From 1-9 October 2012, the Dominican Republic implemented a study, with support from the Pan American Health Organization (PAHO), to assess missed vaccination opportunities in hospitals and health centres across the country in order to identify fac-tors contributing to low coverage levels in high-risk municipali-ties (DPT3 coverage < 85%). The results of the study will help develop and implement interventions in the short and long-term.
The study included 38 municipalities in the country’s eight regions. Municipalities were selected based on the following crite-ria: poverty; average coverage level of pentavalent 3 for 2011 <85%; population size of children aged <1 year by municipality; proximity of municipality to the Haitian border and tourist areas; and fulfillment of measles and rubella surveillance indicators. To ensure a representative sample, surveys were conducted at hospitals and primary health care units in both urban and rural areas (n=75).
Interviewers administered a questionnaire to parents/guardians of children aged <5 years and women of childbear-ing age at the exit of healthcare facilities. Additionally, an anonymous questionnaire was administered to healthcare workers, with an emphasis on workers in vaccination posts, primary health care physicians, paediatricians, and gy-naecologists. The latter survey served to identify knowledge gaps, incorrect vaccination practices, and the partici-pant’s level of motivation toward vaccination services.
The study found missed opportunities for vaccination due to: 1) health care personnel beliefs; 2) parent or guardian issues; and 3) the quality and organization of the immunization programme. The preliminary results will be present-ed to the national authorities at the end of November 2012.
The Dominican Republic is the first country in the Region to use PAHO’s new standardized protocol and surveying tools for assessing missed vaccination opportunities. PAHO developed these tools and tested them in Mexico and in a pilot project in the Dominican Republic prior to the study. The results of this study will allow countries to imple-ment effective and timely corrective measures at the local level and address the persistent challenge of reaching under-immunized children.
The protocol and surveying tools in both English and Spanish will be available by the end of December 2012.
Published in Global Immunization Newsletter, October 2012.