Quality Assessment of Routine Expanded Programme of Immunization (EPI) for Children Under Five In Debre Markos Town, East Gojjam, Amhara Regional State, North West Ethiopia, 2014
Creators: name: Demelash, Alebachew
Publisher: name: National Academic Digital Repository of Ethiopia
Year: 2014

description: Expanded program on immunization (EPI) was launched in Ethiopia in 1980 to achieve universal child immunization by 1990. Children of under-one year of age and women of reproductive age group (15-49 years age) are the targets for the EPI vaccines. In spite of the improvement in immunization coverage over the past many years, achieving this goal becomes difficult to the present time. Therefore quality assessment is important to determine whether the primary health care Service is provided according to the established norms. Although the immunization coverage has increased, the quality of the immunization programme is still questionable. Objective The main aim of this study was to assess the structural, process and outcome quality dimensions of Routine EPI program in terms of client satisfaction in under five children. Methodology This study was descriptive cross-sectional health facility based survey using quantitative method. Data collection for this evaluative research was conducted from March 10/2014-April 11/2014 at five public health facilities found in Debre Markos town. To determine the sample size; 95% confidence interval, 5% margin of error (E) and non-response rate equal to 5% has been used. Using the formula the total sample size calculated for the exit interview was 392 respondents. The study has been conducted on four health centers and one hospital of the town that deliver EPI service. The data collection has been carried out from March 10/2014-April 11/2014. Result In this study two health centers reported as there was no adequate BCG vaccine, almost all facilities reported as there was inadequate financial allocation and 60% of facilities reported as there was deficit in means of transportation and mean score for parents who were told about possible side effects and importance of immunization were (20.2%) and (44.39) respectively Positive findings obtained in this study were for the case of telling the appointment for the next visit (mean score 98%), availability of cold chain monitoring chart, monitoring temperature twice/day including weekend and maintaining normal storage temperature (100%), human power aspect 100% of the EPI coordinators of facilities had above one year working experience, mean score of clients who got all vaccines they were supposed to take that day was 95.5% and 100% availability of functional refrigerators. The mean scores of structure, process and clients' satisfaction (outcome) were found to be 81.98%, 81.26% and 93.42% respectively. Conclusion Overall, the quality of the service was found to be under category three of EVM parameter, but still there existed some areas which needed more attention, such as staffs' in-service training, transportation and financial allocation to run the service properly and addressing proper EPI education and counseling to mothers. The health workers and program coordinators failed to keep up their standards in these works. Positive findings obtained in this study were for the case of telling the appointment for the next visit (mean score 98%), availability of cold chain monitoring chart, monitoring temperature twice/day including weekend and maintaining normal storage temperature (100%), human power aspect 100% of the EPI coordinators of facilities had above one year working experience, mean score of clients who got all vaccines they were supposed to take that day was 95.5% and 100% availability of functional refrigerators. The mean scores of structure, process and clients' satisfaction (outcome) were found to be 81.98%, 81.26% and 93.42% respectively. Conclusion Overall, the quality of the service was found to be under category three of EVM parameter, but still there existed some areas which needed more attention, such as staffs' in-service training, transportation and financial allocation to run the service properly and addressing proper EPI education and counseling to mothers. The health workers and program coordinators failed to keep up their standards in these works.