POST 00986E : QUALITY VS IMMUNIZATION COVERAGE
Follow-up on Posts 00972E and 00976E
8 October 2006
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This posting contains three contributions, but two from Giridhar Babu
(mailto:
[email protected]) who initiated this discussion. Though the first
is from Adelaïde Shearley (mailto:
[email protected]) from WHO/Nigeria.
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Dear All,
Thank you very much for sharing this very important subject of quality
services vs improved utilisation of existing services,therefore, increasing
coverage. I have worked in Zimbabwe, Namibia and Nigeria(presently
Nigeria), and what has been observed is that, indeed improvements in both
technology and/or quality do have influence on 'demand generation' for
immunisation.
The following are examples, not country specific:
1, In countries where I have worked, where HIV/AIDS is a big problem, the
use of AD syringes and other disposables, contributed to the increased
uptake of routine immunisation
2, The use of combined new vaccines, minimising the number of injections to
children
3,Health Facilities where there are adequately trained health workers are
more utilised
4, Private health facilities tend to be better equipped, furnished and with
better sanitary facilities, most mothers have opted to utilise them instead
of the public health facilities.
5, Health workers in most Church related institutions are perceived to have
better IPC with clients, therefore increased demand in those institutions
6, Use of acceptable vaccinators, e.g. females in some Moslem communities
7, Monitoring AEFI and dealing with the media
8, Of course, the use of VVMs and MDVP have minimised vaccine discard
rates, therefore minimising vaccine stock outs resulting in decrease in
missed opportunities
There are a number of quality issues that have been cited as responsible
for our low immunisation coverage in our countries, that have remained a
great challenge. However, improving safe injection practices have restored
public confidence, thus increasing demand. Hope I have contributed some
useful points, this subject is close to my heart.
Cheers
Adelaide Eleanor Shearley (MPH)
WHO Technical Officer,
Routine Immunisation & New Vaccines,
Nigeria Country Office
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Dear Mr. Mike Favin & all,
Thanks for great responses posted to this topic.
However, in countries like India, there is a greater proportion of
population who are relatively unaware of the benefits of immunization and
related health services. Hence it would definitely amount to generate the
demand by educating, making them aware and enable them to bring them within
the ambit of health services.
With regards,
Giridhar
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Dear All
Thanks very much for the responses. I am back with some more comments.
It might still be apt to use the term "Demand generation" in reference to
Immunization services. I am not using it in literal meaning but of course,
the functional meaning would remain the same. This is because most of the
under served population in some parts of India are not aware of benefits of
immunization and so do not turn up at site. The innovative methods of
immunization along with strong awareness campaigns would generate the
demand and these people would turn up at the immunization sessions.
Northern Karnataka, some parts of Bihar and UP in India are classical
examples to watch for the phenomenon of " lack of demand for immunization
being a major reason for
unsatisfactory coverage". With the vigour and extra zeal added under RCH-II
under NRHM in India, the people in these parts are becoming increasingly
aware of the immunization programmes and so this positive reinforcement is
in turn is important in sustenance of regular conduct of sessions.
Finally, I feel that Operational research on the QEC model might be more
fruitful taking cognizance of the prevalent trends of Immunization
programme in India.
With regards,
Giridhar
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