Immunisation coverage of the Western Cape Province : household survey 2005

Abstract

Includes bibliographical references.[Objective] To determine the routine immunisation coverage rates in children aged 12-23 months in the Western Cape and factors affecting immunisation coverage. [Design] Cross-sectional Household Survey using an adaptation of the '30x7' cluster survey technique (multi-stage sampling). [Setting] Households across the Western Cape. [Subjects] 3705 caregivers of children aged 12-23 months who had been living in the Western Cape for at least 6 months. [Outcome Measures] Vaccination Status (1=fully vaccinated, 0=partially vaccinated) as recorded on a Road to Health card or given by history. Factors affecting caregivers' vaccination behaviour established from a questionnaire. [Results] The immunisation coverage was 76.8% for vaccines due by 9 months and 53.2% for vaccines due by 18 months. The reasons given for not being imunised were clinic-related factors (47%), lack of information (27%), lack of information (27%), caregiver being unable to attend the clinic (23%) and lack of motivation (14%). Of clinic factors cited, the two commonest factors were missed opportunities (34%) and being told by clinic staff to come back another time (20%). Factors enhancing coverage included possession of a Road-to-Health card, caregiver knowledge about vaccines and perceived attitude of clinic staff. Certain racial inequities in coverage were also apparent, particularly in the Boland-Overberg Region. [Conclusion] While the coverage indicated that a lot of good work has been done, the coverage was insufficient to prevent outbreaks of measles and other common childhood conditions including polio. The coverage was too low to consider not running periodic mass campaigns for measles and polio. The reasons given by caregivers for their children not being immunized and factors associated with increased coverage are valuable pointers as to where interventions should be focused