Geographic location of health facility and immunization program performance in Hoima district, western Uganda: a health facility level assessment

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Publicado en:BMC Public Health vol. 20 (2020), p. 1
Autor Principal: Magambo, Nicholas Kwikiriza
Outros autores: Bajunirwe, Francis, Bagenda, Fred
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Springer Nature B.V.
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Acceso en liña:Citation/Abstract
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024 7 |a 10.1186/s12889-020-09859-z  |2 doi 
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100 1 |a Magambo, Nicholas Kwikiriza 
245 1 |a Geographic location of health facility and immunization program performance in Hoima district, western Uganda: a health facility level assessment 
260 |b Springer Nature B.V.  |c 2020 
513 |a Journal Article 
520 3 |a Background Globally, immunization coverage for childhood vaccines is below the immunization target of achieving at least 90% coverage with the pentavalent vaccine. In Uganda, a recent survey shows 80% of districts had poor immunization program performance. However, there is significant variation in performance within and between districts. We hypothesized that geographic location of a health facility may influence performance of its immunization programs. Therefore, the purpose of this study was to examine whether geographical location of a health facility within a district is associated with performance of the immunization program in Hoima district, western Uganda. Methods We conducted a cross sectional study using a mixed methods approach. The main study unit was a health center and we also interviewed health workers in-charge of the facilities and reviewed their health facility records. We reviewed the Uganda Health Management Information System (HMIS) 105 reports of six months to obtain data on immunization program performance. Performance was categorized using World Health Organization’s Reach Every District (RED) criteria and classified as poor if a facility fell in category 3 or 4 and good if 1 or 2. We also conducted key informant interviews with immunization focal persons in the district. We examined the association between dependent and independent variables using Fisher’s exact test. Results We collected data at 49 health facilities. Most of these facilities (55.1%) had poor immunization program performance. Proximal location to the central district headquarters was significantly associated with poor immunization program performance (p < 0.05). Attitudes of health workers in the more urban areas, differences in strategies for outreach site selection and community mobilization in the rural and urban areas were suggested as possible explanations. Conclusions Proximal location to the urban setting near district headquarters was strongly associated with poor immunization program performance. To be able to reach larger numbers of children for vaccination, interventions to improve performance should target health facilities in urban settings. 
651 4 |a Africa 
651 4 |a Uganda 
653 |a Childrens health 
653 |a Geographical distribution 
653 |a Vaccines 
653 |a Urban environments 
653 |a Site selection 
653 |a Questionnaires 
653 |a Rural areas 
653 |a Health facilities 
653 |a Independent variables 
653 |a Immunization 
653 |a Urban areas 
653 |a Influence 
653 |a Data collection 
653 |a Dependent variables 
653 |a Drug dosages 
653 |a Health care facilities 
653 |a Performance enhancement 
653 |a Maternal & child health 
653 |a Children 
653 |a Supervision 
653 |a Information systems 
653 |a Access to information 
653 |a Information management 
653 |a Geographical locations 
653 |a Management information systems 
653 |a Medical personnel 
653 |a Public health 
653 |a Social 
700 1 |a Bajunirwe, Francis 
700 1 |a Bagenda, Fred 
773 0 |t BMC Public Health  |g vol. 20 (2020), p. 1 
786 0 |d ProQuest  |t Health & Medical Collection 
856 4 1 |3 Citation/Abstract  |u https://www.proquest.com/docview/2471213480/abstract/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text  |u https://www.proquest.com/docview/2471213480/fulltext/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch 
856 4 0 |3 Full Text - PDF  |u https://www.proquest.com/docview/2471213480/fulltextPDF/embedded/7BTGNMKEMPT1V9Z2?source=fedsrch