Quality assessment of childhood immunisation services in primary health centres in Oron, Akwa Ibom State, Nigeria
Authors: Esu David John , Kicha D. I. 
Published: July 2023

Introduction. With 20% of the African population, low routine immunization coverage, and a wild poliovirus reservoir, Nigeria contributes significantly to the overall regional burden of vaccine-preventable diseases. Since the introduction of the EPI in 1974 (which later became the National Programme on Immunization), Nigeria’s immunization program has suffered declining coverage. Poor quality affects service utilization, even where the services are provided free, just as immunization services are. Quality assessment will give an indication of the degree of satisfaction of clients with services as well as provide a framework for review of program priorities, strategies, and componentsPurpose of the study. The purpose of the study is to evaluate the quality of immunisation services provided to children in primary health centres in Oron, Akwa Ibom State, Nigeria. The study aims to identify the strengths and weaknesses of the immunisation services, assess the level of compliance with national and international standards for immunisation, and make recommendations for improvement where necessary. Additionally, the study seeks to contribute to the body of knowledge on the quality of childhood immunisation services in Nigeria, particularly in the context of primary health centres. Ultimately, the findings of this study may help to improve the delivery of immunisation services in the region and ensure that more children are vaccinated and protected against vaccine-preventable diseases. Materials and methods. This was a cross-sectional descriptive study of the quality of immunization services in Primary Health Centers in Akwa Ibom State, Nigeria. This study utilized some variables as indicators which included physical environment, resource availability, client satisfaction etc. formed into a questionnaire. The study involved 402 caregivers and 156 healthcare providers in 12 Primary Health Centers. The study utilized six instruments namely the Client questionnaire, Facility staff questionnaire, Facility Checklist, Personal Observation, Focus Group Discussion Guide, and Client Flow Chart.Outcomes. The results showed that the quality of immunization services was poor. The caregivers were dissatisfied with the reception by the providers. They were also not satisfied with the waiting time which they complained of as being too long. The attitude of the health care providers was also a cause of dissatisfaction.Discussion. This study found that the Community Health Extension Workers constituted the majority (39,4%) of the immunization service providers. Of the 152 healthcare providers that participated in the study, 92 (60,9%) had attended in-service training on immunization within the previous two years while 59 (39,1%) had not. A comparison of staff categories with attendance at in-service training showed a statistically significant difference (p=0.0072),suggesting that whether one attended in-service training or not depended on the category of staff he/she belongs to. One hundred and twelve (73,3%) of staff knew the correct vaccine storage temperature while 40 (26,7%) did not know. Healthcare providers who do not know the correct vaccine storage temperature may administer vaccines whose potency has been compromised. One-hundred and forty-nine (98,0%) healthcare providers were aware that clients have certain rights collectively referred to as clients’ rights. It is only by knowing the rights of clients that providers would be expected to respect these rights. The clients’ right to which most providers indicated strong agreement that clients are entitled to, was the right to information as indicated by 105 (70,2%) providers while the right to which most providers indicated disagreement was the right to choice of where and when to access services. Fifty-two (34,0%) health care providers felt clients were not entitled to this right.Conclusion. In conclusion, the study conducted a thorough quality assessment of childhood immunisation services in primary health centres in Oron, Akwa Ibom State, Nigeria. The findings reveal both strengths and weaknesses in the delivery of immunisation services to children in the region. While there were areas of average performance, such as experienced and trained healthcare workers, there were also areas of concern, such as inadequate cold chain storage and insufficient record-keeping practices.The study recommends that steps be taken to improve the quality of immunisation services in the region, including strengthening the cold chain system, ensuring adequate record-keeping practices, and implementing regular training and supervision of healthcare workers. These measures are crucial to ensuring that more children are vaccinated and protected against vaccine-preventable diseases.Overall, the findings of this study contribute to the body of knowledge on the quality of childhood immunisation services in Nigeria and underscore the importance of continued efforts to improve the delivery of immunisation services to children. It is hoped that the recommendations put forth in this study will inform policy decisions and ultimately lead to better health outcomes for children in Oron, Akwa Ibom State, and beyond