HEALTH WORKER AND CAREGIVER INTERACTION DURING CHILD VACCINATION SESSIONS AT HEALTH FACILITIES IN SOMALI REGION OF ETHIOPIA: A QUALITATIVE STUDY

Abstract

Abstract Introduction: Somali Region is one of the largest region in Ethiopia which has performed persistently low with immunization coverage. communication during vaccination sessions at health facilities is one of the key factors that influence caregiver’s decision to bring back their children for vaccination. The Objective of this study was to evaluate health worker and caregiver interaction during immunization session and identify communication gaps in Somali region Material and Methods: This was a cross sectional qualitative study. The study was carried out using in depth interview with health workers responsible for vaccination, observation of vaccinator and caregiver interaction during immunization session and exit interview of caregivers who brought their children for vaccination or whose child was vaccinated at the health facility. Results: Health workers responsible for vaccination in twelve health facilities from central and remote part of the region were interviewed. A total of 63 vaccination sessions in the 12 health facilities were observed and caregivers were interviewed on exit. Most caregivers described the vaccinators as friendly and supportive. Some mothers who did not bring the immunization card with them were returned with out child getting the service. The return date for vaccination was written on immunization card in most cases. Most caregivers do not identify vaccines by name or purpose, however they all want their children get all vaccines as recommended by health workers. Conclusion Health worker do not communicate required information for continued use of immunization service at health facilities during vaccination session. caregiver interaction in Somali region will need to be improved though training of health workers on immunization basics and communication

Keywords

• Communication,Ethiopia,health facility,health worker,vaccination

Supporting Institution

USAID Ethiopia

Project Number

AID-OAA-A-17-00026

Thanks

We are thankful to the health workers and caregivers who took their time to participate in the in-depth and exit interviews. We also thank the data collectors, the Somali Region Health Bureau, all study area health facility heads and CGPP admin and Finance team, who made this study possible. This study was supported by USAID through grant to CORE Group Polio Project.

References

1. 1 Casey, R.; Dumolard, L.; Danovaro, C.; Gacic-Dobo, M.; Diallo, M.; Hampton, L.; Wallace, A.S. “Global routine vaccination coverage”, Wkly. Epidemiol. Rec, 91, 537–548, 2016
2. 2 Wolfson LJ, Gasse F, Lee-Martin S-P, Lydon P, Magan A, Tibouti A, et al. “Estimating the costs of achieving the WHO-UNICEF Global Immunization Vision and Strategy, 2006–2015”, Bulletin of the World Health organization, 86(1):27–39, 2008. https://doi.org/10.2471/BLT.07.045096 PMID: 18235887 

3. 3 Maurice JM, Davey S. “State of the World’s Vaccines and Immunization”, World Health Organization; 2009. 

4. 4 Rutherford ME, Dockerty JD, Jasseh M, Howie SR, Herbison P, Jeffries DJ, et al. “Preventive measures in infancy to reduce under-five mortality: a case—control study in The Gambia”, Tropical Medicine & International Health, 14(2):149–55, 2009
5. 5 World health Organization. “WHO vaccine-preventable diseases: monitoring system: 2010”. global summary, 2010
6. 6 Federal Ministry of Health. “Ethiopia National Expanded Program on Immunization, Comprehensive Multi-Year Plan 2016–2020, Addis Ababa”, FMOH April, 2015
7. 7 Ethiopian Public Health Institute and ICF. “Ethiopia Mini Demographic and Health Survey”, EDHS 2019
8. 8 CSA Ethiopia and ICF. “Ethiopia Demographic and Health Survey; Key Indicators Report, Addis Ababa, Ethiopia and Rockville, Maryland, USA”. DHS 2016: 27-28

9. 9 Sawhney M, Favin, M. “Epidemiology of the unimmunized child. Findings from the grey literature, Arlington, VA”, IMMUNIZATIONbasics Project, 2009
10. 10 Favin M, Steinglass R, Fields R, Banerjee K, Sawhney M. “Why children are not vaccinated: a review of the grey literature”, International Health, 4:229–38, 2012.
11. 11 Federal Ministry of Health: “Health Sector Transformation plan : Woreda Based Health Sector Annual Core Plan”, FMOH 2019-2020
12. 12 Ministry of Health, UNICEF/Ethiopia. “National Immunization KABP Survey Report, Addis Ababa, Ethiopia”, 2001 [unpublished]
13. 13 Razum O. “Mothers voice their opinion on immunization services”. World Health Forum, 14:282–6, 1993
14. 14 Perry, HB, El Arifeen S, Hossein I, Weirbach R. “The quality of urban EPI services in Bangladesh: findings from the Urban Initiatives’ Needs Assessment Study in Zone 3 of Dhaka City, Dhaka, Bangladesh”, ICDDR, B, Working Paper No. 24, 1996
15. 15 UNICEF: “Social-Cultural Context of Immunization in Benin”, Evaluation Newsletter [UNICEF] 12:5, 1991
16. 16 Millimouno D, Diallo AA, Fairhead J, Leach M. “The social dynamics of infant ehaveation in Africa, perspectives from the Republic of Guinea, Brighton, UK”, Institute for Development Studies, University of Sussex, Working Paper 262, 2006
17. 17 Tadesse H, Deribew A, Woldie M. “Explorative assessment of factors affecting child immunization in Wonago district, Gedeo zone, South Ethiopia”, Archives of Medical Science, 5(2):233–40), 2009
18. 18 Leach M, Fairhead J. “Understandings of immunization: some West African perspectives”, Bull World Health Organ 2008;86:418
19. 19 Habimana P, Bararwandika A. “Knowledge, attitudes and behaveior of parents concerning immunization”, Imboneza- muryango/Famille, Sante, Development, 20:8–13, 1991
20. 20 M. Favin et al. “Why children are not vaccinated: a review of the gray literature”, International Health 4, 229–238, 2012
21. 21 World Health Organization. “Epidemiology of the unvaccinated child: Findings from the gray Literature”, WHO, October 2009.