The status of immunization program and challenges in Ethiopia: A mixed method study
Introduction: Immunization helps reduce morbidity and mortality attributable to severe vaccine-preventable childhood illnesses. However, vaccination coverage and the quality of immunization data remain challenging in Ethiopia. This has led to poor planning, suboptimal vaccination coverage, and the r...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-03-01
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| Series: | SAGE Open Medicine |
| Online Access: | https://doi.org/10.1177/20503121241237115 |
| _version_ | 1827312239583952896 |
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| author | Tariku Nigatu Loko Abraham Herman Willems Mesfin Tilaye Firew Tiruneh Fantay Gebru Zergu Tafesse Bezawit Getachew Mulualem Bulcha Sami Tewfik Tadesse Alemu |
| author_facet | Tariku Nigatu Loko Abraham Herman Willems Mesfin Tilaye Firew Tiruneh Fantay Gebru Zergu Tafesse Bezawit Getachew Mulualem Bulcha Sami Tewfik Tadesse Alemu |
| author_sort | Tariku Nigatu |
| collection | DOAJ |
| description | Introduction: Immunization helps reduce morbidity and mortality attributable to severe vaccine-preventable childhood illnesses. However, vaccination coverage and the quality of immunization data remain challenging in Ethiopia. This has led to poor planning, suboptimal vaccination coverage, and the resurgence of vaccine-preventable disease outbreaks in under-immunized pocket areas. The problem is further compounded by the occurrence of the COVID-19 pandemic and the disruption of the health information system due to recurrent conflict. This study assessed the current status of the immunization service and its challenges in Ethiopia. Methods: A mixed-methods study was conducted in three regions of Ethiopia from 21 to 31 May, 2023. A survey of administrative reports was done in a total of 69 health facilities in 14 woredas (districts). Nine KIIs were conducted at a district level among immunization coordinators selected from three regions to explore the challenges of the immunization program. Linear regression and descriptive statistics were used to analyze the quantitative data. Thematic analysis was applied to analyze the qualitative data. The findings from the qualitative data were triangulated to supplement the quantitative results. Result: Two-thirds (66.4%) of the children were fully vaccinated, having received all vaccines, including the first dose of the MCV1, by 12 months of age, as reported through administrative reports collected from health facility records. Catchment area population size and region were significantly associated with the number of fully immunized children ( p < 0.001 and p = 0.005, respectively). The vaccination dropout rates of the first to third dose of pentavalent vaccine and the first dose of pentavalent vaccine to the first dose of MCV1 were 8.6% and 7.4%, respectively. A considerable proportion of health facilities lack accurate data to calculate vaccination coverage, while most of them lack accurate data for dropout rates. Longer waiting time, interruptions in vaccine supply or shortage, inaccessibility of health facilities, internal conflict and displacement, power interruption and refrigerator breakdown, poor counseling practice, and caretakers’ lack of awareness, fear of side effects, and forgetfulness were the reasons for the dropout rate and low coverage. The result also showed that internal conflict and displacement have significantly affected immunization coverage, with the worst effects seen on the most marginalized populations. Conclusion: The study revealed low vaccination coverage, a high dropout rate, and poor quality of immunization data. Access and vaccination coverage among marginalized community groups (e.g., orphans and street children) were also low. Hence, interventions to address organizational, behavioral, technical, and contextual (conflict and the resulting internal displacement) bottlenecks affecting the immunization program should be addressed. |
| first_indexed | 2024-04-24T21:39:25Z |
| format | Article |
| id | doaj.art-6c165cd0a1b74a3f84317071507f9811 |
| institution | Directory Open Access Journal |
| issn | 2050-3121 |
| language | English |
| last_indexed | 2024-04-24T21:39:25Z |
| publishDate | 2024-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Medicine |
| spelling | doaj.art-6c165cd0a1b74a3f84317071507f98112024-03-21T10:03:30ZengSAGE PublishingSAGE Open Medicine2050-31212024-03-011210.1177/20503121241237115The status of immunization program and challenges in Ethiopia: A mixed method studyTariku Nigatu0Loko Abraham1Herman Willems2Mesfin Tilaye3Firew Tiruneh4Fantay Gebru5Zergu Tafesse6Bezawit Getachew7Mulualem Bulcha8Sami Tewfik9Tadesse Alemu10JSI Research and Training Institute Inc., Addis Ababa, EthiopiaJSI Research and Training Institute Inc., Addis Ababa, EthiopiaJSI Research and Training Institute Inc., Boston, MA, USAUnited States Agency for International Development, Addis Ababa, EthiopiaJimma University, Jimma, EthiopiaJSI Research and Training Institute Inc., Addis Ababa, EthiopiaJSI Research and Training Institute Inc., Addis Ababa, EthiopiaJSI Research and Training Institute Inc., Addis Ababa, EthiopiaJSI Research and Training Institute Inc., Addis Ababa, EthiopiaJSI Research and Training Institute Inc., Addis Ababa, EthiopiaJSI Research and Training Institute Inc., Addis Ababa, EthiopiaIntroduction: Immunization helps reduce morbidity and mortality attributable to severe vaccine-preventable childhood illnesses. However, vaccination coverage and the quality of immunization data remain challenging in Ethiopia. This has led to poor planning, suboptimal vaccination coverage, and the resurgence of vaccine-preventable disease outbreaks in under-immunized pocket areas. The problem is further compounded by the occurrence of the COVID-19 pandemic and the disruption of the health information system due to recurrent conflict. This study assessed the current status of the immunization service and its challenges in Ethiopia. Methods: A mixed-methods study was conducted in three regions of Ethiopia from 21 to 31 May, 2023. A survey of administrative reports was done in a total of 69 health facilities in 14 woredas (districts). Nine KIIs were conducted at a district level among immunization coordinators selected from three regions to explore the challenges of the immunization program. Linear regression and descriptive statistics were used to analyze the quantitative data. Thematic analysis was applied to analyze the qualitative data. The findings from the qualitative data were triangulated to supplement the quantitative results. Result: Two-thirds (66.4%) of the children were fully vaccinated, having received all vaccines, including the first dose of the MCV1, by 12 months of age, as reported through administrative reports collected from health facility records. Catchment area population size and region were significantly associated with the number of fully immunized children ( p < 0.001 and p = 0.005, respectively). The vaccination dropout rates of the first to third dose of pentavalent vaccine and the first dose of pentavalent vaccine to the first dose of MCV1 were 8.6% and 7.4%, respectively. A considerable proportion of health facilities lack accurate data to calculate vaccination coverage, while most of them lack accurate data for dropout rates. Longer waiting time, interruptions in vaccine supply or shortage, inaccessibility of health facilities, internal conflict and displacement, power interruption and refrigerator breakdown, poor counseling practice, and caretakers’ lack of awareness, fear of side effects, and forgetfulness were the reasons for the dropout rate and low coverage. The result also showed that internal conflict and displacement have significantly affected immunization coverage, with the worst effects seen on the most marginalized populations. Conclusion: The study revealed low vaccination coverage, a high dropout rate, and poor quality of immunization data. Access and vaccination coverage among marginalized community groups (e.g., orphans and street children) were also low. Hence, interventions to address organizational, behavioral, technical, and contextual (conflict and the resulting internal displacement) bottlenecks affecting the immunization program should be addressed.https://doi.org/10.1177/20503121241237115 |
| spellingShingle | Tariku Nigatu Loko Abraham Herman Willems Mesfin Tilaye Firew Tiruneh Fantay Gebru Zergu Tafesse Bezawit Getachew Mulualem Bulcha Sami Tewfik Tadesse Alemu The status of immunization program and challenges in Ethiopia: A mixed method study SAGE Open Medicine |
| title | The status of immunization program and challenges in Ethiopia: A mixed method study |
| title_full | The status of immunization program and challenges in Ethiopia: A mixed method study |
| title_fullStr | The status of immunization program and challenges in Ethiopia: A mixed method study |
| title_full_unstemmed | The status of immunization program and challenges in Ethiopia: A mixed method study |
| title_short | The status of immunization program and challenges in Ethiopia: A mixed method study |
| title_sort | status of immunization program and challenges in ethiopia a mixed method study |
| url | https://doi.org/10.1177/20503121241237115 |
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