Immunisation is a cost-effective public health intervention that contributes to the
attainment of the Sustainable Development Goals (SDGs). About 40% of children
under the age of five years die from vaccine-preventable diseases in Nigeria. Routine
immunisation has been quite low in Nigeria, where national coverage is estimated to
be 33%, according to a 2016–2017 survey. This empirical research was aimed at
determining the key socio-economic and gender determinants of immunisation in the
Federal Capital Territory (FCT), identifying gaps and proffering solutions. Mixed
methods of data collection and analysis were used. Data were gathered from several
secondary sources and from 11 key informants using semi-structured interviews and
501 household and 26 health-facility surveys using questionnaires mounted on Open
Data Kit. Lot quality assurance sampling and probability to population size methodology
were used to size the samples and identify survey locations. Odds ratio analysis and
logistic regression analysis were conducted to gauge the statistical association
between the determinants and the coverage of immunisation. The main finding that
was reached on the basis of the documents reviewed and the feedback received from
the key informants was that they were gender blind at worst and gender neural at best.
Most of the current strategies give little attention to socio-economic and gender
barriers. Over 40 immunisation variables were identified. The analysis, particularly
using the 2x2 odds ratio, yielded mixed results. The majority of the variables exhibited
a close statistical association as far as immunisation indices were concerned. These
variables included urban residency, married couples, literacy, birth at a health facility,
antenatal care experience, vaccination card possession, immunisation knowledge,
child health information, non-farming earnings, socio-economic status and tolerance of
spouse beating. On the other hand, variables that were found to have no statistical
significance included sex, marital status, marriage type, age, religion, tetanus toxoid
(TT) vaccination and adequacy of income. Immunisation and gender are intertwined,
particularly because of mothers’ biological and social attachment to their children. At
the same time, conducting vaccination avails the opportunity to access almost all
households. Moreover, it is important to recognise that socio-economic and gender
determinants are not totally in control of one ministry. Single agenda interventions will
not produce the desired result. A paradigm shift and the concerted effort of various
sectors and partners are required. Therefore, the Nigerian government should
galvanise the relevant stakeholders to bring gender and socio-economic variables into
the mainstream throughout the immunisation ecosystem and to implement integrated
development initiatives by prioritising vulnerable communities.
Ugonyo yindlela engcono yokungenela kwezempilo yabantu engathela esivivaneni
ekufinyeleleni izinhloso zentuthuko eqhubekela phambili ezaziwa ngelokuthi yi-
Sustainable Development Goals (SDGs). Cishe izingane ezifinyelela ku 40%
ezingaphansi kweminyaka emihlanu zibulawa yizifo ezivimbelekayo ngomgcabo
emitholampilo eNigeria. Ukugonya njalo kusezingeni eliphansi eNigeria, laphokhona
ukwengamela kuzwelonke kulinganiselwa ku 33%, ngokuya kocwaningo olwenziwe
phakathi kuka 2016-2017. Ucwaningo lokuthola ubufakazi lwalunenhloso yokubona
imithelela yezesimo sabantu nomnotho (socio-economic) kanye nobulili ngokugonya
kwi-Federal Capital Territory (FCT) ukubona amagebe kanye nokutholakala
kwezixazululo. Amamethodi axubene okuqokelela ulwazi kanye nohlaziyo
kwasetshenziswa. Ulwazi lwaqokelelwa ngokufunda imithombo yemibhalo (secondary
sources) kanye nakubantu ababalulekile abanolwazi (key informants) abangu 11
ngokusebenzisa ama-semi-structured interview kanye nemizi engu 501 kanye namasurvey
amafasilithi ezempilo angu 26 ngokusebenzisa uhla lwemibuzo yamaquestionnaire
ebifakelwe kwi-Open Data Kit. Kwasetshenziswa nemethodi ye-Lot
quality assurance sampling ne-probability, ngemethodoloji yobuningi babantu,
ukwenza usayizi wamasampuli kanye nokubona izindawo okumele kwenziwe kuzo
ama-survey. Kwenziwa nohlaziyo lwe-Odds ratio analysis kanye ne-logisic regression
analysis ukubona ukuhambelana kwamastatistiki phakathi kwezinto eziwumthelela
kanye nokunaba kongamelo lokwenziwa kogonyo. Okukhulu okutholakele
ngokulandela amadokhumende okufundwe kuwo, kanye nezimpendulo ezivela kulabo
abanolwazi ababalulekile (key informants) kube wukuthi bekungaboneleli ubulili
(gender blind) kanti futhi bekungachemile ngokulandela ubulili (gender neutral)
ngezinga elibi nangokungcono kakhulu. Amasu amaningi amanje awanakekeli kakhulu
izihibe ezimayelana nabantu nezomnotho kanye nezobulili. Kwaphawulwa cishe izinto
ezehlukene zama-variable ezingu 40 mayelana nogonyo. Uhlaziyo, ikakhulukazi
ngokusebenzisa i 2x2 odds ratio, lwaveza imiphumela exubene. Ezinto zama-variable
ehlukene eziningi zikhombise ukuhlobana phakathi kwamastatistiki mayelana namaindices
ogonyo. Lama variable, abandakanye ukuhlala emadolobheni, abantu
abashadile, ikhono lokubhala nokufunda, ukuzalwa kwezingane kumafasilithi ezempilo,
izipiliyoni zonakekelo lwengane ngaphambi kokuzalwa, ukuba nekhadi lomgcabo
ix
wasemitholampilo, ulwazi ngogonyo, ulwazi ngempilo yengane, ukuthola imali
ngemisebenzi engeyona eyokulima, isimo sabantu mayelana nezomnotho, kanye
nokuqinisela ukuhlukunyezwa ngokushaywa kwabesimame. Kanti ngakolunye
uhlangothi, ama-variable atholakale engenakho ukubaluleka ngokwamastatistiki,
abandakanya ubulili, isimo ngokomendo, inhlobo yomendo, iminyaka yobudala, inkolo,
umgcabo we-tetanus toxoid (TT), kanye nokwenela kwengeniso lemali. Ugonyo kanye
nobulili kuyangenelana nokuhambelana, ikakhulukazi ngenxa yokusondelana komama
kanye nezingane zabo. Ngaso leso sikhathi, ukwenziwa kogonyo kuhlinzeka ngethuba
lokufinyelela cishe kuwo yonke imizi eminingi. Nangaphezu kwalokho, kubalulekile
ukwamukela ukuthi isimo sabantu mayelana nezomnotho kanye nobulili kuyizinto
ezinomthelela, azinalo ulawulo oluphelele kumnyango kangqongqoshe owodwa.
Ungenelo ngento eyodwa ngeke kwaveza imiphumela efiswayo. Ukugudluka
ngokomqondo (paradigm shift), kanye nemizamo eqhubekela phambili yemikhakha
ehlukene kanye nabasebenzisani kuyadingeka. Ngakho-ke uhulumeni waseNigeria,
kumele agqugquzele ababambiqhaza abafanele ukuhlanganisa nokufaka emkhakheni
ofanele izinto ezimayelana nabantu nomnotho kanye nobulili, kuyo yonke inqubo
yokusebenzisana kwemikhakha okumele isebenzisane nehlangene ukusebenza
ngokulandela inqubo yentuthuko ehlangane ngokubonelela imiphakathi ekwizimo
ezibucayi
