The Role of Nurses in Improving Immunization Compliance Among Toddlers in Slum Areas
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Abstract
Immunization is a crucial public health intervention for preventing vaccine-preventable diseases among toddlers; however, immunization compliance remains low in slum areas due to socioeconomic and health system barriers. Nurses, as frontline health workers, play a strategic role in promoting immunization within underserved communities. This study aims to examine the role of nurses in improving immunization compliance among toddlers in slum areas and to identify key challenges and enabling factors influencing immunization practices. This study employed a mixed-methods research design conducted in selected slum areas. Quantitative data were collected through structured questionnaires administered to parents or caregivers of toddlers to assess immunization compliance and related factors. Qualitative data were obtained through in-depth interviews and observations involving nurses engaged in community and maternal–child health services. Data analysis was performed using descriptive and inferential statistics for quantitative data and thematic analysis for qualitative data. The results indicate that nurses play a significant role in improving immunization compliance through health education, home visits, counseling and effective communication, reminder and follow-up systems, and community engagement. These interventions were found to enhance parents’ knowledge, attitudes, and trust toward immunization services. Key challenges identified include limited parental knowledge, socioeconomic constraints, high population mobility, and restricted access to health facilities. In conclusion, strengthening community-based nursing roles is essential for improving immunization compliance among toddlers in slum areas. Empowering nurses with adequate training, resources, and institutional support can enhance immunization coverage and contribute to better child health outcomes in vulnerable urban populations.
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Bans-Akutey, A., & Tiimub, B. M. (2021). Triangulation in research. Academia Letters, 2(3392), 1–7.
Bergin, T. (2018). An introduction to data analysis: Quantitative, qualitative and mixed methods.
Collaborative, I. H. in S. (2022). Primary care doctor and nurse consultations among people who live in slums: a retrospective, cross-sectional survey in four countries. BMJ Open, 12(1), e054142.
Committee, N. V. A. (2003). Standards for child and adolescent immunization practices. Pediatrics, 112(4), 958–963.
Cox, S. N., Wedlock, P. T., Pallas, S. W., Mitgang, E. A., Yemeke, T. T., Bartsch, S. M., Abimbola, T., Sigemund, S. S., Wallace, A., & Ozawa, S. (2021). A systems map of the economic considerations for vaccination: Application to hard-to-reach populations. Vaccine, 39(46), 6796–6804.
Crocker-Buque, T., Mindra, G., Duncan, R., & Mounier-Jack, S. (2017). Immunization, urbanization and slums–a systematic review of factors and interventions. BMC Public Health, 17(1), 556.
Gilmore, B., & McAuliffe, E. (2013). Effectiveness of community health workers delivering preventive interventions for maternal and child health in low-and middle-income countries: a systematic review. BMC Public Health, 13, 1–14.
Guerra, F. A. (2007). Delays in immunization have potentially serious health consequences. Pediatric Drugs, 9(3), 143–148.
Hoekstra, S., & Margolis, L. (2016). The importance of the nursing role in parental vaccine decision making. Clinical Pediatrics, 55(5), 401–403.
Isangula, K., Pallangyo, E. S., Mbekenga, C., Ndirangu-Mugo, E., & Shumba, C. (2022). Factors shaping good and poor nurse-client relationships in maternal and child care: a qualitative study in rural Tanzania. BMC Nursing, 21(1), 247.
Konwea, P. E., David, F. A., & Ogunsile, S. E. (2018). Determinants of compliance with child immunization among mothers of children under five years of age in Ekiti State, Nigeria. Journal of Health Research, 32(3), 229–236.
Li, A. J., Tabu, C., Shendale, S., Okoth, P. O., Sergon, K., Maree, E., Mugoya, I. K., Machekanyanga, Z., Onuekwusi, I. U., & Ogbuanu, I. U. (2020). Qualitative insights into reasons for missed opportunities for vaccination in Kenyan health facilities. PloS One, 15(3), e0230783.
Lv, K., Zhao, J., & Zhang, P. (2021). The effect of community comprehensive nursing using scenario-based health education on the infant and young child immunization rates. American Journal of Translational Research, 13(8), 9663.
McCollum, M., Kovner, C. T., Ojemeni, M. T., Brewer, C., & Cohen, S. (2017). Nurses improve their communities’ health where they live, learn, work, and play. Policy, Politics, & Nursing Practice, 18(1), 7–16.
Nandy, S., & Gordon, D. (2009). Children living in squalor: Shelter, water and sanitation deprivations in developing countries. Children, Youth and Environments, 19(2), 202–228.
Nuwarda, R. F., Ramzan, I., Weekes, L., & Kayser, V. (2022). Vaccine hesitancy: contemporary issues and historical background. Vaccines, 10(10), 1595.
Obi-Jeff, C., Garcia, C., Adewumi, F., Bamiduro, T., David, W., Labrique, A., & Wonodi, C. (2022). Implementing SMS reminders for routine immunization in Northern Nigeria: a qualitative evaluation using the RE-AIM framework. BMC Public Health, 22(1), 2370.
Oku, A., Oyo-Ita, A., Glenton, C., Fretheim, A., Ames, H., Muloliwa, A., Kaufman, J., Hill, S., Cliff, J., & Cartier, Y. (2017). Perceptions and experiences of childhood vaccination communication strategies among caregivers and health workers in Nigeria: A qualitative study. PloS One, 12(11), e0186733.
Oliveira, V. C. de, Gallardo, P. S., Gomes, T. S., Passos, L. M. R., & Pinto, I. C. (2013). The nurse’s supervision in the vaccination room: the nurse´ s perception. Texto & Contexto-Enfermagem, 22, 1015–1021.
Onamade, A. A., Oyerinde, O. O., Oduwole, A. O., & Lala, O. G. (2022). Development of a Low-Cost Mobile Phone-Based Intervention to Support Infants’ Vaccination among Nursing Mothers. Special Education, 2(43).
Organization, W. H. (2022). Implementation guide for vaccination of health workers. World Health Organization.
Pinto, R. M., da Silva, S. B., & Soriano, R. (2012). Community health workers in Brazil’s Unified Health System: a framework of their praxis and contributions to patient health behaviors. Social Science & Medicine, 74(6), 940–947.
Powers, D., Armellino, D., Dolansky, M., & Fitzpatrick, J. (2016). Factors influencing nurse compliance with Standard Precautions. American Journal of Infection Control, 44(1), 4–7.
Woldie, M., Feyissa, G. T., Admasu, B., Hassen, K., Mitchell, K., Mayhew, S., McKee, M., & Balabanova, D. (2018). Community health volunteers could help improve access to and use of essential health services by communities in LMICs: an umbrella review. Health Policy and Planning, 33(10), 1128–1143.
Yazdani, A. T., Muhammad, A., Nisar, M. I., Khan, U., & Shafiq, Y. (2021). Unveiling and addressing implementation barriers to routine immunization in the peri-urban slums of Karachi, Pakistan: a mixed-methods study. Health Research Policy and Systems, 19(Suppl 2), 55.

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