Prevalence And Factors Associated With Missed Opportunities For Immunization Among Children Below 60 Months At Siaya County Referral Hospital.

Abstract

Background: Immunization is today one of the safest, most cost-effective, and powerful means of preventing deaths and improving lives. Even though immunization currently averts an estimated 2 -3 million deaths every year, an estimated 21.8 million infants worldwide are still missing out on basic vaccines. Missed opportunities for immunization contributes to the low immunization coverage seen worldwide adding to the pool of children who have not been effectively immunized. These pockets of low coverage create a risk for the reintroduction of vaccine-preventable diseases (VPDs) that have been eradicated, eliminated, or are under epidemiological control. The Western region of Kenya has a long history of poor vaccine coverage. The devolution of healthcare to the County provides an opportunity for a more detailed understanding of the challenges and barriers in the local setting. This study was conducted in Siaya, one of the counties in the Western region of Kenya. Objective: To evaluate the prevalence and factors associated with missed opportunities for immunization among children aged below 60 months at Siaya County referral hospital. Methodology: This was a hospital based descriptive cross sectional study of children seeking health services at Siaya County referral hospital. The study was conducted between January and February 2016 at the Paediatric inpatient and outpatient departments at the facility. The study groups included eligible parent/guardian-child pairs and eligible health care workers who had consented to participate in the survey. A total of 370 child-parent/guardian pairs were interviewed. Exit interviews of the guardians of children who consented to the study was carried out using the standard WHO tool for missed opportunity surveys. The MCH booklet of the target child was examined to determine whether they were eligible for a vaccine and whether it had been offered, and the reasons for missed opportunities. In addition, a total of 116 Health Care Workers were interviewed to determine their knowledge, attitude and practice regarding childhood immunization. Ethical approval was sought from Kenyatta National Hospital/ University of Nairobi Ethics and Review Committee. Data was entered into SPSS, Version 21.0 and analyzed using descriptive statistics and chi square test. The results are presented in tables, graphs and pie charts. x RESULTS: Three hundred and seventy children aged 0-60 months were included in the survey and116 health workers interviewed. The prevalence of missed opportunity for immunization in the study was 16.2 %.The reasons given missed opportunity for immunization were mainly vaccine stock outs and children being unwell at the time of immunization. CONCLUSION AND RECOMMENDATIONS: The prevalence of missed opportunity for immunization at Siaya County referral hospital is 16.2%. Missed opportunities for immunization can be reduced by strengthening of immunization services through identification of reasons for vaccine stock outs and educating health workers on immunization practices to improve knowledge on routine immunization practices.