1 / 20

A Job Half Done: missed childhood vaccination opportunities in MSF health structures

A Job Half Done: missed childhood vaccination opportunities in MSF health structures. OCB OR day Brussels, 13 th June 2014 Catherine Bachy. Background. 1983 : Vaccinate at every opportunity (WHO) MSF keeps focus on reactive mass campaigns 2008 : Vaccination becomes a priority for MSF

joie
Download Presentation

A Job Half Done: missed childhood vaccination opportunities in MSF health structures

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. A Job Half Done: missed childhood vaccination opportunities in MSF health structures OCB OR day Brussels, 13th June 2014 Catherine Bachy

  2. Background • 1983: Vaccinate at every opportunity (WHO) • MSF keeps focus on reactive mass campaigns • 2008: Vaccination becomes a priority for MSF • 2010: EPI is integrated in some OCB projects

  3. Rationale • Vaccination monitoring fragmented • Blind on what we DON’T do… 2011-2013 Missed vaccination opportunities surveys in projects with routine vaccination

  4. Objectives • Measure the magnitude of missed opportunities • Describe misses by age group and by vaccine • Understand the reasons for missed opportunities  Is improvement needed? • Can we do something about it?

  5. Methods • Authorization by authorities • Standardized questionnaire • Exit interview of ALL children after consent • Vaccination cards or recall • Expanded age-group EPI calendar as reference

  6. Received all vaccines for which eligible Without contraindication Eligible for at least one vaccine Did not receive all vaccines for which eligible Study population With contraindication Vaccination up-to-date

  7. Missed vaccination opportunities Received all vaccines for which eligible Without contraindication Eligible for at least one vaccine Did not receive all vaccines for which eligible Study population With contraindication Vaccination up-to-date = Prevalence of missed vaccination opportunities

  8. Missed vaccination in eligible Received all vaccines for which eligible Without contraindication Eligible for at least one vaccine Did not receive all vaccines for which eligible Study population With contraindication Vaccination up-to-date = Inefficiency of the system

  9. Example Received all vaccines for which eligible = 2 Without contraindication = 4 Eligible = 4 Did not receive all vaccines for which eligible = 2 n = 100 With contraindication Vaccination up-to-date = 96 Missed vaccination opportunities = 2/100 = 2% Missed vaccination in eligible = 2/4 = 50%

  10. Description of baseline surveys • 14 baseline surveys • 4 sub-Saharan countries • MSF-supported health structures • Duration: 6 days [1-15] • Children:

  11. Main results: median [range] Vaccination card: 70% [20-100%] 100% [69-100%] Received all vaccines for which eligible 72% [51-95%] Without contraindication 147 [41-242] Eligible for at least one vaccine Did not receive all vaccines for which eligible With contraindication Study population Vaccination up-to-date

  12. Main results: median [range] Received all vaccines for which eligible Without contraindication Did not receive all vaccines for which eligible Did not receive all vaccines for which eligible Eligible for at least one vaccine Eligible for at least one vaccine With contraindication Study population Vaccination up-to-date Prevalence of missed opportunities: 48% [18-73%] Missed opportunities in eligible: 77% [20-100%]

  13. Reasons for visit of misses (n=14) • Curative consultation: 48% [27-99%] • Ambulatory feeding centre: 18% [0-49%] • Vaccination: 9% [0-43%] • Accompanying a patient: 5% [0-23%] • MCH consultation: 2% [0-36%]

  14. Reasons for missed opportunities (n=14) • Lack of information: 38% [10-79%] • Lack of vaccines: 31% [0-60%] • Unknown: 13% [0-44%] • Other: 11% [3-50%] • Long waiting time: 2% [0-6%] • Vaccinator absent: <1% [0-38%]

  15. Missed opportunities by age group

  16. Missed opportunities by vaccine

  17. Follow-up surveys: Did it change? • PHCC Sae Saboa and Guidam Roumdji, Niger • November 2011 & January 2013 • Missed vaccination opportunities in 0-11 months

  18. Conclusions • Performance needs to be improved • Reasons are easy to address • It can be done  Where is the real missed opportunity in MSF?

  19. Recommendations •  Simplified tools available • Baseline study in EVERY project • Follow-up studies • … In the meantime: check and vaccinate!

  20. Acknowledgements The national and international staff of all projects involved; Marie-Eve Burny & Isabella Panunzi: Vaccination Referents; Ilaria Porta & Ibrahim Barrie: MIO Vaccination; Michel Van Herp: Head of the Disease Control Unit The Operational Research Unit

More Related