An evaluation of expanded programme on immunization in New Juaben municipality using components of the flashlight triad evaluation model

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Immunization is essential in the maintenance of child health and is seen as a cost effective way of preventing child mortality and morbidity. However a lot of children die from causes which could have been prevented by extensive coverage of these immunization programmes. This study was a retrospective evaluation of the practice of EPI in the New Juaben Municipal using the flashlight triad model of evaluation under the headings of technology, inputs and outcome. A total of 500 caregivers with children less than five years were chosen for this study and interviewed with a structured questionnaire by visiting the households. A total of 40 health centre personnel responsible for EPI were selected to answer a self-administered questionnaire. An evaluation of the health centres providing these services was done using the components of the FTE model aided by an observational study using a checklist. Descriptive statistics were used to describe demographic characteristics and knowledge level of caregivers and health workers and other independent variables while the associations between these factors were determined using Pearson Chi square, Fisher’s exact test, bivariate and multivariate logistic regression. It was found out that the EPI programme in the New Juaben Municipal was of high quality with a good proportion of children being vaccinated. Maternal characteristics such as education, parity, occupation, and ethnicity, number of children and age of child contributed significantly to child’s vaccination status. There was a strong link between the caregivers’ knowledge of EPI and completion of the vaccination series. This means that good public education would lead to increase immunization coverage. Some service factors such as the type of facility, time spent to get to the facility, time spent at the facility and satisfaction with the service provided were associated with completing immunization schedule as appropriate for age. EPI in the municipal had these few challenges and they include inadequate staff numbers, lack of infrastructure improvement and maintenance, inadequate materials for health education and low motivation for staff and volunteers. There was a good coverage of EPI with a low dropout rate and good client satisfaction. It is recommended that more emphasis be put on training programmes for the health personnel responsible for EPI in the municipal. There should be adequate staff in all the centres to enhance the daily management of the facilities, provision of adequate logistics and increase public education on EPI.
A dissertation presented to the school of research and graduate studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfillment of the requirements for award of the MPH.