A research proposal submitted to Debre

Brehan university research coordinating

office on assessment of mothers
practice towards child vaccination and
its associated factors with child
vaccination in
Debre Brehan town
Principal Investigator
Endale Melesse (M.Sc.)

Debre Brehan, Ethiopia.

October, 2010.
1

A research proposal submitted to Debre

Brehan university research coordinating
office on assessment of mothers
practice towards child vaccination and
its associated factors with child
vaccination in
Debre Brehan town
Team Members
1. Tesfa Dejenie (B.Sc.)
2. Yohannes Gebireegzeabher (B.Sc.)
3. Sisay Mulugeta (B.Sc.)

Debre Brehan, Ethiopia.

October, 2010.

Table of content

Page
2

Table of content------------------------------------------------------------------------------------I
List of abbreviation-------------------------------------------------------------------------------III
Abstract---------------------------------------------------------------------------------------------1
1. Introduction-------------------------------------------------------------------------------------2
1.1. Back ground---------------------------------------------------------------------------2
2. Statement of the problem---------------------------------------------------------------------3
3. Literature review-------------------------------------------------------------------------------4
4. Significance of the study-----------------------------------------------------------------------5
5. Objective of the study--------------------------------------------------------------------------6
5.1. General objectives--------------------------------------------------------------------6
5.2. Specific objectives--------------------------------------------------------------------6
6. Methodology--------------------------------------------------------------------------------------6
6.1
6.2
6.3
6.4
6.5
6.6
6.7
6.8

study area----------------------------------------------------------------------------6
study design------------------------------------------------------------------------6
study period-------------------------------------------------------------------------6
study population--------------------------------------------------------------------6
source population------------------------------------------------------------------6
sampling unit------------------------------------------------------------------------6
study unit-----------------------------------------------------------------------------7
study variable------------------------------------------------------------------------7
6.8.1. Independent variables-------------------------------------------------------7
6.8.2. Dependent variables---------------------------------------------------------7

6.9. Inclusion and exclusion criteria--------------------------------------------------------7

6.9.1. Inclusion criteria--------------------------------------------------------------7
6.9.2. Exclusion criteria-------------------------------------------------------------7
6.10. Sampling technique and sampling size determination----------------------------7
6.11. Data collection tools and procedures------------------------------------------------8
6.12. Data quality assurance-----------------------------------------------------------------8
6.13. Data processing and analysis---------------------------------------------------------8
6.14. Operational definition of terms-------------------------------------------------------9
7. Dissemination of result----------------------------------------------------------------------------9
I
8. Ethical consideration-------------------------------------------------------------------------------9
3

9. Action plan------------------------------------------------------------------------------------------10
10. Budget proposal-----------------------------------------------------------------------------------11
11. Reference-------------------------------------------------------------------------------------------14
12. Annex------------------------------------------------------------------------------------------------16
12.1. Questionnaire----------------------------------------------------------------------------17

II
4

List of abbreviation
AEFI: Adverse effect following immunization
BCG; Bacillus calmette Guerin
BSC: Bachlore of science
DTP: diphtheriatetanuspertussis
EFY: Ethiopian fiscal year
EPI: Expanded program of immunization
FMOH: Federal Ministry of Health
GAVI: Global alliance Vaccine and Immunization
Heb: Hepatitis type b
Hib: Homophiles influenza type b
HSDP: Health sector development program
IMR: Infant mortality rate
MCH: Maternal and Child Health
MDG: millennium development goal
MPH: Master of Public Health
NGO: Non-governmental organization
NPW: Non pregnant women
OPV: Oral Polio Vaccine
PEI: Polio Eradication Initiative
PI: Principal Investigator
PW: Pregnant women
RED: Reaching every district
RHB: Regional health Bureau
SOS: Sustainable outreach service
TT: Tetanus toxoid Vaccine
UN: United Nations
UNICEF: United Nations children fund
URTI: upper respiratory tract infection
V.P.D: vaccine preventable diseases
WCBA: Women child bearing Age
WHO: world health organization

III
5

ABSTRACT
Introduction: Infant and under five mortality rates in Ethiopia is among the highest in
the world. About 472,000 children die each year before their fifth birth days. The highest
proportion for childhood deaths is due to Vaccine preventable diseases. EPI program
encompass multiple activities to be conducted by different bodies at different level of
organization and health sectors. EPI was started in Ethiopia in 1980 with the aim of
reducing morbidity and mortality of children and mothers from vaccine preventable
diseases. During the inception of EPI the objective was to increase immunization
coverage by 10 % annually but this target has not been realized even after two decades
because of factors such as poor health infrastructure, low number of trained manpower,
high turnover of staff and lack of donor funding.

Objective:

To assess knowledge, attitude and practice of mothers towards

immunization in Debre Brehan district/ town, North Shoa administrative zone, Amhara
region, Ethiopia.

Methodology: A descriptive community based cross sectional survey will be

undertaken to assess Knowledge, Attitude, and Practice among mothers of Debre
Brehan town towards immunization from November to January 2003. A multi stage
sampling technique will be used to select samples from the general population. By
considering 5% non-response rat, the total sample size will be 845. From the total 9 kebeles in
the town 4 of them will be selected by lottery method. A structured questionnaire composed

of closed-ended questions will be administered to the respondents to collect the

quantitative data. Qualitative data will be collected by observation by using check list.
Data collectors will approach by introducing him/her self and interview the selected
respondents after informed consent obtained. The data collectors will be recruited
depending on the criteria, the one who has Bachelor of Science in nursing and above,
and both female and male applicants will be accepted. The data gathered through the
structured questionnaire will be entered to EPI- INFO version 6 and SPSS version 16 a
statistically packed soft ware for analysis. Qualitative data will be analyzed and
presented by descriptive statement.

Expected result:

80% of the sample mothers have good knowledge, 80% of the

sample mother have good attitude, and 75% of the sample mother have good practice
of immunization.

Budget summary: This proposal will require a total of 20,642.50 Ethiopian birr with
personnel cost of 12,600.00, equipment and supplies cost of 3,460.00, transportation
and communication cost of 480.00, training /Refreshments cost of 1,410.00, and
contingency (10%) of 2,692.50.

1. Introduction
1.1. Back ground
Infant immunization is considered essential for improving infant and child survival. In
1974 when the world health organization (WHO) launched the Expanded program of
immunization (EPI), the program was based on the belief that most countries already
had some elements of nation immunization activities which could be successfully
expanded if the program become a national priority with the commitment from the
government to provide managerial manpower and fund to provide service to at least
85% of the target population .i.e. children under four years. Because of differences in
epidemiological factors the common childhood diseases targeted for vaccination in
Expanded Program on Immunization (EPI) are vary in different countries around the
world. WHO recommended targeted diseases, and also adopted in Ethiopia are
measles, pertussis (whooping cough), tuberculosis, tetanus, poliomyelitis and
diphtheria. (1)
Recently Hepatitis B virus and Homophiles Influenza type b are included in EPI
program in Ethiopia. (2)
EPI was started in Ethiopia in 1980 with the aim of reducing morbidity and mortality of
children and mothers from vaccine preventable diseases. During the inception of EPI
the objective was to increase immunization coverage by 10 % annually but this target
has not been realized even after two decades because of factors such as poor health
infrastructure, low number of trained manpower, high turnover of staff and lack of donor
funding. The same factors still affect the program today. The target group when the
program started were children under two years of age until it changed to one year in
1986 to be in line with the global immunization target. (3, 4)
Ethiopia has developed a health policy in 1993 and revised EPI policy in 1997. The
national EPI policy recommends that health workers should use every opportunity to
immunize eligible children according to the recommended schedule. The policy says
children who are hospitalized should be immunized as soon as their general condition
improve and at least before discharge from hospital. An individual with known or
asymptomatic HIV infection should receive all EPI vaccine at as early age as possible.
Patients with overt AIDS should receive all vaccine except BCG and yellow fever. EPI
service should be routinely available preferably on daily bases in all facilities
(Governmental, NGO and private).The policy also state about the need to screen and
assess status of children and women at every contact prior to giving antigens. The
program strategies of EPI are directed for increasing immunization coverage, to reduce
missed opportunities/ defaulters, increasing the quality of immunization service, improve
public awareness and community participation, to sustain high immunization coverage
and disease Eradication/control/Elimination strategies.
One of the strategy to combat vaccine preventable disease is immunization , 2001 EFY
national report showed that the immunization coverage of DPT3,measle and fully
7

vaccinated has reached to 72.6%,64.9%,and 52.5% respectively and in Oromia region

the coverage was 74.4% 81.8% and 51.0 % respectively. (5)
The Polio Eradication Initiative (PEI) is a global program with the target of a polio free
world by the year 2005. Ethiopia has achieved tremendous progress in its Polio
Eradication Initiative activities since it commended in 1996.
To achieve the Millennium Development Goal (MDG) of reducing child deaths by twothirds in 2015, Ethiopia has adopt strategies such as Sustainable outreach service
(SOS) and Reaching every district (RED) that focus on identifying bottlenecks and
developing community ownership of the services in order to improve routine
immunization services and increase coverage. (6)
The immunization program is funded primarily by partners and government; vaccine
cost by UNICEF, salary by government, cold chain equipment, transport equipment,
social mobilization and some operational cost by WHO, UNICEF and other development
partner. In terms of health financing and budget provisions, the government has taken
steps to reallocate resource from curative to preventive care targeting the rural
population. So the involvement of stakeholders/partners is important for strengthening
immunization service and the achievement of high coverage.
Ethiopia is using different strategies and innovations to increase the national EPI
coverage throughout the country to benefit from it in reducing child and infant mortality
that is one of the millennium development goals of 2015 but still national EPI coverage
is low. During the years 2001-2002 there was an increasing trend in EPI coverage
where the national coverage based on DPT3 reached 70% and after wards the
coverage began to decline to 65 % in 2003/4. (7)
Currently, EPI policy guideline has revised in 2007,the countrys immunization effort
move from developmental phase focusing on coverage to a phase that concentrates on
disease control and eradication and this showed that the country commitment for
strengthening immunization service and sustaining high immunization coverage. (13)
Reaching every district (RED) is a multi-faceted approach with the goal of reaching
>80% DTP3 coverage in every district in >80% of developing countries by 2005. This
goal is referred to as the "80/80 goal". It is the accepted approach to achieve a
sustained and equitable access to good quality immunization services and accelerate
progress towards achieving the 80/80 goal. This approach means reaching every child
in every district with quality immunization services. The main components of reaching
every district (RED) include re-establishing outreach vaccination, supportive
supervision, linking communities and services, monitoring for action, and planning and
management of resources. The comprehensive approach for immunization are increase
and monitor vaccination coverage, improve health system service delivery and
management, decrease drop-out rate, improve logistics system, promote positive
behaviors in support of immunization, improve epidemiological surveillance System,
increase supervision process review and follow-up , maximize cost-effectiveness,
improve inter-agency coordination. (7, 15)

2. Statement of the problem

About 472,000 Ethiopian children die each year before their fifth birthdays. This make
8

under five mortality rate bout 140/1000 with variations among the regions from 114 to
233/1000 .This tragic fact places Ethiopia sixth among the countries of the world in
terms of the absolute number of child deaths. Among the cause of mortality, vaccine
preventable diseases are the major ones (2).
Every year more than 10 million children in low- middle-income countries die before
they reach their fifth birthdays. Most die because they do not access effective
interventions that would combat common and preventable childhood illnesses (3).
A 2001 vaccine-preventable diseases estimate of WHO showed that the greatest
burden of disease in Sub-Saharan Africa were deaths of pertussis, tetanus, and
measles which account 58 percent, 41 percent, 59 percent, and 80 percent respectively.
East Asia and the Pacific have the greatest burden from hepatitis B with 62 percent of
deaths worldwide. South Asia also experienced a high disease burden particularly for
tetanus and measles (11).In 2007, A total of 24.3 million infants not immunized DPT3,
from which Africa account 7.3%, South East Asian account 11.5% ,Europe account
0.4%, Western pacific and Eastern Mediterranean account 1.95 each and America
account 1.1% (12).
Ethiopia has an estimated population of approximately 76 million. Although infant
mortality rate (IMR) has declined from 97/1000 in 2000 to 77/1000 in 2005, it is still
among the highest in the world. From a total under five deaths in Ethiopia 28% is due to
pneumonia, 25% due to neonatal condition 20% each due to malaria and diarrhea, 4%
due to measles and the rest by other. Yet there is effective low cost intervention to
prevent two/third of these deaths of every 100 children in Ethiopia (14).
EPI is essential for improving infant and child survival although the coverage can be
improved by increasing KAP of the population.
In Debre Brehan town there are health facilities that give service to the community
including child vaccination. There are 1 hospital, 1 health center, 4 health post, 1
pharmacy, 1 higher clinic, 7 medium clinic, 8 low level clinic, 2 special clinic and 4 drug
store which are both governmental and non-governmental. According the 2002 annual
woreda health bereau report, the coverage of child vaccination is 56.3% BCG, 51%
Penta3, 57.7% Penta2, 51% OPV3, 41.5% measles. 43.9% of childrens are fully
immunized.

3. Literature review
A survey conducted in China about KAP towards Vaccine preventable disease the result
shows that the level of immunization knowledge among parents was positively
associated with attitude and practice of immunization. Immunization coverage was
89.3% in the high stratum in 63.8% in the low stratum service area (28).
In Africa, a serious 30 cluster immunization coverage survey was undertaken as a
survey of KAP among parents result of the survey showed 90% of population begins
immunization but 30% drop out. The survey conducted in Ethiopia and the weighted
national immunization coverage assessed by card plus history for children aged 12-23
months vaccinated before the age of one year was BCG 83.4%, DPT1 84.3%, DPT3
66.0% ,measles 54.3%, and fully immunized children 49.9% . A community based cross
sectional survey in Ziway town eastern showa shows 53% of children was fully
9

immunized, 19 % was defaulters and the rest were totally non-immunized. The reasons
for defaulters were inconvenience of vaccination time, child sickness and lack of
information about the need for repeated vaccination (30).
April 1995 in Gonder and surrounding villages in West Ethiopia cluster sampling was
conducted to assess immunization coverage in area and problem associated with
vaccination delivery. Among the sample children 47.4% fully immunized while 30% were
not immunized at all. The reason given for not immunizing children were lack of
knowledge 39.7% social problem 38.7% various obstacles 22% such as child sickness
and health institution related problems (31).
A cross sectional community based study was carried out in Jimma town South west
Ethiopia to determine reason for defaulting from expanded program of immunization
(EPI) using structured questionnaire in March 1997. A total of 376 children aged 12 to
23 months and their mothers were covered in study. Out of total 376 children 46.5%
were fully immunized, 53.5% were defaulters. The reason given by mothers for not
completing vaccination were missed appointments time (48.8%) mothers and no
enough time (25.9%) and child was sick (23.4%) maternal age, neonatal care , parity,
education knowledge about vaccine preventable disease and immunization. Another
study in Jimma town shows higher acceptance of immunization by mothers who have
been educated to above 6 grade and the higher of educational status the higher rate of
completing the vaccination schedule and the relation between occupation and child
immunization were government employee was the first to fully immunize their child that
is i.e. 94% and the least was house made that is 50% the reason for this might be
government employee could have access to know the benefit of immunization from their
passed education and daily activities but house maids might have lack of education &
economy. Also the study had been identified factors associated with non immunization
and defaulters was illiteracy, lack of knowledge about EPI target diseases attitude of
mothers were 45.6% said very useful, 54.1% said useful and the rest 0.3% said not
useful (32).
Currently a great consideration have given for immunization, the result have been under
expected. The aim of this study will be to assess the obstacles in relation to the mother
KAP to child immunization.

4. Significance of the study

The highest proportion for child hood death is due to vaccine preventable disease (2).
The service with the provision of health message to the population about the vaccine is
the first to increase the EPI coverage. Non- immunization was associated with low
socioeconomic status, maternal illiteracy and lack of mothers knowledge on vaccination
as recommended by the expanded program on immunization (23).
The problem of management of intersectional co-ordination and lack of public
awareness of the purpose and importance of immunization persisted (25). Lack of
information about the childs immunization status, complexities of immunization
schedules, misconception regarding multiple vaccine contradiction and inadequate
emphasis to parent about the importance of the timely completion of immunization are
factors that affect immunization (25). Lack of community participation was also found to
be crucial constraining factors (26). However, the two principle problems in the way of
10

achieving effective immunization for all children are lack of awareness and lack of
knowledge. Miss information about immunization is amongst the most serious traits to
the success of immunization program. Some examples of rumors are: Vaccines are
contraceptives to population or to limit the size of certain ethnic group, Vaccines are
contaminated by HIV , and Children are ding after receiving vaccines.
The consequence of rumors can be serious and if not unchecked those can drawback
the EPI program (21).
This study helps to detect mothers KAP towards the eight types of vaccination, common
defects of mothers for not vaccinate their child. The result could be help to plan for child
immunization based health education to the community, and better practice among
mothers who have poor practice to immunize their children. In addition the study will
used as literature for others (individual, group, organization both governmental and nongovernmental) who wants to intervene based on the result obtained or who wants to do
further study to answer question that are not answered by this study.

5. Objective of the study

5.1. General Objectives
To assess practice of mothers towards child vaccination and its associated factors with
child vaccination in Debre Brehan district/ town, North Shoa administrative zone,
Amhara region, Ethiopia.

5.2. Specific objectives

To assess the practice of mother to vaccinate their children in Debre Brehan

town.

To determine the associated factors towards child vaccination in Debre Brehan

town.

6. Methodology and material

6.1. Study Area
The study will be conducted in Debre Brehan district/ town, North Shoa administrative
zone, Amhara region, Ethiopia. The district has 9 administrative kebeles. The district /
Debre Brehan town is located at 130 km North of Addis Ababa, capital city of Ethiopia.
Based on the 2007 population and housing census, the total population size of the
district estimated to be 72,097. The number of married couples/ households in the
district is estimated to be 16,767. According to the information obtained from District
Health Office; in the district there are 1 hospital, 1 health center, 18 clinics and 4 health
posts which render health services for the community. In most of the health facilities
including health posts immunization in service and outreach service is available for who
need the service.

6.2. Study design

A descriptive community based cross sectional survey will be undertaken to assess
11

practice of mothers towards child vaccination and its associated factors with child
vaccination in Debre Brehan district/ town.

6.3. Study period

From November to January 2003.

6.4. Source population

All mothers between the age of 15-49 years old in Debre Brehan town.

6.5. Study population

All mothers between the age of 15-49 years old in the selected sample kebeles.

6.6. Sampling unit

Household in the selected cluster.

6.7. Study unit

Individual mother with the age between 15-49 years.

6.8. Study variable

6.8.1. Independent variables
Age
Sex
Occupation
Educational status
Monthly income
BCG scar

6.8.2. Dependent variables

Knowledge
Attitude
practice

6.9. Inclusion and Exclusion criteria

6.9.1. Inclusion criteria
Mothers in selected kebeles.
Mothers with age 15-49 year.
Mothers who can able to communicate without difficulty.

6.9.2. Exclusion criteria

Mothers with age <15 and >49 years.
12

 Mothers cant able to communicate easily.

Mothers of other kebeles of the town.

6.10. Sampling technique and Sampling size

determination
A multi stage sampling technique will be used to obtain the total sample size of
respondent. The total sample size to be calculated based on the assumption below.
Z (Confidence level) = 95%, which have 1.96 value.
P (Proportion of Secuss) =50%, because it is unknown.
d (Margin of error) = 5%,
p (Proportion of failurity) =1-P
Design effect = 2
n

Z 2 pq
=
d2

1.96 2 * 0.5 * 0.5

= 384
0.05 2

n = 384*2, with design effect of 2. By considering 5% non-response rat, the total sample
size will be 845. From the total 9 kebeles in the town 60%of them (5 kebeles) will be selected by
lottery method. From those kebeles households are selected proportionally until we meet the
total sample. The first house hold will be obtained by using sharp dot pencil with closed eye on
the sample frame. Every Kth house hold will be included in the sample. K is calculated by
dividing the total number of house hold by the sample house hold.

Schematic presentation of sampling

Debre Brehan Town

Kebele-1

Kebele-2

Kebele-3

Kebele-2

Kebele-4

Kebele-5

Kebele-4

Kebele-6

Kebele-6

Kebele-7

Kebele-8

Kebele-8

Kebele-9
13

Kebele-9

Household

6.11. Data collection Tools and Procedures

A structured questionnaire composed of closed-ended questions will be administered to
the respondents to collect the quantitative data. Qualitative data will be collected by
observation by using check list. The questionnaire is prepared in English and it will be
translated in to Amharic language for appropriate and easiness in interviewing the study
subjects as they are Amharic language speakers. The Amharic version will again be
translated back to English to check the consistency of meaning. Translation of
questionnaire will be done by language experts in both cases. The questions included in
the questionnaire are prepared depending on review of different related literatures and
variables identified to be measured.
Data collectors will approach by introducing him/her self and interview the selected
respondents after informed consent obtained. A household will be revisited for two more
times if the study the next subject not available on the first visit and if not be found
during the revisit, household will be considered. Incase there is no eligible mother in the
household the next household is taken as a sample.

6.12. Data quality assurance

The data collectors will be recruited depending on the criteria, the one who has
Bachelor of Science in nursing and above, and both female and male applicants will be
accepted. Training will be given on the basic technique of interviewing. The issue of
confidentiality and privacy will be stressed during the training session and they will
practice on pre-testing of the questionnaire after their training.
The data collectors will be supervised daily by supervisors who are qualified in masters
of public health. The filled questionnaires will be checked daily by the supervisors and
principal investigator. If there is any problem the solution will be given daily by
discussing with the supervisors and the data collector. Data quality will also be
maintained by Cross checking the filled questionnaire by repeating the interview on a
randomly selected households from which that data collected. Different methods of
handling missed data will be used. Moreover, a pretest of questionnaire will be
conducted on 30 mothers age 15-49 years to assess its completeness in providing the
information needed for the study in the area that will be out of selected kebeles.

6.13. Data processing and analysis

The data gathered through the structured questionnaire will be entered to EPI- INFO
14

version 6 and SPSS version 16 a statistically packed soft ware for analysis. Also the
data will be checked and cleaned for its completeness and errors in data entering. All
the data obtained from the study population will be entered, cleaned and analyzed by
the investigator. The result will be presented by using tables, charts, and graphs.
Qualitative data will be analyzed and presented by descriptive statement.

6.14. Operational definition

Satisfactory knowledge those mothers who answers >80% of the knowledge
questions.
Un Satisfactory knowledge those mothers who answers < 60% of the knowledge
questions.
Good attitude those mothers who answers >75% of the attitude questions.
Poor attitude those mothers who answers <55% of the attitude questions.
Good practice-those mothers who answers >70% of the practice questions.
Poor practice-those mothers who answers <50% of the practice questions.

7. Dissemination of result
The result of the study will be disseminated to;
District health office.
Debre Brehan University research coordinating office.
Debre Brehan University, School of Health science.
Debre Brehan Save the children coordinating office.
Private clinic in the town.

8. Ethical consideration
This study will be conducted after the approval of the proposal by Debre Brehan
University research coordinating office. Primarily, ethical clearance will be obtained from
director of research coordinating office of Debre Brehan University. Formal letter of
cooperation will be written for District Health Office. Consent from District Health Office
will be obtained. The District Health Office will write cooperation letter to the town/district
administrator. The town/district administrator will write to the respective kebeles. The
data collectors will clearly introduce him/her self and explain the aims of the study.
Information will be collected after obtaining verbal consent from each participant.
Respondents will also be informed that they can refuse or discontinue participation at
any time they want and the chance to ask anything about the study. Information will be
recorded anonymously and confidentiality will be assured throughout the study period.
Data collectors will put their signature for they could obtain verbal consent for the
interview from the respondents. A woman who did not practice will be advised about the
benefits of immunization and for more information to communicate with health workers
in the district.

15

9. Action Plan
Time frame (2010)
No Major Activities

October

November

December

.
1.

Topic Selection

2.

Proposal Development

3.

Selection of data

4.

collectors
Training of data

5.

collectors
House numbering

6.

Conducting pretest

7.

Data collection

8.

Data coding, entry and

cleaning

9.

Data analysis and write

up
10. Submission of first draft
of the result
11. Submission of final
research paper.
12. Presentation of findings
N.B. For the above activities Debre Brehan University, Nursing Staffs are responsible.

10. Budget proposal

16

Personnel Cost
Title

Qualification

Rate

Duration of
work
(DAYS)

Number of
persons

Total

Data collectors

BSCs above

100

10

7,000.00

Supervisors

MPH, BSC

200

2,800.00

Trainer of data collector

MPH/statistician

150

600.00

Data analysis, write up

and presentation

MPH

250

2,000.00

Secretarial work

Diploma

100

200.00

SUB TOTAL 1

12,600.00
Equipment and supplies cost

Category

Unit

Quantity

Unit price

Total price Remark

Questionnaire Printing

Page

2.00

10.00

Questionnaire
duplication

Page

4225

0.50

2,112.50

Result paper printing

Page

80

2.00

160.00

Result paper duplication

page

480

0.50

240.00

Stapler

Number

60.00

60.00

Staples

Pack

15.00

30.00

Eraser

Number

1.50

7.50

Pen

Number

3.00

21.00

BIC

Pencils

Number

1.50

10.50

DOT

Binder

Number

20

140.00

Flash disk

Number

300.00

300.00

GENX-4GB

Compact disc (CD)

Number

6.00

18.00

Nature-720MGB

Bag

Number

70

350.00
17

SUB TOTAL 2

3,460.00
Transportation and communication cost

Category

Unit

Quantity

Unit price

Total
price

Remark

Transport

Trip

140

2.00

280.00

Minibus

Mobile-phone card

Card

50.00

200.00

SUB TOTAL 3

480.00
Others for training /Refreshments

Category

Unit

Number
of person

Number of
days

Unit price/price
per day

Total price

Food /launch

Individual
person

50.00 per
individual

700.00

Soft drink

Individual
person

5.00 per
individual

70.00

Tea break

Individual
person

10.00 per
individual

140.00

Per diem for trainee

50 per
individual

500.00

SUB TOTAL

1,410

SUB TOTAL (1+2+3+4)

17,950.00

Contingency

2,692.50

GRAND TOTAL

20,642.50

Summary: Personnel Cost =12,600.00

Equipment and supplies cost =3,460.00
Transportation and communication cost =480.00
Others for training /Refreshments = 1,410.00
18

Remark

Contingency (10%) = 2,692.50

11. Reference
1, M.K.JINADU, Lecturer, perspective in primary care: A case study in the Administration
of the expanded program of immunization in Nigeria, Journal of tropical pediatrics, 1983
29(217-219)
2. World Health Organization, United Nations Foundation, (2004). Immunization in
Practice Modules for Health Staff 2004 update, United Printers, Ethiopia
3. FMOH, EPI policy guideline, Ethiopia 2007.
4. http://www.who.int/countries/eth/areas/immunization/en/ (1 of 2) accessed in
19

8/25/2009 10:19:32 AM
5. FMOH, health and health related indicator, 999E.C (2006/7 G. c)
6. Expanded program of immunization, Ethiopia, November 8, 2008, accessed from
internet, in 26/8/2009
7. (FMOH, 2004). FMOH, Ethiopia Family Health Profile, 2003/4.
9, UNICEF, Immunization-expanding immunization coverage, accessed from internet in
Aug.25, 2009
10. FMOH, National strategy for child survival in Ethiopia, July 2005, AA, Ethiopia
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and essential tools for implementation, no date]-2
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EPI: Comprehensive multi-year plan 2006-2010, August 2006 Ethiopia.
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policy, July 2005, AA, Ethiopia
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12. Annex
12.1. Questionnaire

Consent form
My name is______________________ I am from Debre Brehan University, School of
Health Science, Program of Nursing. I am here on the behalf of Debre Brehan
University that conduct research in the community to collect data on assessment of
mothers practice to wards child vaccination and its associated factors with child
21

vaccination. The university gets permission from the district/ town health office and
kebeles administrator to conduct this research in your community. The objective of this
study is to assess mothers practice to wards child vaccination and its associated
factors with child vaccination at Debre Brehan town to provide useful information for
program managers and providers who enable them to improve the service provision.
You were selected for the study because you are in the study group. We are kindly
requesting you to answer the questions that we have prepared for you. Your information
is very useful to this study and it needs your patience, full cooperation and sincerity. All
information taken will be kept confidential. Only the data collector and principal
investigator access the information. You have the right not to participate in the interview
or to refuse at any stage of interviewing. There is no compensation that is given to you
after end of interview or observation.
Would you be willing to participate?
I agree

continue

Data collector: Name______________________

Signature________

I disagree

Stop

Respondent

Signature___________________
Date____________
Date_______________________

Questionnaire for child immunization status.

Part I: Socio - demographic characteristics
1. Name of mother (Code) _____________________
2. Age_____________
3. Address /Keble/___________________
4. Marital status
22

1. Single

2.Married

3. Divorced

4.Widowed

5. Religion
1. Muslim
2. Orthodox
specify_____________

3. Protestant

4. Other

6. Ethnicity
1. Tigre

2.Oromo

3.Amhara

4. Others (specify)

7, Educational status mother

1. Illiterate

2. Read and write

3. Grade 1-6

4. Grade 7-11

5. 12+

8. Occupation of the mother

1. House wife 2. Government Employed 3. House maid 4. Self- employed
Farmer 6. Other (specify) _____________

5.

9. Monthly income of the family

1. <150

2. 150-300

3. 300-600

4. 600-1000

5. > 1000

10. Who in the family make the decision to take the child for vaccination?
1. Mother
2. Father
(specify)___________

3. Both together

4. Other

Part II-Practice towards immunization

1. Have you vaccinated your child?
1. Yes

2. No

2. If your answer is No for Q No1, why?

1. Too far from vaccination site
was sick
4. Mother is sick
Other /specify/______

2. Lack of information about vaccination 3. Child

5. Time inconvenience
6. Mother is busy 7.

3. If your answer is yes for Q NO 1, did the child complete vaccination according to the
schedule?
1. Yes /Fully immunized/

2. NO /Defaulter/

4. If your answer is No (Defaulter) for Q No 3, why?

1. Too far from vaccination site 2. Child was sick 3. Mother is sick
4. Time
inconvenience
5. Unaware the need to return for repeated vaccine dose
6. Forget to go for
repeated dose
7. Change in place of vaccination site
8. Other
/specify/___________________________
5. How much times your child received vaccine?
1. Once 2. Twice 3.Three times 4. Four times
Other/specify_____________

5. > Five

6.

6. Have you ever seen side effect of a vaccine while childrens have vaccinated?
23

1. Yes

2. No

7. If Yes for Q. No 7 describe

1. Fever
2. Swelling, pain, readiness at the site of injection
4. Loss of apatite
5. Other /specify/_____________

3. Rash

8. Does the provider told you about the importance of immunization?

1. Yes

2. No

9. Do you have a card that you immunize your child?

1. Yes

2. No

10. If your answer is No for Q No 2, why?

1. Not given by health professional
(Specify)_________

2. Teared by children

3. Other

9. Do you have any idea how the service can be improved?

Check lists for direct observation

Schedul
e

Immunization given
BCG

Polio
OPV0

BCG scare

OPV1

Pentavalent

OPV
2

OPV3

Present

DPT-HIBHBV1

DPT-HIBHBV2

Measles
DPT-HIBHBV3

Not Present

THANK YOU!
Name of Interviewer_______________________ Date______________
Sign_________
Name of
supervisor________________________Date______________Sign__________

24