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Title Page: ———————————————————–                i

Declaration: ——————————————————–                           ii

Certification: ——————————————————-                           iii

Approval Page:     ————————————————–                iv

Dedication: ———————————————————                           v

Acknowledgment: ————————————————-                           vi

Table of Contents: ————————————————–                vii

Abstract: ————————————————————                           ix


1.1     Background of the Study:         —————————–             1

1.2     Statements of the Problem: ——————————-                 4

1.3     Research Questions: —————————————                 6

1.4     Purpose of the Study: ————————————–                 6

1.5     Hypothesis: ————————————————-                 7

1.6     Significance of the Study: ———————————                8

1.7     Scope of the Study: —————————————–                8

1.8     Limitations of the Study: ———————————–               9

1.9     Definition of Terms: —————————————                 10

1.10   Organization of the Study: ———————————               11



2.1     Literature Review: ——————————————-               12

2.2     Theoretical Framework: ————————————               17




3.1     Research Design: ——————————————-                 21

3.2     Area of the Study: ——————————————                 21

3.3     Population of the Study: ———————————–                21

3.4     Sample and Sampling Techniques: ———————–               22

3.5     Methods of Data Collection: ——————————-               23

3.6     Instruments of Data Collection: —————————               24

3.7     Reliability of the Instruments: —————————–               24

3.8     Validity of the Instruments: ——————————-                24

3.9     Distribution and Retrieval of Instruments: ————-                 24

3.10   Methods of Data Analysis: ——————————–               25




4.1     Data Presentation: —————————————–                  26

4.2     Analysis of Research Questions: ————————-                29

4.3     Testing of Hypothesis: ————————————-                35


4.4     Interpretation of Results: ———————————                  42





5.1     Summary: —————————————————                 43

5.2     Conclusion: ————————————————-                 44

5.3     Recommendations: —————————————-                  44

References: ————————————————-                  46

Appendix A: ————————————————                 47

Appendix B: ————————————————                 48




This research project titled: child immunization and infant mortality in the rural area of Aguata L.G.A (a case study of Ekwulobia general hospital, Anambra State) is a case study type of research, and the instrument used in gathering date is the questionnaire method. Every dick and harry on the rate of death of our children attracts concern from every rural areas in Nigerian. It is clear that the only way to wipe out a race is to cut its means of future reproduction which is the children and this children are believed to be our future presidents, governors etc and the ensure older generation of a better tomorrow. Infant morality have a considerable significance on demography. The level of death rate in early life has been described as a crucial test of the health service and special progress of a country. The young child’s life is wholly dependent on the care of mothers.  It is base on this that the government through Ekwulobia general hospital to fights, to ensure that all the preventable childhood disease that leads to infant deaths the reduced to most minimal level. Immunization is one of the world’s most cost-effective health interventions that helps prevent childhood diseases. However, many infants are not usually fully vaccinated especially in developing countries. This contributes to mortality Vaccine-Preventable Diseases (VPD) in children   This gave way to the introduction of Expanded programme on immunization (EPI) and ORAL Dehydration Therapy (ORT).  These programmes are aimed at teaching parents on how to make salt, sugar, water as oral drip to cure diarrhea and to immunize poliomyelitis, small pox, chicken pox, whooping cough and tuberculosis. Ever since the introduction of these programmes, great lots have been achieved by reducing the number of infants death.  This instigated my writing this project. With the data I collected from Ekwulobia general hospital, Anambra State on the number of infants death and sex distribution.





1.1     Background to the Study

          Infant mortality is mostly caused by diseases and these diseases are due to the prevalence of parasite hosts in certain areas.  It is believed that year, thousands of children are born in this country and thousands of these children die from diseases such as diphtheria, whooping cough, tetanus, poliomyelitis, measles and childhood tuberculosis.

This is stated in a pamphlet on Expanded Programme on Immunization (EPI) published by the Federal Epidemiological unit, Federal Ministry of Health, Lagos, 1981.

Children’s development and survival are influenced by a number of factors which include environmental sanitation, most of all nutrition and parents lack of awareness some children are malnourished due to the fact that their parents do not know what constitutes a balanced diet for.  They lack the knowledge of what helps the children to grow normally and build up strong immunity against such diseases that emanate from under – nourished diet.  Some parents are illiterate and ignorant, that is why in some remote areas of the country children die out of carelessness and parent ignorance.

Ignorance, in the sense that some parents do not know or observe the programme introduced by the ministry of Health to ward – off those six killer diseases which is Expanded Programme on Immunization (EPI), presently, the government of Nigeria has carried out a national expanded programme on immunization (EPI) to control these six childhood diseases throughout the federation.

Although, Nigeria has been declared small pox free surveillance against the disease is still being maintained.  Government should be commended on their efforts to create awareness on the side of the parent and their effort to ward off these diseases, thereby reducing the infant deaths in the country.

More can be done also by educating the parents o how to maintain good environmental hygiene and nutritional standard of their diet so as to rear healthy children.

Actually, the rate of infant mortality motivated me to carry out a research on this project topic and also suggest ways which can reduce the rate of infant mortality.


Immunization is an inexpensive and increasingly easy to administer strategy which when combined with improved nutrition and sanitation saves children 3. In most developed nations, immunization programmes have had dramatic success in reducing morbidity and mortality rate significantly. Such programmes have helped in the eradication of diphtheria, measles, neonatal tetanus, pertusis and poliomyelitis since 1993 4. Immunization has saved over 20 million lives in the last two decades. More than 100 million infants are immunized each year. This saves more than 3 million lives annually. Global mortality attributed to measles decline by 78% from an estimated 733,000 deaths in 2000 to 161,260 deaths in 2008. The prevalence of polio had decline dramatically since 1990. The number of polio cases world wide as of 2009 was 1606 and as of May 2010 it was 115 5. Immunization is defined as the creation of immunity against a particular disease. It could be the treatment of an organ and/ or making a body immune to subsequent attack by particular pathogens through giving of vaccine,6.7. These vaccines protect individuals at risks of acquiring infection by inducing a variety of immune mechanisms. Immunity so acquired can be active or passive.




1.2     Statement of the Problem

Immunization is aimed at the prevention of infectious diseases. In Nigeria, the National Programme on Immunization (NPI) suffers recurrent setbacks due to many factors including ethnicity and religious beliefs. Nigeria is made up of 36 states with its federal capital in Abuja. Nigeria was estimated to have a population of 167 million in 2011. The Expanded Programme on Immunization (EPI), introduced in 1978 with the aim of providing routine immunization to children less than the age of two years, recorded initial but intermittent successes. The optimum level was recorded by the early 1990s with the country achieving a universal childhood immunization coverage of 81.5%. But since that period of success, Nigeria has witnessed gradual but consistent reduction in immunization coverage. By 1996, the national data showed less than 30% coverage for all antigens, and this decreased to 12.9% 2003. This figure which is consistent with the 2003 national immunization coverage survey figures is among the lowest in the world and explains the poor health status of children in the country. It is the worst in the west African subregion, only better than Sierra Leone. For instance, the polio epidemic in Nigeria is the worst in the African region and constitutes threat to other nations

1.3     Research Questions

  1. To what extent does child immunization impact on infant mortality in the rural areas?
  2. To what does the expanded Programme on Immunization in rural areas in Anambra State fell?
  3. To What can be infant deaths be minimized in the rural areas through immunization?


1.4     Purpose of the Study

          The aims and objectives of this project are as following

  1. To determine the effect of child immunization and infant mortality in the rural areas.
  2. To know the impact of Expanded Programme on Immunization in rural areas in Anambra State.
  3. To find out, if child mortality can be reduced through immunization occur in the rural areas.

1.6 Significance of the Study

Immunization has been one of the most significant, cost-effective and stimulatory public health intervention. Nigeria, along with the whole world, stands committed to the welfare of children, as reflected in the theme of ‘World Health Day, 2005,’ viz., “Make every mother and child count”. Globally about one-quarter or 25% of the under-five mortality is due to vaccine preventable diseases.

Even with all the hard work done by the governmental and non-governmental institutes for 100% immunization coverage, there are yet areas with very low coverage. In Nigeria, immunization services are offered free in public health facilities, but despite rapid increases, the immunization rate remains low in some areas. According to the National Family Health Survey (NFHS-3) 2005-06, in Nigeria 44% of the children of age one to two years have been fully immunized, whereas in Ekwulobia only 5.5% children were fully immunized.

According to DLHS-3 (2007-2008) in rural area of Anambra, 46.6% children were fully immunized, 13.2% of the children were unimmunized, while the overall rates in the state of Ekwulobia were 5.5 % and 12.1 %, respectively. The present study was planned to assess the child immunization and infant mortality in the rural areas


1.7     Scope of the Study

This study has as its scope to know the child immunization and infant mortality in the rural areas, using Ekwulobia general hospital as a case study


1.8     Limitations of the Study

          This study is limited in scope and coverage area to the Ekwulobia general hospital, Anambra State.  The age interval considered in this project is are the infant, because from the definition of the term, “infant mortality” the most ideal age is under 1 month to 5 years.

1.9     Definition of Terms

IMMUNIZATION: When you get sick, your body makes antibodies to fight the disease to help you get better. These antibodies stay in your body even after the disease is gone, and protect you from getting the same illness again. This is called immunity. However, you don’t have to get sick to develop immunity. You can gain immunity against disease through immunization.

Infant mortality: refers to deaths of young children, typically those less than one year of age. It is measured by the infant mortality rate (IMR), which is the number of deaths of children under one year of age per 1000 live births. The Under-Five Mortality Rate is also an important statistic considering the Infant Mortality Rate has a strict limit on focusing on children only under one year of age.

A rural area: is an open swath of land that has few homes or other buildings, and not very many people.


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