dc.contributor.author | Dr Gwer, Benard Ochieng | |
dc.date.accessioned | 2013-05-23T11:14:10Z | |
dc.date.available | 2013-05-23T11:14:10Z | |
dc.date.issued | 2010 | |
dc.identifier.citation | Master of Medicine in Paediatrics and Child Health | en |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/11295/24816 | |
dc.description.abstract | Background: Vaccination is one of the most effective Public Health interventions. In spite of
this, immunization coverage in Kenya has remained below the WHO recommended thresholds.
This low coverage is seen not only in the remote areas of the country. but also in urban areas like
Nairobi Province where with a relatively better infrastructure and access to health facilities one
would expect better immunization coverage. Missed opportunity for immunization may represent
a significant barrier to achieving the requisite coverage. This study was carried out to evaluate
the prevalence of missed opportunity for immunization in Nairobi Province.
Objectives:
Broad objective: To assess the occurrence of missed opportunity for Immunisation in Nairobi
province.
Specific Objectives:
• To determine the prevalence of missed opportunity for immunisation in Nairobi Province
• To determine the socio-demographic characteristics of the caretakers of children with
missed opportunity immunisation.
• To establish reasons for occurrence of missed opportunity for immunisation.
• To assess health worker knowledge and practice and correlate this to missed
opportunities for immunisation.
Design: Cross sectional descriptive study.
Study site: Twelve health facilities selected by random sampling from Kibera, Embakasi and
Westlands divisions.
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Methods: Children aged below 24 months exiting from these health facilities and whose
caretakers consented were recruited into the study. The caretakers were interviewed regarding
the immunization status of these children, reasons for missing immunisation and any barriers to
immunisation. The health workers running immunisation services in these facilities were also
interviewed on their knowledge, practice and attitudes towards immunisation and their practice
observed. Standard pre-coded instruments were used to collect the information.
Results: A total of 277 eligible caretakers participated in the exit interview while 21 health
workers were interviewed. Overall prevalence' of missed opportunity for immunisation in the
study population was 23.8%. There was variation with Kibera division having a prevalence of
32%, while Embakasi and Westlands divisions had prevalence of 11.6% and 14.2% respectively.
Socio-demographic factors tha~ significantly affected vaccination rates were place of delivery,
where children born out at home had higher missed opportunity rates than those born in a health
facility (p=O.008). Lack of information and antigen stock-outs were the commonest reasons for
missing vaccines. The general attitude. of the health worker towards the client was found to be
good. There was a lack of knowledge on immunisation practice among the health workers.
Conclusions: Prevalence of missed opportunity for immunisation in Nairobi province is'23.8%.
Kibera division has. a significantly higher prevalence of missed opportunity compared to the
other 2 divisions. Community and health system barriers to immunisation exist. Of note is lack
of adequate knowledge by the health workers on immunisation, especially on contraindications
to vaccination. Home delivery was adversely associated with missed opportunity for
immunisation.
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Recommendations: Strategies are required to improve immunisation coverage especially in
Kibera division. Measures to promote screening all children for vaccination. facilitate defaulter
tracing and improve health worker knowledge on vaccination are required.
..- .
10 | en |
dc.language.iso | en | en |
dc.publisher | University Of Nairobi | en |
dc.title | Missed opportunies for immunisation in Nairobi province | en |
dc.type | Thesis | en |
dc.description.department | a
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya | |
local.publisher | College of Health Sciences | en |