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  • Title: Immunization coverage and identification of problems associated with vaccination delivery in Gondar, north west Ethiopia.
    Author: Gedlu E, Tesemma T.
    Journal: East Afr Med J; 1997 Apr; 74(4):239-41. PubMed ID: 9299826.
    Abstract:
    A cluster sample survey using the Expanded Programme for Immunization (EPI) methodology was conducted in April 1995 in Gondar town and surrounding villages in north west Ethiopia to assess immunisation coverage in the area and problems associated with vaccination delivery. Two hundred and thirteen children aged 12-24 months were enrolled into the study from the chosen thirty clusters. Among the sampled children, 101 (47.4%) were fully immunised while 64(30%) were not immunised at all. Only 38% of the mothers had received tetanus toxoid vaccination more than once. Reasons given for not immunising a child were lack of knowledge (39.8%), social problems (38.7%) and various obstacles (22.8%), such as child sickness and health institution related problems. A strategy of strengthening of health education, primary health care and extension of the eligibility criteria are suggested as solutions to improve coverage. This study determines the extent and nature of immunization of children and mothers in rural Ethiopia. Data were obtained from a sample of 213 children from visits to 1269 households in Gondar town and surrounding rural villages in northwest Ethiopia in April 1995. 80.3% of respondents were mothers, 7.5% were fathers, and the rest were grandparents or other relatives. 49.3% of children were females. The mean age of children was 18.2 months. 85.9% were Christians, and 14.1% were Muslims. 62% of children were delivered at home, 28.2% were delivered at a hospital, 5.6% were delivered at a health center, and 3.8% were delivered at a health station. 47.4% of the children were fully immunized; 30.0% were not immunized at all; 22.6% were partially immunized. 56% received immunizations at outreach posts. 5.2% did not believe that immunization was useful. 91.7% believed that immunization prevented disease. 3.9% believed that immunization cured disease. 3.4% believed that immunization made symptoms milder. Many knew that measles and pertussis were prevented by vaccines. Fewer were aware of the prevention of tetanus and poliomyelitis. 15.4% believed that vaccines prevented tuberculosis. 21.6% of mothers were immunized at least once; 22.5% were immunized twice; 8.5% were immunized three to four times; 7% were immunized five times; and 40.4% were never immunized. Polio coverage was the lowest among children, because many were delivered at home and did not receive immunization at birth as recommended by WHO. The reasons given by mothers for the lack of immunization or incomplete immunization included: lack of knowledge, unawareness of the need for second and third doses and measles protection, and a belief that disease is better than immunization. Other common reasons were social problems and lack of time.
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