Quality Assessment of Routine Expanded Programme of Immunization (EPI) for Children Under Five In Debre Markos Town, East Gojjam, Amhara Regional State, North West Ethiopia, 2014
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Date
2014-06
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Addis Ababa University
Abstract
Expanded program on immunization (EPI) was launched in Ethiopia in 1980 to achieve universalchild immunization by 1990. Children of under-one year of age and women of reproductive agegroup (15-49 years age) are the targets for the EPI vaccines. In spite of the improvement inimmunization coverage over the past many years, achieving this goal becomes difficult to thepresent time. Therefore quality assessment is important to determine whether the primary healthcare Service is provided according to the established norms. Although the immunization coveragehas increased, the quality of the immunization programme is still questionable.
Objective:The main aim of this study was to assess the structural, process and outcome quality dimensionsof Routine EPI program in terms of client satisfaction in under five children.
Methodology:This study was descriptive cross-sectional health facility based survey using quantitative method.Data collection for this evaluative research was conducted from March 10/2014-April 11/2014 atfive public health facilities found in Debre Markos town. To determine the sample size; 95%confidence interval, 5% margin of error (E) and non-response rate equal to 5% has been used.Using the formula the total sample size calculated for the exit interview was 392 respondents.The study has been conducted on four health centers and one hospital of the town that deliver EPIservice. The data collection has been carried out from March 10/2014-April 11/2014.
Result:In this study two health centers reported as there was no adequate BCG vaccine, almost allfacilities reported as there was inadequate financial allocation and 60% of facilities reported asthere was deficit in means of transportation and mean score for parents who were told aboutpossible side effects and importance of immunization were (20.2%) and (44.39) respectively Positive findings obtained in this study were for the case of telling the appointment for the nextvisit (mean score 98%), availability of cold chain monitoring chart, monitoring temperaturetwice/day including weekend and maintaining normal storage temperature (100%), human poweraspect 100% of the EPI coordinators of facilities had above one year working experience, meanscore of clients who got all vaccines they were supposed to take that day was 95.5% and 100%availability of functional refrigerators. The mean scores of structure, process and clients’satisfaction (outcome) were found to be 81.98%, 81.26% and 93.42% respectively.
Conclusion:Overall, the quality of the service was found to be under category three of EVM parameter, butstill there existed some areas which needed more attention, such as staffs’ in-service training,transportation and financial allocation to run the service properly and addressing proper EPIeducation and counseling to mothers. The health workers and program coordinators failed to keepup their standards in these works.Positive findings obtained in this study were for the case of telling the appointment for the nextvisit (mean score 98%), availability of cold chain monitoring chart, monitoring temperaturetwice/day including weekend and maintaining normal storage temperature (100%), human poweraspect 100% of the EPI coordinators of facilities had above one year working experience, meanscore of clients who got all vaccines they were supposed to take that day was 95.5% and 100%availability of functional refrigerators. The mean scores of structure, process and clients’satisfaction (outcome) were found to be 81.98%, 81.26% and 93.42% respectively.
Conclusion:Overall, the quality of the service was found to be under category three of EVM parameter, butstill there existed some areas which needed more attention, such as staffs’ in-service training,transportation and financial allocation to run the service properly and addressing proper EPI
education and counseling to mothers. The health workers and program coordinators failed to keep
up their standards in these works.
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Keywords
Expanded Programme Immunization