Factors influencing coverage of the expended program of immunization in Inga district, Eastern Uganda

Abstract

Background: The EPI coverage in Iganga district was 79.3% in the year 2017/2018. This was below the 95% MOH target coverage for control of immunizable diseases. The under coverage by 15.7% in Iganga prompted the researcher to carry out a study to understand factors that were responsible for such performance. It’s in light of this that the researcher focused on assessing the factors influencing the coverage performance of the EPI in the district. The study objectives were; to describe the coverage performance trend of EPI in Iganga district over five-year period from 2018/17-2014/13; to identify workforce related factors influencing coverage of the EPI performance in Iganga district; to establish health facility related factors influencing coverage performance of EPI in Iganga district and to ascertain health data management factors influencing coverage of the EPI performance in Iganga district. Methodology: A descriptive cross-sectional study with a design involving both quantitative and qualitative approaches were undertaken. The study was conducted in Iganga district in DHOs office, one hospital, 4 HCIV/HSDs and 10 HCIIIs of Eastern Uganda. Data was collected from a sample size of 53 respondents using self-administered questionnaires and through KII interviews. Data was collected, edited analyzed and presented to SPSS Version 20 and using descriptive analysis for quantitative while qualitative was analyzed through organized themes and reported as verbatim. Findings: Immunization coverage measured by the 3rd dose of DPT3 Hep3 Hib3 and measles was persistently below 80% for the past 5-review period, 2013/14-2017/18 compared to the national target of 95% (Figure 2). The major factors that influenced the coverage of the EPI performance were attributed to staffing levels, motivation, transport and distribution of vaccines. Others were data quality and availability, skills development, inadequate supervision and monitoring. Also, the EPI program was affected by inadequate funding, cold chain equipment functionality, and the lack of real time data documentation and reporting as well as waste management. Recommendations: Increasing funds allocation to EPI activities like out reaches, continuous community sensitization, capacity building for health workers, incentives to village health teams during immunization activities. Others are procurement of solar refrigerators, investment in Management Information Systems for quality data and provision of adequate disposal and waste management equipment.