Assessment Of Second Year Of Life Immunization Performance In The Accra Metropolis By Oxygen Gershion Wullar

Abstract

Background Vaccination in the second year of life is to boost the immunity of children after the first birthday to five years of age. The second-year vaccination exposes children who did not seroconvert during the first year of life vaccination in nine months to now have the opportunity to be fully immunized against killer diseases. The study assesses suboptimal second year of life immunization coverage performance in Okaikoi Sub metro, Accra Metro for 2017. Method: A mixed method comprising of a qualitative and a quantitative study was used to assess health workers, health facilities and guardians of vaccinees. Semi-structured questionnaire was used for 169 respondents in 28 outreach sites visited and 2 focus group discussion conducted. Chi-square tests were used for bivariate associations between categorical variables and Fisher's exact tests used in instances where the assumptions underlying Chi-square failed (i.e. low expected cell frequencies). Wilcoxon rank-sum test was also used to investigate if significant differences in output levels existed between facilities that had a shortage of vaccines and those that did not. Results: The results showed that facilities without shortage had a mean output level of 23.3% compared to the mean output level of 49.8% for those with shortage and this difference was highly significant (p <0.001). All facilities that know of the second year of life catch up policies also had a shortage of the vaccines compared to only some of those that did not know the policies and these differences were significant (p<0.007). Most mothers do not go for vaccination after 9 months due to health staff not scheduling them as identified in focus group discussion. Conclusion Shortcomings identified in this research shows that serious challenges do exist which have to be addressed when vaccines are introduced. The irregular vaccine shortage in the facilities and staff not scheduling for 18 months after receiving 9 months vaccination is found to be some factors affected the vaccination coverage performance which if addressed will significantly help improve the second year of life immunization coverages.