KNOWLEDGE, ATTITUDE, AND AWARENESS REGARDINCHILDHOOD VACCINATION AMONG PARENTS OF UNDER-FIVE CHILDREN IN DISTRICT KURRAM: A SURVEY-BASED STUDY

Abstract

Background:
Childhood vaccination is recognized as one of the most effective and economical public health strategies for reducing morbidity and mortality associated with vaccine-preventable diseases. In Pakistan, immunization services are provided free of cost through the Expanded Programme on Immunization (EPI); however, vaccination coverage among children remains inadequate, particularly in rural and underserved communities. Parents’ knowledge, awareness, and attitudes toward immunization significantly influence the completion of childhood vaccination schedules. In District Kurram, limited evidence is available regarding parental perceptions and practices related to childhood immunization.

Objective:
To assess the knowledge, attitudes, and awareness regarding childhood vaccination among parents of under-five children in District Kurram.

Materials and Methods:

A descriptive cross-sectional survey-based study was conducted in District Kurram, Khyber Pakhtunkhwa, Pakistan, over a four-month period from December 2025 to March 2026. A total of 220 parents/caregivers of under-five children were included through a community-based survey approach. Data were collected using a structured and pre-tested questionnaire adapted from WHO and UNICEF guidelines. The questionnaire gathered information regarding socio-demographic characteristics as well as parental knowledge, attitudes, and awareness about childhood vaccination. Data were entered and analyzed using SPSS version 24. Descriptive statistics, including frequencies and percentages, were used to present the findings.

Results:
A total of 220 parents/caregivers participated in the study. The majority of respondents were between 26–35 years of age (43.6%), while females constituted 53.6% of the participants. Most respondents had secondary or higher secondary education and belonged to rural areas. Overall awareness regarding childhood vaccination was found to be satisfactory, with 70.9% of participants reporting awareness of vaccines and 95.0% acknowledging the availability of vaccination services in their area. Regarding knowledge, 54.1% correctly identified the recommended age for routine immunization, and 90.9% knew that vaccination should begin at birth. However, notable gaps were identified in knowledge related to the total number of vaccine doses, multiple-dose vaccination schedules, and the importance of the EPI vaccination card. Attitudes toward childhood vaccination were generally positive, as the majority of parents considered vaccination essential for child health and expressed confidence in healthcare providers.

Conclusion:
The study findings demonstrate that parents in District Kurram generally possess positive attitudes toward childhood vaccination and satisfactory overall awareness. Nevertheless, important deficiencies remain in detailed knowledge regarding immunization schedules and vaccine-preventable diseases. Strengthening community-based awareness campaigns and health education initiatives may improve parental understanding and contribute to higher vaccination coverage and complete immunization among under-five children