Immunization is the process by which an individual's immune
system becomes fortified against an agent known as the immunogen (Frazer & Cooper, 2009).
Child mortality has fallen significantly in may low income countries however, sub-Saharan Africa countries to experience the slowest fall in mortality cater among children. It is estimated that 10.8 million children die worldwide each year, of which 41% of these deaths occurs in sub-Saharan Africa and 34% in South Asia. Six countries; India, Nigeria, china, Pakistan, the democratic republic of the Congo and Ethiopia account for half of worldwide childhood deaths Nigeria is ranked 2nd overall and 17th when ranked by under five mortality rate. The minimum development goals (MDG) for health in 2002, set targets for nations to reduce under five mortality rate by two thirds by 2015, from the base year 1990.
According to Nigeria's first millennium Development Goals Report in December 2004 Nigeria has already missed the 2005 target of the Goal for gender. The country may however not meet the other goals by 2015, unless current trends are reversed. Among the reasons for slow progress in attending the goal for reduction in child mortality the goal for reduction in child mortality in Nigeria are the inequitable access to immunization services deficient vaccine supplies and equipments.
Expanded Programme on Immunization (EPI) and National Programme on Immunization (NPI) (2005) in collaboration with Internal Journal of Paediatric Medicine (2010) made extensive surveillance coverage and estimated prevalence rates of EPI (6.4%) and NPI (2.9%), mothers who did not receive antenatal care (81.4% EPI and 25.6%, (NPI), those who did not take antenatal vaccine in pregnancy (87.7%).
Factors militating against implementation of immunization programme include inequitable access to immunization services, efficient vaccine supplies and equipments, high absenteeism rates of health care provide, lack of understanding about purpose of importance of vaccine, fear of government, health services; scientific innovation to increase efficacy and decrease cost socio-cultural perceptions of a vaccine.
Efforts and progress made to incase uptake and combat these factors are monthly survey surveillance of immunization coverage, monthly report on incidence of childhood killer diseases to WHO regional office, adoption of more aggressive operational strategies to expand immunization coverage in each district mobilization of responses by EPI and NPI partners (EPI & NPI 2005 & WHO 2007).
This paper work is aimed at:-
vTo discus the concept of immunization
vTo assess the level of coverage of Nigeria national immunization programme.
vTo explore the immunizable diseases.
vTo evaluate the current immunization schedule.
vTo assess the role of a nurse in immunization programme.
CONCEPT OF IMMUNIZATION
According to Bailliere’s Nurses’ Dictionary, 25th edition, immunization is the act of creating immunity by artificial means. So many individual have some amount of immunity, that protect them from infective agents, for instance some minor injuries and infections resolve's on it own without medical intervention, while to some when infected with some infective organism, the individual is being weighed done my symptoms of the disease except haven immunized against the disease example measles, polio, chicken pox. (Bercht, 2004).
Types of Immunization
A person who is immune to a disease is one who is protected against that disease by means of antibodies circulating in his blood or present in the cells of the tissues of his body. Immunity may be:-
* Passive immunity
* Active immunity
Passive Immunity: The antibodies in serum given to patients who are ill with diphtheria a tetanus, hence passive immunization refers to injection of prepared antibodies into a person who has either already been infected or is at risk of acquiring an infection. In this case the infected person's immune system is not actively protecting the body, hence the name passive immunization.
In congenital immunity, the body receives antibodies from the mother through the placenta the antibodies from the mother through me placenta. The antibodies pass into the baby's blood and help to protect against infections such as measles.
They slowly disappear from the baby's body, but may be present even up to the age of 1 year. Antenatal immunization of mothers against tetanus protects the newborn baby against neonatal tetanus. Another very important source of antibodies is breast milk; colostrums in particular contains large amounts of antibodies.
Most of the antibodies in colostrums and breast milk remain within tie baby's intestine, coating the surface of the living cells and not being absorbed. Thus they prevent bacteria and viruses from sticking to the lining of the intestines and finding their ways into cells and bloodstream. This is the reason why breast fed babies suffer much less from diarrhea and other infectious disease.
Active Immunity: It entails the introduction of a foreign molecule into the baby, which cause the body itself to generate immunity against infection. In this, the child makes his own antibodies in order to start the production of antibodies, it is necessary for the person for the person to be infected with the disease or given a vaccine which contains the bacteria or their products in a harmless form. Active immunization, whether brought about by illness or vaccines, lasts a long time some times throughout life. (Jelliffe, 2004).
LEVEL COVERAGE OF THE NIGERIA NATIONAL PROGRAMME ON IMMUNIZATION (NPI)
NPI is an acronym for national programme on immunization. The national programme on immunization is a tool which aids or supports immunization activities in Nigeria. According to Obionu, (2007), the agency was formerly known as the Expanded programme on immunization, but the Nigerian government in 1996 renamed the programme on immunization as the “national programme on immunization” with the aim of reawakening national consciousness and demonstrating ownership of the programme. The national programme on immunization aims to achieve immunization coverage by the year 2001 with the objectives to reducing drastically the number of death among children from vaccine preventable diseases for instance, the national programme on immunization (NPI) has successfully attained the universal child immunization (UCI) target of 80% by 2000 as in many countries. Woodruff, (2004). The national programme on immunization also aims at getting all women of childbearing age (15-44years) vaccinated against tetanus for the deal purpose of protecting the unborn baby and the mother.
Unfortunately, the national programme on immunization has also been changed recently to “the expanded programme on immunization (EPI)” this is because the coverage could not be sustained and there was a decline in coverage and increase in the number of reported cases of the target disease as noticed on some part of the country especially in the northern part of the country. Because of the importance of this programme, the new expanded pogramme on immunization (EPI) was established by “reaching the unreachable” and also charged with implementing, monitoring and evaluating the programme of immunization the programme has the following concepts as stipulated by Obionu (2007).
- To achieve polio eradication by the year 2005
- To eliminate maternal and neonatal tetanus by the year 2005
- To reduce measles by 90% and mortality by 95% compared to pre-immunization era by the year 2005.
- To improve routine immunization service delivery in order to achieve 80% coverage for all the antigens in all local government area by the year 2005.
- To consolidate the integration of new vaccine such as yellow fever, hepatitis B, and haemophilis influenza type B vaccines into the routine system in phased manner by the year 2007.
- To strengthen the new district based on social mobilization structure such that 80% community ownership is achieved by the year 2007.
- To conclude the cold chain rehabilitation plan by 2007.
- To ensure financial sustainability of the programme through expansion of source of funds and increase internal generated fund to 60% by the year 2007.
- To pursue knowledge and skills development among all the categories of health workers involved in immunization activities both public and private by ensuring that by the year 2007, 100% of all health institute providing immunization services are manned by adequately trained personnel.
After the implementation of these programmes, His expected that by 2010 all countries have routine immunization coverage of 90% of their child population, the Hep B be introduced in 80% of all countries by 2007 and that 50% of the poorest countries have Hib vaccine by 2005. (Stone Gold, 2005).