Immunisation safety surveillance in Asosa Zone, Ethiopia

Abstract

Background

Surveillance for immunisation safety is a scheme for guaranteeing immunisation safety through identifying, reporting, investigating and countering to adverse events following immunisations (AEFIs). Most of the AEFI surveillance reports are delivered through health care providers, it is imperative to be clear not only about the factors such as awareness and incidence of reporting, rather the health care providers’ knowledge, perceptions and practice regarding AEFIs.

Purpose of the study

The purpose of this research was to assess immunisation safety surveillance in Asosa zone, Ethiopia, detect barriers in the health care providers’ existing guidelines, and develop an immunisation safety surveillance pocket manual for health care providers.

Methods

A convergent parallel mixed research method was used. Three hundred respondents participated for the quantitative design and nine participants were included for the qualitative design. Data were analysed through the Statistical Package for Social Sciences (SPSS) 25.0 version and Atlas ti 8 for quantitative and qualitative approaches, respectively. Results

Of the total sample, (94.7%) had heard about AEFI, but only (22.3%) were able to define AEFI as per WHO standard definition. Some (45.7%) of the respondents were not informed that AEFI surveillance had to be practised in each health facility. Most respondents, (90.7%) were not trained in immunisation safety surveillance. Nearly, (42%) of the respondents had below the average value and (56%) had more than mean value of knowledge indicators. Respondents, (56%) agreed and (32.7%) strongly agreed that detecting, reporting and investigating AEFI is not within their job description. The respondents overall mean value for all the perception indicators of immunisation safety surveillance were, (44.7%), (41.3%) which was below mean value and above the mean value respectively. Only 5.7% respondents had ever reported to higher level and (23%) had treated an AEFI case. The mean values of all the practice indicators of immunisation safety surveillance scored by respondents were (46.7%) below mean and (31.3%) above the mean. Challenges impacting on effective immunisation safety surveillance were outlined. The findings from the qualitative design, confirmed the quantitative results on knowledge, perceptions including challenges of health care providers regarding immunisation safety surveillance. These results were merged to provide a concrete analysis of the research problem. Gaps were identified from the national guidelines for AEFI and recommendations proposed. The investigator developed immunisation safety surveillance pocket manual for health care providers.

Conclusion

The overall detecting and reporting rate of AEFI cases was very low, implying that a concerted effort of health care providers and stakeholders’ partnership is important to enhance immunisation safety surveillance.