hib vaccine, Hepatitis A, Typhoid vaccine, pneumococcal vaccine, Meningococcal vaccine, influenza vaccine, rotavirus vaccine etc. into the routine immunization programme5-8.
Haemophilus influenza is caused by Type B influenza virus and this infection occurs usually between the ages of 3 months to 3 years and is nearly always associated with septicaemia. Typhoid fever is the result of systemic infection mainly by Salmonella Typhi9.
Almost one-fourth children born in developing countries die before their fifth birthday, in sharp contrast to only 2% in developed countries. 71-73% of underfive mortality is in the first year of life10. The neonatal mortality accounts for 45-62% of infant deaths in India. The major causes of sickness and death of children in India is mainly because of infectious disease many of which are preventable by administering vaccines11.
In view of the above mentioned statistical data and studies and also with researcher personal encounter with the parents of child suffering from some of the infectious diseases viz. typhoid, pneumonia etc. during her hospital experience, the researcher witnessed that the parents have inadequate knowledge regarding vaccines other than specified in national immunization schedule. So, the importance of selected vaccines must be repeatedly stressed to parents by health Personnel. A delay can lead to undue risk of serious illness. For the achievement of Universalisation of Immunity and to protect the children from infectious disease, to reduce mortality and morbidity, the parents of under five children need to be aware about vaccines other than specified in national immunization schedule and its importance to reduce the under five mortality rate. So, considering parents knowledge, the researcher personally felt that there is a need to study in this area and also to change the parental Practices through educational interventions.
STATEMENT OF THE PROBLEM:
“A Quasi Experimental Study to Evaluate the Effectiveness of Planned Teaching Program Regarding Knowledge about Vaccines Other Than Specified in National Immunization Schedule among Parents of Under- five Children in a Selected Hospital at Gurgaon, Haryana.”
OBJECTIVES:
To develop and validate the planned teaching program regarding vaccines other than specified in national immunization schedule.
To assess the pretest level of knowledge regarding vaccines other than specified in national immunization schedule among parents of under-five children.
To assess the posttest level of knowledge regarding vaccines other than specified in national immunization schedule among parents of under-five children.
To assess the effectiveness of planned teaching program regarding vaccines other than specified in national immunization schedule among parents of under five children.
To find the association between the knowledge level regarding vaccines other than specified in national immunization schedule among parents of under-five children and their socio demographic variables.
Hypothesis
H1- There will be a significant difference between pre-test and post-test knowledge level regarding vaccines other than specified in national immunization schedule among parents of under- five children at 0.05level of significance.
H0- There will be no significance difference between pre-test and post-test knowledge level regarding vaccines other than specified in national immunization schedule among parents of under- five children at 0.05 level of significance.
RESEARCH METHODOLOGY:
Research design- Quasi-experimental (Non-equivalent control group pre-test post-test design)
Setting of study- The study was conducted at Aarvy Hospital, Gurgaon. Data were collected from the parents of under five children in immunization clinic of Aarvy hospital, Gurgaon.
Population- Parents of under five children attending immunization clinic in Aarvy hospital, Gurgaon.
Sample size-Total sample size is 60. Experimental group- 30. Control group-30
Sample and sampling technique
Sampling method-Convenient sampling
Sample-Parents of under five children attending immunization clinic and who met the inclusion criteria
Tools and Techniques of Data Collection
Screening sheet: Based on the objectives of the study screening sheet was prepared to identify the subjects for the inclusion and exclusion criteria
.
Subject data sheet: To collect information about socio demographic characteristics of subjects, subject data sheet was constructed. Structured knowledge questionnaire was prepared regarding vaccines other than specified in national immunization schedule for under five children which was having 34 items.
Structured knowledge questionnaire regarding vaccines other than specified in national immunization schedule for under five children: It was for assessing knowledge of parents of under five children regarding vaccines other than specified in national immunization schedule. It was developed by investigator.
FINDINGS:
· In the present study parents of boys (53.3) % in both experimental and comparison group outnumbered girls (46.7) %.
· In both the groups experimental(100%) and comparison(100%) majority of parents belongs to Hindu family
· In both experimental and comparison group no parent is having family income less than 10,000.
· The multigravida mothers 21(70) %,18 (60) % is more than primigravida 9 (30) %,12(40) % in experimental and comparison group respectively.
Mean knowledge score of 30 parents in experimental group was 16.13± 4.659 in pre test which has been increased to 27.77±2.208 after teaching of parents with the help of PTP. (P=0.00) in table no. 1.
Mean Knowledge score of 30 parents in comparison group pre test score enhanced from 15.50± 3.93 to 18.27± 4.177 in post test in table no. 1.
Conceptual framework
The conceptual framework for this study is based on the “System Model” given in WHO SEARO technical publication, 1983 in fig-1.
Fig-1-Conceptual framework of the study based on a “system model” on planned teaching program.
Table-1 Mean, Median, Standard deviation and Mean difference in experimental and control group N=60
|
Knowledge level |
Baseline Score |
Post Score |
||
|
Experimental PRE |
Comparison PRE |
Experimental POST |
Comparison POST |
|
|
Mean Score |
16.13 |
15.50 |
27.77 |
18.27 |
|
Median Score |
17.5 |
15.5 |
28 |
17.5 |
|
S.D. |
4.659 |
3.937 |
2.208 |
4.177 |
|
Mean Difference |
0.633 |
9.500 |
||
|
Unpaired Test |
0.569 |
11.014 |
||
|
P value |
0.5718 |
0.0000 |
||
|
Table Value at 0.05 |
2.00 |
2.00 |
||
|
Result |
Non Significant |
Significant |
||
Fig-2; Comparison bar chart of pre and post test mean knowledge scores in experimental and comparison group
After implementation of PTP the mean post test knowledge score (27.77) was significantly higher than the mean pre test knowledge score (16.13) at 0.05% in fig-2.
There is no significant association between the post test knowledge scores of parents of under five children with their socio demographic variables.
IMPLICATIONS:
Nursing education
Vaccines other than specified in national immunizaton schedule should be specifically teached so that they can counsel the parents to have informed choice.
Nursing administration
Train the staff posted in immunization clinic regarding vaccines other than specifed in national immunization schedule given in under five children so that they can educate the parents coming in clinic.
Nursing practice
Awareness about different communicable and killer diseases other than considered in national immunization schedule should be there to nursing staff and major killer diseases to be identified.
RECOMMENDATIONS:
Similar study can be replicated in different setting on large sample size.
A comparative study can be done to assess the knowledge about vaccines other than specified in national immunization schedule among rural and urban parents of under five children.
True experimental study can be done to assess the knowledge about vaccines other than specified in national immunization schedule.
Similar study can be replicated with the solomon four group design.
REFERENCES:
1. Dr. K. Chandramohan. The Hindu. Online edition of India's National Newspaper
2. K.Park. Text Book of Preventive and social medicine. 20th edition. Banarsidas Banot Publication, Jabalpur. PP 603-610. Vaccines recommended for Indian children Available from URL http://www.bolohealth.com/expertspeak/Indukhosla/healthyskin and-hair/82vaccines-recommended-for-indian-children
3. Y K Amdekar. Optional vaccines: a critical appraisal. Issues Med Ethics.2000 Jan-Mar;8(1) .Available from URL: http://www.issuesinmedicalethics.org/081mi007.html
4. Hemant Patel, Mahesh Balsekar. Optional Vaccines. Journal of Preventive Medicine. 2011 September; vol 63: p: 52-54.
5. Park. K. Text Book of Preventive and Social Medicine.16thed.Jabalpur. M/S. Banarasidas Bhonot Publishers.2000;115-157
6. Mosley H. Child Survival research and policy. World health forum. 1985;6:352-353
7. International Institute of population sciences and ORC Marco.2000. http://www.nfhsindia.org/data/india/indintro.pdf
8. Chaturvedi P, Ayengar J, Chaturvedi D. Mortality Trends of Hospital Admission in a Rural Medical College Hospital with Special Emphasis on Infant Mortality. Indian Journal of Community Medicine.2004;29( 4): 10 -12 Chandra. P. Child health Development after Alma Atta Declaration. Indian Paediatrics.2000; 38:1129-1143.
9. Wardlaw T, Jahnson EW, Hodyge M. Pneumonia-The forgotten Killer of Children. 2006. http://www.unicef.org/publications/files/pneumonia-the-forgotten-killer- of- children.pdf
10. Puri S, Bhatia V, Singh, Swami HM, Kaur A. Uptake of newer vaccines. 2007 Jan; 74(1): 47-50
11. Shriyan Amrita. Incidence of Japanese encephalitis in a tertiary care canter. Issue no.-4. Volume-4. Page-2697.Available from URL: http://www.jcdr.net.
Received on 08.11.2014 Modified on 25.11.2014
Accepted on 02.12.2014 © A&V Publication all right reserved
Int. J. Adv. Nur. Management 3(1):Jan. - Mar., 2015; Page 64-68
DOI: