Health systems support factors' influence on uptake of immunization services in Kajiado North sub-County.
Toweett, John Kipngetich
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Access to health care services is described as the ability by patients to reach and demand health services based on individual needs. Immunization is one of the most effective, safest and efficient public health interventions as it is estimated to save at least 3 million lives from vaccine preventable diseases. Many cultural, religious, or social factors may impede the demand for health care. This study focused on the service delivery pillar. The overall objective was to determine the health system support factors and their influence on access of immunization services in Kajiado North Sub-County. Specific objectives were a) to determine the socio-cultural values that contribute to low access of immunization health services, b) to assess how the packaging of immunization services in the health facilities influence access and c) to establish the relationship between the health promotion activities. This was a cross-sectional study design with a sample size of 280 respondents who were mothers with children below 12 months. Nine health workers were purposively selected for a focused group discussion. Data was analyzed using of ms-Excel, SPSS version 20 and results presented in narratives, tabulations, and graphs. The results revealed that in 2012 and 2013 in Ngong hospital and Fatima health center had a drop in immunization coverage of 128 and 273 children respectively. In addition, the comparative analysis of Kajiado sub-counties on immunization coverage indicated that the sub-county antigen specific coverage reduced as follows: BCG dropped by 4% to 61%, OPV increased by 5% to 75% and measles increased by 3% to 77%. The mean age of respondents was 26.7 years and analysis indicated that level of education negatively influenced immunization access. The distance between households and health facilities ranged from a hundred meters to 20Kms. Approximately 48(17.1%), of mothers visit facilities which are outside the 5 kilometer distance advocated by Kenya health policy. 120(42.8%) suggested that there is need for health promotion activities in the community. The correlation of visits to awareness indicated a p-value of 0.209. 233 (83%) agreed that immunization program is well explained to them when they visit health facilities. The correlation of health education with awareness indicated a p-value of 0.406. The modes of communication clearly portrays that 183(65.4%) of mothers got the information about immunization through continuous health education that is routinely offered in health facilities, whereas 39 (13.9%) mothers got the information through community health promotion. The study recommends a) form outreach teams to trace defaulters of immunization schedules, b) sub-county health office to frequently conduct community health promotion in the villages to discourage cultural believes which contribute to low access to immunization services, and c) package simplified information about the benefits of immunization services shared in health education sessions and during community health promotion.