Knowledge of Mothers Who Attending HaciQadir Antenatal Clinical Center Regarding Immunization حيقلتلا لوح رداق یجاحزكرمل تاعجارملا تاهملاا فراعم

Back ground: Immunization remains one of the most important public health interventions and costs effective strategy to reduce both the morbidity and mortality associated with infectious disease. Over two Million deaths are delayed through immunization each year worldwide. Objectives: This study aims to assess knowledge of mothers who attending Haci Qadr antenatal clinical center in Koya city and to identify age and level of education of mother’s effect of Knowledge about immunization. Methods: A descriptive study and quantitative design which was select sample by simple random sampling of 200 mothers who attending HaciQadr antenatal clinical center in Koya city for immunization of their children’s from 5 February 2013 to the 10 May 2013 were interviewed using questionnaire. Data was analyzed by using descriptive analysis (frequency and percentage) and applying SPSS through Chi-square test. Result: Most of mothers don’t have knowledge about immunization (61.5%). A statistically significant relationship was seen between level of education of mothers and knowledge about vaccination; university and institute graduation mothers showed have high knowledge (78.1%), ( 79%), while illiterate mother (7.14 %). Age of mother also have significant association with Knowledge of mother (20-30) year have (55.1%), while 40 year and over it was (16.7%). Almost all (97%) the respondents agree that immunization was important it could prevent childhood illness. Conclusion: According to the results of the study, many mothers don’t come regularly for vaccination of their children. As a result they miss the due date of vaccination. Low literacy level of mother is a matter of worry most of them don’t know about the disease for which their child is being immunized. Recommendation: It is dire need to arrange for health education program session for mothers, with main emphasis on important of vaccination and vaccine preventable disease. Media (television) was the most important source which can be used for spreading health education message.


INTRODUCTION:
The process of immunization increase resistance to an infectious disease by a means other than experiencing the natural infection, when the human immune system exposed to disease once it can developed the ability to quickly respond to subsequent infection, there for by exposing an individual to an Immunogen in a controlled way the person's body will then be able to protect itself from infection laten on in life (1) .
Immunization of infant and young children against serious infectious disease is among the most successful cost effective intervention in preventative health care, it is effective, safest and efficient public health intervention (2,3,4) .
The World Health Organization (WHO) rates of immunization as one of the interventions with the large potential impact on health outcome, the success of vaccination program relies on sufficiently high coverage to maintain herd immunity (WHO,  2000).While the impact of immunization on childhood morbidity and mortality has been great.Epidemiological study has shown that (2.5) million deaths occur every year as a result of vaccine preventable disease, mainly in African and Asian among children less than (5) years old (5) .
Parental Knowledge and beliefs about vaccine are an important factor in predicting a childes immunization, acceptance of immunization program is highly dependent on parental attitude, for example in response to hypothesized to link to Autism, coverage to Meals, Mumps, Rubella immunization in some area of Scotland decreased significantly reaching dangerous level below 80% (6,7) .

OBJECTIVES OF THE STUDY:
This study aims to assess knowledge of mothers who attending HaciQadr antenatal clinical center in Koya city and to identify age and level of education of mother's effect of Knowledge about immunization.

METHODOLOGY:
The present study was carried out through the application of quantitative design a descriptive study which used assessment approach.A sample of 200 mothers simple randomly selected who attending HaciQadr clinical center in Koya City from 5 th February 2013 to the 10 th May 2013 were interviewed using a questionnaire.The questionnaire included two part, part one socio demographic information and part two knowledge of mothers about vaccine which contain (13) items.Inclusion criteria were: the mothers who attending HaciQadir clinical center from Koya city for immunization of children's.Appling SPSS through Chi-square test and descriptive analysis (frequency and percentage).Table 1 shows thatA total of 200 mothers were assessed.The highest percentage of mothers (%49) were at age range of (20-30) years, majority of them level of education were primary school (25%), house wife occupation for mothers (56%)  Table 2presented that all vaccine preventable diseases knowledge about tuberculosis was highest as (47%), while diphtheria, Hepatitis B virus and tetanus were lowest (10%), (10%), (16%) respectively.Those mothers who could name at least one vaccine preventable disease as having knowledge and those who could not even name a single vaccine preventable disease were taken as not having any knowledge.Positive attitude were found among mothers (97%) of them declared that immunization was an important intervention because it protect child against diseases.Table 3 showed that there was high significant association between age and knowledge about vaccine, (20-30) year showed having knowledge (55.1%), while (41 year and over) showed less knowledge (16.7%).Table 4 shows that as far as High significant association between level of education and knowledge about vaccine, illiterate mother have less knowledge about vaccine (7.14%), while institute, collage graduation mothers have higher knowledge (79%), (78.1%)respectively.

DISCUSSION:
The findings of this study showed that most of the mothers don't have knowledge about immunization, there are many studies which support the finding of present research (3,8,9,10,11) .
Virtually all the mothers had heard about immunization however confusion in their mind to which disease was prevented by immunization.Maximum number of respondents (55%) knew about poliomyelitis followed by tuberculosis (47%), while Knowledge about hepatitis B viruse are very less it was (10%), the study conducted by (Rachna&Seetal, 2010) which support the findings of present research maximum number of respondents knew about poliomyelitis (85%) 3 , however Knowledge about hepatitis B viruses are very less it was (15%),while the study conducted by (Rahul and Sanjiv, 2008) most of mother knowledge about measles it was (61%) followed by tuberculosis it was (52.5%).This is probably related to different sample and even different in educational level of mother, because no information is given by nurse may have effect of knowledge of mothers regarding vaccine and vaccine preventable diseases (12) .
Mothers attitude about vaccination were positive, (97%) were agree that immunization was an important intervention because it could prevent childhood sickness, only (3%) of them believed that immunization was optional since there was alternatives for protecting child, also the studies was conducted by (Berensen et al 2011), (Manjunath and Pareek) were supported our findings (90%) of respondent have good attitude about immunization, it was indicating a very favorable attitude ( 9,13) .
The other findings of the present study is that there is relationship between level of education of mothers and knowledge about vaccine, illiterate mother have less knowledge compare to high level education mother, this association has also been reported by other investigators (Parashar, 2005) (14) & (Racine and Joyce, 2007) (15) .
Age of mothers have high significant association with knowledge of mother, (20-30) year of mother have high knowledge it was (54%), this age group was young may have educated and interested with most up-to-date information such internet, TV and media play a role in spreading health education and awareness of immunization, while the study conducted by( Nazish etal 2012), (Berensen et al 2011), (Awodele et al, 2005) was not agreement with our findings they showed that there was no significant association between age of mother and knowledge found, the researchers founded that older women were more educated about immunization (11,9,16) .

CONCLUSION
According to the results of the study, many mothers don't come regularly for vaccination of their children.As a result they miss the due date of vaccination.Low literacy level of mother is a matter of worry most of them don't know about the disease for which their child is being immunized.

RECOMMENDATION
It is dire need to arrange for health education program session for mothers, with main emphasis on important of vaccination and vaccine preventable disease.Media (television) was the most important source which can be used for spreading health education message.

Figure 1 :Figure 1
Figure 1: Knowledge of mothers about immunization