Background

Despite the remarkable achievements of the Expanded Programme on Immunization (EPI) in Burkina Faso, numerous challenges remain, including missed opportunities for vaccination (MOV) which occur when people visit a health facility with at least one vaccine due according to the national immunization schedule, are free of contraindications, and leave without receiving all due vaccine doses. In 2016, we used the revised World Health Organization’s (WHO) MOV strategy to assess the extent of and reasons for MOV in Burkina Faso.

Methods

We purposively selected 27 primary health facilities (PHFs) from the eight health districts with the highest absolute numbers of children who missed the first dose of measles-rubella (MR1) in 2015. We conducted exit interviews with caregivers of children aged 0–23 months, and requested health workers to complete a self-administered knowledge, attitudes and practices (KAP) questionnaire.

Results

A total of 489 caregivers were interviewed, of which 411 were eligible for inclusion in our analysis. Medical consultation (35%) and vaccination (24.5%) were the most frequent reasons for visiting PHFs. Among the 73% of children eligible for vaccination, 76% of vaccination opportunities were missed. Among eligible children, the percentage with MOV was significantly higher in those aged ≥12 months and also in those attending for a reason other than vaccination. A total of 248 health workers completed the KAP questionnaire. Of these, 70% (n = 168/239) considered their knowledge on immunization to be insufficient or outdated; 83% failed to correctly identify valid contraindications to vaccination.

Conclusion

Addressing MOV offers the potential for substantial increases in vaccine coverage and equity, and ultimately reducing the burden of vaccine-preventable diseases (VPDs). This will require the implementation of a series of interventions aimed at improving community knowledge and practices, raising health workers’ awareness, and fostering the integration of immunization with other health services.

中文翻译：

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使用世界卫生组织修订的MOV战略评估布基纳法索错过的疫苗接种机会（MOV）：改善常规儿童免疫接种覆盖面的发现和战略考虑

背景

尽管布基纳法索的扩大免疫计划（EPI）取得了令人瞩目的成就，但仍然存在许多挑战，包括错过疫苗的机会（MOV），这是由于人们根据国家免疫时间表前往具有至少一种疫苗的医疗机构时发生的，没有禁忌症，离开时不接受所有适当的疫苗剂量。2016年，我们使用经修订的世界卫生组织（WHO）MOV策略来评估布基纳法索的MOV范围和原因。

方法

我们有针对性地选择了八个卫生区中的27个初级卫生机构（PHF），这些地区在2015年绝对漏诊了第一剂麻疹-风疹（MR1）的儿童绝对数量最高。 ，并要求卫生工作者填写一份自我管理的知识，态度和做法（KAP）问卷。

结果

总共采访了489名护理人员，其中411名符合纳入我们分析的条件。前往PHF的最常见原因是进行医疗咨询（35％）和接种疫苗（24.5％）。在有资格接种疫苗的73％的儿童中，错过了76％的接种机会。在符合条件的儿童中，≥12个月的儿童以及因接种疫苗以外的原因参加MOV的儿童的比例明显更高。共有248名卫生工作者完成了KAP问卷。其中，有70％（n = 168/239）认为他们对免疫的知识不足或过时；83％的人未能正确识别出有效的疫苗禁忌症。

结论

解决MOV可能会大大提高疫苗覆盖率和公平性，并最终减轻疫苗可预防疾病（VPD）的负担。这将需要实施一系列旨在改善社区知识和做法，提高卫生工作者的意识以及促进免疫与其他卫生服务结合的干预措施。