Evaluation of Child Immunization Service Quality at Governmental Health Centers in Gondar Town, Amhara Region, North West Ethiopia

Abstract

Background: In Ethiopian, the immunization program was launched in 1980 with the objective of achieving 100% immunization coverage of all children under two years old by 1990. The available information on quality of immunization Program in Gondar town was insufficient. This evaluation tried to fill the identified gap and to help identify the strength and weakness. Evaluation Objective: To evaluate child immunization service quality at governmental health centers in Gondar town. Methods and materials: Case study design and both quantitative and qualitative data collection methods were employed from March 1 to 30, 2017 at six governmental health centers of Gondar town. This evaluation was focused on process component of the program based on Donabedian structure-process–outcome model of health care quality with formative evaluation approach. A sample of 422 care givers were interviewed using structured and interviewer administered questionnaire. Moreover, twelve health workers providing vaccination services and Program focal persons were interviewed using semi-structured questionnaire. A sample of 36 direct observations of service provision processes were carried out. Registration books, immunization charts and immunization units were reviewed. Quantitative data was checked, coded and entered into EPI data version 3.1 and exported to SPSS window version 21 for Logistic regression analysis was used. Qualitative data was used and analyzed under each thematized area. Result: Lack of in service trained providers due to high attrition and constantly turned over of trained providers. Satisfaction was positively affected by convenience working hours and service received based on previous appointment. The dimension of availability of resources, compliance with Guidelines and satisfaction of immunization program was 73%, 67.6% and 74% respectively based on Pre-set criteria. Conclusion: The overall quality of child immunization program based on the stakeholder’s three dimensions of pre-set criteria parameter value was 71.5% which had good achievement level. But facilitate in-service training for providers and undertake integrative supportive supervision and provide job aid materials for the professionals. Finally, Good to conduct community based study.