Quality of immunization services in primary health Care facilities of Wolaita zone, South Ethiopia

Abstract

Background: Increasing the quality of immunization services is one of the strategies to reach at objective of EPI in Ethiopia. Infant and childhood mortality in Ethiopia are still among the highest in the world. Each year more than one-third of a million children die from infectious disease where the prevention and control measures are available. Objective: Objective of this study was to assess the quality of EPI service in primary health care facilities. Methods: The study used facility based cross sectional study design. Both quantitative and qualitative data was collected by using different data collection methods. Source population: mothers who utilize EPI service in the selected health facilities and total primary health care facilities of Wolaita zone. Result: Majority of health facilities found to have adequate supplies and equipments but difference was seen between health centers and health posts. About one third of health posts lack refrigerators. One third (33.3%) of the observed health centers were found with temperature in the fridge below or above recommended range. All health centers used AD syringes for injection but only 3 of 36 (8.34%) observed procedures were sterile. Three hundred forty nine (86.2%) the responded mothers were satisfied by EPI service and technical competence of the provider, consultation, confidentiality, waiting time, explanation about immunization and waiting area structure of EPI service were found to be important predictors of client satisfaction. Two hundred forty eight (61.2%) of clients were knowledgeable about immunization. Conclusion: Majority of health facilities rated as adequate in terms of equipment and supply necessary for EPI services. But majority of health posts lack refrigerators. Below or above normal temperature in the fridge and inappropriate arrangement of vaccines in the fridge were found to be the key constraints concerning vaccine handling and cold chain management. Factors related with service provider were found to be important determinants of client satisfaction. Although it has been argued that clients do not know what the technically acceptable level of care is, it is agreed that dissatisfaction is an indication that services delivered are lacking in some aspects of provider related factors.