Why High Dropout on Immunisation Programme in the Ashanti Akim North District

Abstract

Expanded Programme on Immunisation is one of the health intervention that holdout the prospect of reducing infant and childhood mortality in developing countries. In Ghana efforts are being made to folly immunise all children against the six childhood killer diseases. Unfortunately access to and utilisation of the services by the children remains poor in many districts. The Ashanti Akim North district for instance recorded dropout rate of 29% in 1999. This dropout rate is unacceptable at the time when the country has aimed at achieving a minimum of 75% coverage for DPT3/OPV3 by the year 2001. According to WHO, there is a problem whenever dropout rate exceeds 10%. The study looked into the reasons for such a high dropout rate in the Ashanti Akim North district. The Ashanti Akim North district is one of the 18 districts in the Ashanti Region of Ghana. It has a population of 107,771. Konongo is the district capital, with the Agogo Presbyterian Hospital as its district hospital. The main objective of the study was to provide information to enable the District Health Directorate design and implement appropriate and relevant immunisation programme that will serve to enhance immunisation coverage and encourage mothers to folly immunize their children in the Ashanti Akim North District. The study was descriptive in nature and combined both quantitative and qualitative methods. The findings from the qualitative research (group discussions) were used to complement the information obtained from the sample survey questionnaire that was administered to mothers of children between 6 weeks to 24 months, who had dropout of the immunisation schedules. The sample size for the study was 170. The results of the study showed that the dropout rate in the district was 17.3% instead of the calculated rate of 29%. The overestimation was due to poor recording of the immunisation registers. For those who dropout out, several reasons were given as to why they could not comply with the immunisation schedules. Most of the reasons 62.1% were obstacles with lack of money as the most prominent. Lack of motivation resulted in 20.6% of the respondents postponing their visit until another time. The rest were mother being busy, traveling, fear of side effect and laziness. Lack of nice clothing was not a major reason why a mother would not attend or complete the schedule. The study revealed that the mothers prefer outreach clinic to any other immunisation strategy. The main recommendations were that; 1. Education at antenatal, postnatal and child welfare clinics should stress the total number of times mothers need to visit the clinic to complete the immunisation and when the measles vaccine needs to be taken. 2. The CHN should be trained on the need for the immunisation register and should be encouraged to do proper recording and follow up on defaulters. It is hoped that the recommendations will be critically considered to improve immunisation coverage in the Ashanti Akim North District.