Immunisation is the administration of particles or the complete form of bacteria or viruses (antigen) to induce or make the body produce,

immunity against that particular bacteria or virus. Immunity is a state of resistance to a particular illness (e.g. measles, tuberculosis), despite the prevalence of the disease. Immunity starts from the womb, as the mother may transfer to the child through the placenta, and/or breast milk. This is common with measles where babies are protected in the first nine months of life, and tetanus toxoid transferred to baby by mother. Immunisation of mothers, and babies as they are born, thus seeks to prevent deaths and deformities in children from common diseases. Measles very contagious. Spread by droplet infection, as virus grows in cells at the back of the throat. About 200,000 died in 2008 despite immunisation. Severe measles is seen in malnourished children, vitamin A deficient children, and HIV/AIDS. It can cause blindness, and other complications, e.g. pneumonia and swelling of the brains. Two doses of vaccine is recommended to ensure immunity. Poliomyelitis affects mainly children under 5 years. It causes paralysis, and if chest muscles are affected patient dies. Polio cases have reduced by 99%. Only 4 countries in the world have polio, and Nigeria is one of them. Multiple vaccines are needed to protect the child. Hepatitis B it affects the liver. It causes chronic liver disease, and leaves the patient prone to cancer and cirrhoses. It is transmitted like HIV (body fluids and secretions), but more infectious. It is dangerous when contracted in childhood. Yellow Fever a haemorrhagic disease transmitted by mosquitoes. The yellow coloration of the eyes and other parts of the body gives it the name yellow fever. 50% or more patients die if infected, and there is no cure, except protection with vaccination. Tuberculosis contagious disease spread through droplet infection; sneezing and coughing. It is a chronic disease of the lungs, and may be fatal. It is difficult to treat to achieve a cure, and most complications result in death. Tetanus it is referred to as the 7th-day death. Tetanus bacteria are everywhere, the soil, animal droppings, etc. It infects newborns if the umbilical cord is cut with unsterilized instruments and contaminated dressings used on the cord.

Diphtheria, Pertussis (Whooping Cough) spread by droplet infection and contact. In acute infections the bacteria attack the bronchial trees and the lungs causing chronic coughs and pneumonia with breathing difficulties. Immunised individuals against diphtheria and pertussis may be infected by toxin-producing strains but neurological complications are rare. Immunisation Schedule (see updated version with NPI, Federal Ministry of Health) a) Women of child bearing age, and the pregnant. Time of Administration - 1st Contact T.T.1 - 4 wks after T.T.1 T.T.2 - 6 wks after T.T.2 T.T.3 (or during next pregnancy) Soon after delivery Vit. A to mother At 6 wks after delivery Vit. A to mother At least 1 year after T.T.3 T.T.4 (or during subsequent pregnancy) At least 1 year after T.T.4 T.T.5 (or after subsequent pregnancy) Protection duration None 3 years 5 years Breast feeding mothers 10 years for life

Immunisation and Vitamin A Administration Schedule for Newborns. Time of administration - At birth - 6 wks of age - 10 wks of age - 14 wks of age - 9 months - 18 months reinforce) Vaccine/Nutrient BCG, OPV0, Hepatitis B1 DPT1, OPV1, Hepatitis B2 DPT2, OPV2 DPT3, OPV3 Hepatitis B3, Measles, Yellow fever, and Vit. A DPT and OPV boosters (measles is given to

Maternal deaths in Pregnancy In Nigeria, about 1,500 women in every 100,000 live births die trying to deliver babies. Some put it higher in parts of the North and South South. In some hospitals in Akwa Ibom State, about 10% of those who attend ante natal come back to deliver.

The major causes of death in pregnancy are (not necessarily in this order), haemorrhage, hypertensive disease in pregnancy, obstructed labour, infection, unsafe abortion, and others not so specific. Poverty is a major cause of maternal mortality as it prevents women from getting adequate and proper medical attention. It makes the practice of medicine ethically fall short of showing care in Nigeria. Service quality, staff attitudes to patients, inadequate skills, decaying infrastructures, chronic shortages of essential drugs, all contribute to maternal mortality. There is also major differentials in access to, and uptake of maternity services across educational levels. Educating the girl child may just be the key to reduction of maternal deaths in Nigeria. Summary of Hospital events in Pregnancy Weeks of pregnancy/months Expectations/Procedures 2 4 weeks (1 month) Confirm pregnancy, tests 12 14 weeks (3 months) Seek professional counselling, treat discomfort 16 24 weeks (4 months) Register in a hospital for regular ANC, immunisation, laboratory tests, etc 36 38 weeks (8 months) Should be examined by a doctor to rule-out problems weekly ANC. 40 weeks (9 months) Expected date of delivery, (EDD). Should be seen by a doctor for sweeping of membranes. 41 weeks (10 months) Should be delivered of baby.