POST 00976E : QUALITY VS IMMUNIZATION COVERAGE
Follow-up on Post 00972E
19 September 2006
_____________________________________
This posting contains four contributions :
1- Naresh Goel (mailto:[email protected]) from India
2- Steven Toikilik (mailto:[email protected]) from Papua New Guinea
3- Vijay Kiran (mailto:[email protected]) also from India , and finally
4- Mike Favin (mailto:[email protected]) from the United States
_____________________________________
Dear All
This is in addition to Dr Babu's excellent observations on improving
coverage through improving quality.
I am in total agreement that quality has a tremendous impact on the demand
generation and thereby improving coverage. In addition to introduction of
ADS the concept of quality overall has many components. Some of these are :
1. Observing timeliness at session site
2. Meeting the commitment of organizing a scheduled session in spite of holiday
3. Smiling behaviour of health care provider
4. Cleanliness at site and
5. Maintaining privacy of clients.
All these have played a major role in generating demand and improving
coverage. Tamil Nadu in India is a good example.
Regards.
Naresh Goel
WHO-NPSP INDIA
--------------------------------
Dear Doctor Babu,
Yes indeed, Papua New Guinea immunization program has experienced similar
phenomenon when it introduced AD Syringe 4 years ago. I think the
experience on AD Syringe is among many other innovations that could
increase immunization demand. There is one that I have been trying to adapt
to improve the system rather than the specific program. And that is to
create standards based on "Quality, Efficiency and Consistency".
This is a concept where each program or service provided is centered on the
QEC model. I believe by improving the system we could be able to realize
increased demand for immunization and other services at the district or
facility level.
Thank you,
Best regards,
Mr. Steven Toikilik,
National EPI Manager,
Department of Health,
Papua New Guinea
--------------------------------
This is in response to Dr. Giridhar Babu's queries.
Firstly Government of India has to be commended for taking such a decision
to introduce AD syringes for immunizations throughout the country. The
basic intention of introduction was to ensure 'Injection safety" and GOI
could achieve the same. Though the safe disposal issues are presently in a
fluid state probably in a few months the same can be addressed.
Unless we do an operational research we may not be in a position to say
weather the initiative has improved the demand. On the other hand, let me
quote some negative observations during the field visits,
1. The mothers were apprehensive about more bleeding from the site of injection
2. Mothers were complaining that the length of the needle was more and
hence were bringing their own disposable syringes
3. Habit of touching the needle by the health worker still continues.
These are the training and advocacy issues which need to be addressed.
Vijay
---------------------------------------
This is an interesting question on several levels. Firstly, I think that
most of us would agree that most people in general are attracted by new
gadgets and gizmos, so that introduction of new syringes or vaccines, for
example, may cause a temporary spike in coverage.
Secondly, I find the term "demand generation" in relation to immunization a
bit misleading. In most countries and local areas – although clearly there
are exceptions -- lack of demand for immunization is not a major reason for
unsatisfactory coverage. Most mothers or other caregivers, in most places,
are highly motivated to have their children immunized, an act that they may
not fully understand but which they know is good for their children's
health and survival. Finally, I think it's impossible to generalize about
what is needed to increase coverage, because the important appropriate
actions will vary by local situation. The list of possible helpful actions
includes:
improving the availability of immunization services via outreach and/or
modifying service hours;
improving the reliability of immunization services, so that when a
caregiver and child arrive for services they be confident that the health
worker and vaccine needed will be available;
improving the manner in which health staff treat and communicate with
caregivers and children;
improving defaulter tracking and community participation in ensuring that
each caregiver understands when their children's next immunization is due.
Mike Favin
Technical Officer,
IMMUNIZATIONbasics
______________________________________________________________________________
All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services.
The comments made in this forum are the sole responsibility of the writers and do not in any way mean that they are endorsed by any of the organizations and agencies to which the authors may belong.
______________________________________________________________________________
Visit the TECHNET21 Website at http://www.technet21.org
You will find instructions to subscribe, a direct access to archives, links to reference documents and other features.
______________________________________________________________________________
To UNSUBSCRIBE, send a message to : mailto:[email protected]
Leave the subject area BLANK
In the message body, write unsubscribe TECHNET21E
______________________________________________________________________________
The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (http://www.ccisd.org)
______________________________________________________________________________
There are no replies made for this post yet.