What Are the Health Service Factors Contributing To Persistent Low Immunization Coverage In The Volta Region; The Case of Nkwanta District

Abstract

The programme of immunization against polio, diphtheria, whooping cough, tetanus, tuberculosis, and measles has reached all the sub-districts of Nkwanta district, but it has not yet had a demonstrable effect on low EPI coverage. The study looked at the possible health service factors leading to persistent low EPI coverage in the district particularly on the adequacy of EPI supplies to the periphery and the strategies used in EPI in the district. Data were collected from all the Community Health Nurses (CHNs) and from heads of health facilities using structured questionnaires and checklist. It was established that among the health service factors hindering high achievement of EPI coverage were lack of team spirit among health workers and maldistribution of CHNs resulting in some areas without EPI services. Inability to resolve administrative and managerial issues had also influenced EPI uptake in the district. But failure to adequately supply the periphery with EPI logistic supplies and non-adherence to Ministry of Health’s recommended EPI strategies for low coverage areas were perhaps the greatest shortcomings. The main recommendations were that just as much as the Ministry of Health headquarters were to make available enough EPI materials to the RHMT for onward distribution to the district, the DHMT should also try to supplement its existing strategies (static and out-reach) with occasional mini-mass campaigns to improve coverage and that the DHMT should resolve its administrative and managerial problems in the sub-districts.