Routine Immunization Service Delivery Through the Basic Package of Health Services Program in Afghanistan: Gaps, Challenges, and Opportunities. (30th June 2017)

• Record Type: Journal Article
• Authors: Mbaeyi, Chukwuma; Kamawal, Noor Shah; Porter, Kimberly A.; Azizi, Adam Khan; Sadaat, Iftekhar; Hadler, Stephen; Ehrhardt, Derek
• Is Part Of: Journal of infectious diseases. Volume 216(2017)Supplement 1
• Page Start: S273
• Page End: S279
• Publication Date: 2017-06-30
• Subjects: Routine Immunization -- BPHS -- Afghanistan -- Survey -- Health Service Delivery -- Polio Eradication.; Communicable diseases -- Periodicals; Diseases -- Causes and theories of causation -- Periodicals; Medicine -- Periodicals; Communicable Diseases -- Periodicals; Electronic journals; 616.9
• DOI: 10.1093/infdis/jiw549
• Languages: English
• ISSNs: 0022-1899

Abstract

Abstract: Background: The Basic Package of Health Services (BPHS) program has increased access to immunization services for children living in rural Afghanistan. However, multiple surveys have indicated persistent immunization coverage gaps. Hence, to identify gaps in implementation, an assessment of the BPHS program was undertaken, with specific focus on the routine immunization (RI) component. Methods: A cross-sectional survey was conducted in 2014 on a representative sample drawn from a sampling frame of 1858 BPHS health facilities. Basic descriptive analysis was performed, capturing general characteristics of survey respondents and assessing specific RI components, and χ 2 tests were used to evaluate possible differences in service delivery by type of health facility. Results: Of 447 survey respondents, 27% were health subcenters (HSCs), 30% were basic health centers, 32% were comprehensive health centers, and 12% were district hospitals. Eighty-seven percent of all respondents offered RI services, though only 61% of HSCs did so. Compared with other facility types, HSCs were less likely to have adequate stock of vaccines, essential cold-chain equipment, or proper documentation of vaccination activities. Conclusions: There is an urgent need to address manpower and infrastructural deficits in RI service delivery through the BPHS program, especially at the HSC level.