Process Evaluation on the Quality of Routine Expanded Program on Immunization (EPI) in Dire Dawa City Administration, Eastern Ethiopia
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Date
2010-06
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Addis Abeba Universty
Abstract
Background: Dire Dawa is a city administration and among the smallest administration regions of Ethiopia both in terms of size and number of population. In spite of good opportunity for easy manageability to achieve the immunization coverage target set by FMOH, there has been low immunization coverage compared to other regions of the country for the past five years.
Objective: To assess the structural and process quality of routine EPI and their outcome in terms of client satisfaction.
Methods: Data collection for this evaluative research was conducted from February 5-26/2010 at 11 public health facilities found in Dire Dawa. Components for quality of immunization care were assessed using Donabedian’s model.
The study is descriptive cross-sectional health facility based survey. Stratified sampling for selecting the facilities and systematic sampling for the exit interview were used. The stratification considered level of the health facility and place where they did exist. As the interview was conducted for 385 mothers or guardians, simultaneous observation of care provided was being conducted in immunization rooms. On the other hand, record review for assessing immunization coverage and accuracy of reporting; also self-administered questionnaire for EPI coordinators was employed.
To judge the quality of components as a whole a weighted scores were given for the variables under structure and process.
Result: The result from analysis shows that structural quality was found at better position (out of the maximum 31, mean score=19.7) and clients satisfaction rate also higher (95%). But low quality was found regarding the process of care (mean score is 22.8 out of 45). The full immunization coverage calculated was 61.5% for the previous fiscal year.
Conclusion: In spite of better structural quality compared to other regions and higher satisfaction rate, full immunization coverage was low.
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Process Evaluation on the Quality of Routine Expanded