Cargando…

Descriptive study of measles vaccination second dose reporting and barriers to improving coverage in six districts in Malawi

INTRODUCTION: Malawi’s National Immunization Program introduced a second routine dose of measles containing vaccine (MCV2) in 2015 but found coverage lagging. We assessed data quality and gaps in service delivery. METHODS: Investigators used a modified data quality audit in 6 low performing district...

Descripción completa

Detalles Bibliográficos
Autores principales: Chirwa, Geoffrey, Wilkins, Karen Annette, Mercer, David John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196333/
https://www.ncbi.nlm.nih.gov/pubmed/32373256
http://dx.doi.org/10.11604/pamj.supp.2020.35.1.19096
_version_ 1783528704378404864
author Chirwa, Geoffrey
Wilkins, Karen Annette
Mercer, David John
author_facet Chirwa, Geoffrey
Wilkins, Karen Annette
Mercer, David John
author_sort Chirwa, Geoffrey
collection PubMed
description INTRODUCTION: Malawi’s National Immunization Program introduced a second routine dose of measles containing vaccine (MCV2) in 2015 but found coverage lagging. We assessed data quality and gaps in service delivery. METHODS: Investigators used a modified data quality audit in 6 low performing districts accompanied by questionnaires for health facilities (HF) and households with children with >1 vaccination. RESULTS: MCV2 doses administered according to source were: 733 in registers, 2364 in reports, 1655 in district reports, 2761 in the electronic database. There was 77% agreement regarding status for MCV2 between the register and the home-based record (HBR). Drop-out differences were found between HF according to the practice of waiting for a minimum number of children to open an MCV vial, canceling sessions due to stock-out and requesting payment for a home-based record. Eighty one percent (81%) of children whose caregivers knew 2 doses were needed had received MCV2 vs fifty eight (58%) of children whose caregivers didn’t know. Sixty two (62%) of children who were charged for HBR received MCV2 vs 78% reporting no charge. CONCLUSION: The drop-out between the first and second doses of MCV was high and inconsistent with elimination goals. The quality of administrative data in these 6 districts was found to be poor. This investigation found that session cancelation, charging for HBR and lack of caregiver knowledge affected completion of the vaccination series. The authors recommend program improvements in these areas to increase uptake of MCV2 and improved reporting practices at all levels of the system.
format Online
Article
Text
id pubmed-7196333
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher The African Field Epidemiology Network
record_format MEDLINE/PubMed
spelling pubmed-71963332020-05-05 Descriptive study of measles vaccination second dose reporting and barriers to improving coverage in six districts in Malawi Chirwa, Geoffrey Wilkins, Karen Annette Mercer, David John Pan Afr Med J Research INTRODUCTION: Malawi’s National Immunization Program introduced a second routine dose of measles containing vaccine (MCV2) in 2015 but found coverage lagging. We assessed data quality and gaps in service delivery. METHODS: Investigators used a modified data quality audit in 6 low performing districts accompanied by questionnaires for health facilities (HF) and households with children with >1 vaccination. RESULTS: MCV2 doses administered according to source were: 733 in registers, 2364 in reports, 1655 in district reports, 2761 in the electronic database. There was 77% agreement regarding status for MCV2 between the register and the home-based record (HBR). Drop-out differences were found between HF according to the practice of waiting for a minimum number of children to open an MCV vial, canceling sessions due to stock-out and requesting payment for a home-based record. Eighty one percent (81%) of children whose caregivers knew 2 doses were needed had received MCV2 vs fifty eight (58%) of children whose caregivers didn’t know. Sixty two (62%) of children who were charged for HBR received MCV2 vs 78% reporting no charge. CONCLUSION: The drop-out between the first and second doses of MCV was high and inconsistent with elimination goals. The quality of administrative data in these 6 districts was found to be poor. This investigation found that session cancelation, charging for HBR and lack of caregiver knowledge affected completion of the vaccination series. The authors recommend program improvements in these areas to increase uptake of MCV2 and improved reporting practices at all levels of the system. The African Field Epidemiology Network 2020-01-03 /pmc/articles/PMC7196333/ /pubmed/32373256 http://dx.doi.org/10.11604/pamj.supp.2020.35.1.19096 Text en © Geoffrey Chirwa et al. http://creativecommons.org/licenses/by/2.0/ The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Chirwa, Geoffrey
Wilkins, Karen Annette
Mercer, David John
Descriptive study of measles vaccination second dose reporting and barriers to improving coverage in six districts in Malawi
title Descriptive study of measles vaccination second dose reporting and barriers to improving coverage in six districts in Malawi
title_full Descriptive study of measles vaccination second dose reporting and barriers to improving coverage in six districts in Malawi
title_fullStr Descriptive study of measles vaccination second dose reporting and barriers to improving coverage in six districts in Malawi
title_full_unstemmed Descriptive study of measles vaccination second dose reporting and barriers to improving coverage in six districts in Malawi
title_short Descriptive study of measles vaccination second dose reporting and barriers to improving coverage in six districts in Malawi
title_sort descriptive study of measles vaccination second dose reporting and barriers to improving coverage in six districts in malawi
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196333/
https://www.ncbi.nlm.nih.gov/pubmed/32373256
http://dx.doi.org/10.11604/pamj.supp.2020.35.1.19096
work_keys_str_mv AT chirwageoffrey descriptivestudyofmeaslesvaccinationseconddosereportingandbarrierstoimprovingcoverageinsixdistrictsinmalawi
AT wilkinskarenannette descriptivestudyofmeaslesvaccinationseconddosereportingandbarrierstoimprovingcoverageinsixdistrictsinmalawi
AT mercerdavidjohn descriptivestudyofmeaslesvaccinationseconddosereportingandbarrierstoimprovingcoverageinsixdistrictsinmalawi