Medical equipment in government health facilities: Missed opportunities

Background Despite efforts to improve childhood immunization coverage in Nigeria, coverage has remained below the national acceptable level. In December 2019, we conducted an assessment of Missed Opportunities for Vaccination (MOV) in Ondo State, in Southwest Nigeria. The objectives were to determine the magnitude of, explore the reasons for, as well as possible solutions for reducing MOV in the State. Methods This was a cross-sectional study using a mixed-methods approach. We purposively selected 66 health facilities in three local government authorities, with a non-probabilistic sampling of caregivers of children 0–23 months for exit interviews, and health workers for knowledge, attitudes, and practices (KAP) surveys. Data collection was complemented with focus group discussions and in-depth interviews with caregivers and health workers. The proportion of MOV among children with documented vaccination histories were determined and thematic analysis of the qualitative data was carried out. Results 984 caregivers with children aged 0–23 months were interviewed, of which 869 were eligible for inclusion in our analysis. The prevalence of MOV was 32.8%. MOV occurred among 90.8% of children during non-vaccination visits, and 7.3% during vaccination visits. Vaccine doses recommended later in the immunization series were given in a less timely manner. Among 41.0% of health workers, they reported their vaccination knowledge was insufficient. Additionally, 57.5% were concerned about and feared adverse events following immunization. Caregivers were found to have a low awareness about vaccination, and issues related to the organization of the health system were found to contribute towards MOV. Conclusions One in three children experienced a MOV during a health service encounter. Potential interventions to reduce MOV include training of health workers about immunization policies and practices, improving caregivers’ engagement and screening of vaccination documentation by health workers during every health service encounter.

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The Influence of Maternal Age, Parity and Education on Infant Mortality in West Aceh Regency

J-Kesmas: Jurnal Fakultas Kesehatan Masyarakat (The Indonesian Journal of Public Health) ◽

10.35308/j-kesmas.v6i2.1188 ◽

2019 ◽

Vol 6 (2) ◽

pp. 80

Author(s):

Sukma Elida ◽

Siti Maisyaroh Fitri Siregar ◽

Arfah Husna ◽

Dian Fera ◽

Azwar Azwar

Keyword(s):

Infant Mortality ◽

Maternal Age ◽

Medical Equipment ◽

Maternal Education ◽

Conditional Logistic Regression ◽

Health Facilities ◽

Infant Mortality Rate ◽

Bivariate Analysis ◽

Control Group ◽

Case Group

One of the important index to reflect health status in a certain area is Infant Mortality Rate (IMR). IMR is also global soccioeconomic indicator in a population. Besides, The Statistical index indicates the quality of life, not only the quantity and number of death. It is the main health problem In Indonesia, There was 32 deaths per 1000 live births In Indonesia. The research was to analyze the influence of maternal age, parity, and education to infant mortality in West Aceh Regency. The research was quantitative with case control design, a case group was 45 mothers whose babies died when they were under one years old and a control group was 45 mothers whose babies were alive when they were under one year old. The maching was done on the babies based on their age and sex. The Data analyzed by using univariate and bivariate analysis with McNemar test, meanwhile, multivariate analysis with conditional logistic regression test at the significant level of 0.25. The Result of analysis in this research showed that maternal age and parity significanly influence of infant mortality. In the otherhand, maternal education did not significanly influence of infant mortality. The most significanly variable which influence of infant mortality was maternal age (OR=4.745). To Prevent Infant mortality from the variabel maternal age and parity, it is suggested for women to get merried at the age ≥20 years old, increases reproductive health education for female teenagers at schools and increases the conerage of using KONTAP (long term contracepcion) for women that have more than four children. It is also suggest to provide adequate medical equipment to support the childbirth and increase the access of health facilities by optimizing village polycliclic and It is also suggested to provide adequate medical equipment to support childbirth, increase the convenience of health facilities, and increase the access to health facilities by optimizing village polyclinics and midwives performance.

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