Investigating underlying reasons for excess vaccination coverage in Phalombe district

Abstract

Introduction: Immunization helps to prevent diseases known as vaccine preventable diseases to children. However, this is more effective when the immunization coverage is high (Coverage of above 90 %). Phalombe district is one of the districts with high vaccination coverage. Most of the health facilities have been registering an excess coverage of above 100 % and the reasons were being investigated for such excess coverage. Objectives: The broad objective of the study was to investigate the underlying reasons for excess vaccination coverage in Phalombe district. Methods: The study was conducted in 8 health facilities which were selected randomly across the district. The sample size of 134 of which 125 were clients from health facilities with both excess and normal vaccination coverage, 8 Health Surveillance Assistants and 1 Expanded Program on Immunization coordinator. Data was collected using survey questionnaires and self-administered questionnaires. Discussions: There were disparities of data from the District and health facilities. The district reported higher coverage than health facilities. Most people (96.8 %) were able to access immunization services. However, there are more people accessing the services from outside Phalombe. Most of the clients recommended the way the health workers treat them during vaccination clinics. The good behaviour of the health workers contributed positively to the turn up of most of clients for vaccination services. Results: The reasons for excess vaccination coverage were due to poor management of vaccination data, use of small target population (denominator) because some clients (48 %) were from outside the district. This denominator did not capture clients from outside the district. The district had also been providing quality vaccination services to the clients and these services attracted more clients even from outside the district. Conclusions: The revision of district vaccination denominator (target population) and validation of district and health facilities vaccination data can address the problem of excess vaccination coverage in Phalombe. The coverage should be within acceptable margins of not more than 100%.