Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016.

<h4>Background</h4>In November 2016, the Kenya National Vaccines and Immunization Programme conducted an assessment of missed opportunities for vaccination (MOV) using the World Health Organization (WHO) MOV methodology. A MOV includes any contact with health services during which an eli...

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Main Authors: Anyie J Li, Collins Tabu, Stephanie Shendale, Kibet Sergon, Peter O Okoth, Isaac K Mugoya, Zorodzai Machekanyanga, Iheoma U Onuekwusi, Colin Sanderson, Ikechukwu Udo Ogbuanu
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0237913
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author Anyie J Li
Collins Tabu
Stephanie Shendale
Kibet Sergon
Peter O Okoth
Isaac K Mugoya
Zorodzai Machekanyanga
Iheoma U Onuekwusi
Colin Sanderson
Ikechukwu Udo Ogbuanu
author_facet Anyie J Li
Collins Tabu
Stephanie Shendale
Kibet Sergon
Peter O Okoth
Isaac K Mugoya
Zorodzai Machekanyanga
Iheoma U Onuekwusi
Colin Sanderson
Ikechukwu Udo Ogbuanu
author_sort Anyie J Li
collection DOAJ
description <h4>Background</h4>In November 2016, the Kenya National Vaccines and Immunization Programme conducted an assessment of missed opportunities for vaccination (MOV) using the World Health Organization (WHO) MOV methodology. A MOV includes any contact with health services during which an eligible individual does not receive all the vaccine doses for which he or she is eligible.<h4>Methods</h4>The MOV assessment in Kenya was conducted in 10 geographically diverse counties, comprising exit interviews with caregivers and knowledge, attitudes, and practices (KAP) surveys with health workers. On the survey dates, which covered a 4-day period in November 2016, all health workers and caregivers visiting the selected health facilities with children <24 months of age were eligible to participate. Health facilities (n = 4 per county) were purposively selected by size, location, ownership, and performance. We calculated the proportion of MOV among children eligible for vaccination and with documented vaccination histories (i.e., from a home-based record or health facility register), and stratified MOV by age and reason for visit. Timeliness of vaccine doses was also calculated.<h4>Results</h4>We conducted 677 age-eligible children exit interviews and 376 health worker KAP surveys. Of the 558 children with documented vaccination histories, 33% were visiting the health facility for a vaccination visit and 67% were for other reasons. A MOV was seen in 75% (244/324) of children eligible for vaccination with documented vaccination histories, with 57% (186/324) receiving no vaccinations. This included 55% of children visiting for a vaccination visit and 93% visiting for non-vaccination visits. Timeliness for multi-dose vaccine series doses decreased with subsequent doses. Among health workers, 25% (74/291) were unable to correctly identify the national vaccination schedule for vaccines administered during the first year of life. Among health workers who reported administering vaccines as part of their daily work, 39% (55/142) reported that they did not always have the materials they needed for patients seeking immunization services, such as vaccines, syringes, and vaccination recording documents.<h4>Conclusions</h4>The MOV assessment in Kenya highlighted areas of improvement that could reduce MOV. The results suggest several interventions including standardizing health worker practices, implementing an orientation package for all health workers, and developing a stock management module to reduce stock-outs of vaccines and vaccination-related supplies. To improve vaccination coverage and equity in all counties in Kenya, interventions to reduce MOV should be considered as part of an overall immunization service improvement plan.
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spelling doaj.art-18c34fb44ba54512884d2c0922b9bd562022-12-21T21:26:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01158e023791310.1371/journal.pone.0237913Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016.Anyie J LiCollins TabuStephanie ShendaleKibet SergonPeter O OkothIsaac K MugoyaZorodzai MachekanyangaIheoma U OnuekwusiColin SandersonIkechukwu Udo Ogbuanu<h4>Background</h4>In November 2016, the Kenya National Vaccines and Immunization Programme conducted an assessment of missed opportunities for vaccination (MOV) using the World Health Organization (WHO) MOV methodology. A MOV includes any contact with health services during which an eligible individual does not receive all the vaccine doses for which he or she is eligible.<h4>Methods</h4>The MOV assessment in Kenya was conducted in 10 geographically diverse counties, comprising exit interviews with caregivers and knowledge, attitudes, and practices (KAP) surveys with health workers. On the survey dates, which covered a 4-day period in November 2016, all health workers and caregivers visiting the selected health facilities with children <24 months of age were eligible to participate. Health facilities (n = 4 per county) were purposively selected by size, location, ownership, and performance. We calculated the proportion of MOV among children eligible for vaccination and with documented vaccination histories (i.e., from a home-based record or health facility register), and stratified MOV by age and reason for visit. Timeliness of vaccine doses was also calculated.<h4>Results</h4>We conducted 677 age-eligible children exit interviews and 376 health worker KAP surveys. Of the 558 children with documented vaccination histories, 33% were visiting the health facility for a vaccination visit and 67% were for other reasons. A MOV was seen in 75% (244/324) of children eligible for vaccination with documented vaccination histories, with 57% (186/324) receiving no vaccinations. This included 55% of children visiting for a vaccination visit and 93% visiting for non-vaccination visits. Timeliness for multi-dose vaccine series doses decreased with subsequent doses. Among health workers, 25% (74/291) were unable to correctly identify the national vaccination schedule for vaccines administered during the first year of life. Among health workers who reported administering vaccines as part of their daily work, 39% (55/142) reported that they did not always have the materials they needed for patients seeking immunization services, such as vaccines, syringes, and vaccination recording documents.<h4>Conclusions</h4>The MOV assessment in Kenya highlighted areas of improvement that could reduce MOV. The results suggest several interventions including standardizing health worker practices, implementing an orientation package for all health workers, and developing a stock management module to reduce stock-outs of vaccines and vaccination-related supplies. To improve vaccination coverage and equity in all counties in Kenya, interventions to reduce MOV should be considered as part of an overall immunization service improvement plan.https://doi.org/10.1371/journal.pone.0237913
spellingShingle Anyie J Li
Collins Tabu
Stephanie Shendale
Kibet Sergon
Peter O Okoth
Isaac K Mugoya
Zorodzai Machekanyanga
Iheoma U Onuekwusi
Colin Sanderson
Ikechukwu Udo Ogbuanu
Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016.
PLoS ONE
title Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016.
title_full Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016.
title_fullStr Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016.
title_full_unstemmed Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016.
title_short Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016.
title_sort assessment of missed opportunities for vaccination in kenyan health facilities 2016
url https://doi.org/10.1371/journal.pone.0237913
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