| Popis: |
Background: The availability, reliability and quality of immunization data is critical to the success of any immunization program. Poor quality data result into unreliable projections, planning, and programmatic implementation, which ultimately undermine immunization investments. Uganda, like many other developing countries, faces challenges of unreliable estimates for her immunization target population. Strengthening immunization data quality and use for improving immunization program performance are critical steps towards improving coverage and equity of immunization programs.The goal of this study was to determine the effectiveness of using community health workers (CHWs) to obtain quality and reliable data that can be used for planning and evidence-based response actions. Methods: A three phased cluster randomized trial in which 5 health facilities were randomized in two groups to (i) receive a package of interventions including monthly health unit immunization data audit meetings, and defaulter tracking and linkage through home visits; and (ii) to serve as a control group between July and September 2020 was conducted. Immunization coverage in both arms was determined before and after the interventions. In addition, key informant and in-depth interviews were conducted to explore the feasibility of the interventions. Results: Overall, a total of 2,048 eligible children were registered by CHWs which compares to the district estimated population of 1,889. The study further showed that it is feasible to use CHWs to track and link defaulters to points of services: More than two thirds (68%) of the defaulters were tracked and linked to immunization services. Immunization coverage for specific antigens was significantly higher in the intervention health facilities as compared to that in the control health facilities: DPT3 95.6% vs 88.4% (p=0.004); MR 88.9% vs 81.9% (p=0.048); BCG 81.4% vs 55.5% (pConclusion: Use of CHWs to obtain reliable population estimates is feasible and can be useful in areas with consistent poor immunization coverage to estimate target population. Facilitating monthly health unit immunization data audit meetings to identify, track and link defaulters to immunization services is effective in increasing immunization coverage and equity. |
