Assessing the dropout rate of the expanded programme on immunisation in Asutifi District.

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The induction of an immune response to infectious disease by vaccination has become a widely applied and acceptable public health intervention. For immunisation to be effective as a long-term global childhood disease control strategy, it is essential that parents continue to present their children for vaccination. A recent study in assessing the dropout rate of immunization has shown that, immunization coverage in Asutifi District has been high with percentage of fully vaccinated children ranging between 95% in the district and 90% to 97% in the sub-districts. There is an account of high dropout rate of eligible children receiving the vaccines in the sub-district above the National and WHO, recommended level of dropout rate less than 10% (WHO, 2005). The aim of the study was to determine the dropout rate of the Expanded Program on Immunization to assess the ability of the service to hold on to the number of children who started the vaccination. A descriptive cross-sectional survey among a representative sample of 300 children between the ages of 12-23 months from households with varying socio-economic status from both urban and rural sub-districts was done to illicit information on the immunization coverage. Approximately 95% of children under the age of two had been completely vaccinated. Averagely about 40% of eligible children in the district had timely received vaccines during EPI programme. Seventy seven percent of children receive their vaccination at the outreach post. The vaccination schedule showed that 4.4% who started BCG vaccination dropped out as at the time of receiving measles vaccine. The dropout rate for DPT1 and DPT 3 was 0.67%. More than 62% of mothers do not present their children for vaccination because they are busy with their economic activities and 31.25% of household are unaware of the need to return for subsequent doses. These shortcomings are affecting the sustainability of routine immunisation programmes and are promoting the growth of a large number of partially immunised children. To protect the continued operations and to enhance the coverage of routine vaccination programmes, it is important that the dropout rate and these difficulties be addressed. The dropout rates for children in the sub-district are between 5% and 10% signifying differences in how each sub-district is able to hold the number of eligible children who were targeted for vaccination. Generally the dropout rate indicates that the efficiency of the service delivered during EPI programme in the sub-district differ from one sub-district to another. The difference that exist in the dropouts within the sub-districts demonstrate a service delivery gap and suggest that greater efforts are required by government and the district health management team to rethink of resource allocation and strengthening processes to improve immunization coverage among rural poor.
A dissertation submitted to the School of Graduate Studies (Kwame Nkrumah University of Science and Technology) in partial fulfillment of the requirements for the Master of Public Health Degree In The Health Services Planning And Management, 2008