MISSED OPPORTUNITIES TO NATIONAL PROGRAMME ON IMMUNIZATION-SCHEDULED CHILDHOOD IMMUNIZATIONS IN ABAKALIKI – A HEALTH FACILITY SURVEY

Abstract

This study determined the extent and causes of missed opportunities to NPI
scheduled childhood immunizations in 500 consecutive child/mother pairs who
accessed the Paediatric curative services of Ebonyi State University Teaching
Hospital Abakaliki. The exit interview method of the World Health
Organization was used. The knowledge and practice of NPI-scheduled
childhood immunization by 32 doctors and 35 nurses in the Paediatric
department of the hospital were also assessed through a questionnaire-interview.
Only 41.6% of the children were fully immunized. Missed opportunities for
immunization occurred in 277 (55.4%) children and were responsible for 94.9%
of the non-fully immunized children. Missed opportunities occurred more in the
age group of 0-11 months (92.4%) compared to those aged 12-23 months
(7.6%), P<0.05. The social class of the parents was statistically significant in
predicting the likelihood of missed opportunities in this study (P< 0.05).
Of all the vaccines, only BCG and OPV0 attained the 2007 NPI target of 80%
coverage for all antigens with rates of 86.4% and 92.2% respectively. Yellow
fever vaccine had the lowest coverage of 19.0%. The drop-out rate was
35.7%.The risk of missed opportunities to immunization remained high in
EBSUTH, given that immunization was conducted once a week in the
preventive department only. The most common reason for missed opportunities
in this study was the unavailability of vaccines (78.3%). Other reasons include
false contraindications (13.0%) and negative practices by the doctors and nurses
such as failure to ascertain the immunization status of children leaving their
clinics (2.5%).
Many doctors and nurses exhibited poor knowledge of true contraindications to
immunization. In this study, 37.1% of nurses will not immunize a child who has
cough and catarrh that does not require admission, while 21.9% of doctors will
do the same (P>0.05).
It is recommended that vaccines be constantly available while all hospital visits
should be utilized for immunization services in order to reduce missed
opportunities. Furthermore, health workers especially doctors and nurses should
undergo regular training/re-training on immunization practices.

MISSED OPPORTUNITIES TO NATIONAL PROGRAMME ON IMMUNIZATION-SCHEDULED CHILDHOOD IMMUNIZATIONS IN ABAKALIKI – A HEALTH FACILITY SURVEY