Maternal Knowledge, Perceptions and Age-appropriate Coverage of Routine Immunization in Children under Five Years in Southern Sri Lanka

Background: Immunization is one of the most cost-effective strategies used for control of life-threatening infectious diseases. Use of immunization services in childhood is greatly influenced by parental knowledge and attitudes regarding immunization and its benefits.Objective: To assess the maternal knowledge, perceptions and coverage of routine immunization in children under five years in Bope-Poddala health division in Southern Province, Sri Lanka.Methods: A cross-sectional study was conducted among 216 mother-child pairs attending Maternal and Child Health clinics in Bope-Poddala area. An interviewer-administered questionnaire was used to collect data on maternal knowledge, beliefs and attitudes regarding routine immunization of children under five years, under Expanded Programme of Immunization (EPI). The level of knowledge was determined by assigning marks to correct responses for questions on knowledge. Age appropriate immunization of children was assessed using Child Health Development Records. Data were analyzed using SPSS statistical software package.Results: Although 32% of mothers knew that vaccination prevents communicable diseases, only 11% had good knowledge regarding the EPI vaccine schedule and the diseases prevented by these vaccines. Public Health Midwife was the source of knowledge in 91.2%. Mothers' knowledge was significantly associated with their occupation (p<0.001). Majority of the mothers (>75%) had positive attitudes towards immunization, while attitudes were not associated with maternal characteristics. Almost all of the children (99.5%) were appropriately vaccinated for their age.Conclusions: Maternal knowledge regarding the EPI schedule is poor and is influenced by their occupation. In contrast, the attitudes and practices regarding immunization appear to be satisfactory. Further health education is necessary to eliminate misbelieves regarding immunization.