Planning and Programing as a Factor Affecting Expanded Programme on Immunization (EPI) Vaccination in Uasin Gishu County, Kenya

Abstract

EPI vaccination was introduced by the world health organization (WHO) with an objective to vaccinate children throughout the world. EPI vaccination has completely eradicated disease such as polio in the world. In Kenya Kenya's immunization coverage for DTP3 has averaged between 73% and 88%.  The dropout rate was reported at 7% in 2009. In Uasin Gishu County immunization coverage Bacillus Calmette-Guérin (BCG), diphtheria-tetanus-pertussis (DTP), polio, measles, Hepatitis B (HepB)  and  yellow fever  at 12 months of age  declined from 91%  to 88%, in 2016.The study will be on planning and programing as a factor affecting expanded programme on immunization (epi) vaccination in Gasin Gishu County. The study was guided by the following objectives; to find out the influence of planning and management on EPI vaccination in Uasin Gishu County, to examine the influence of organization and coordination on EPI vaccination in Uasin Gishu County, to determine the influence of training on EPI vaccination in Uasin Gishu County and to determine the influence of communication and social mobilization on EPI vaccination in Uasin Gishu County.  Cross- sectional research design was used in the study. A target population of 35 health facilities in Uasin Gishu County were targeted.  A sample size of 35 health officials who are responsible for vaccination were selected to participate in the study. A census survey was carried out where one health worker in all the health centres in Uasin Gishu County was selected to participate in the study. Snowball was used to identify health workers responsible for immunization. Questionnaire with both open ended and closed ended questions was used in the study.  Qualitative and quantitative data analysis was used.  Quantitative analysis was used where both descriptive and inferential data analysis will be employed. In descriptive analysis mean, frequency and percentages were used. While in inferential statistics, correlation and ANOVA was used to test the relationship between variables. The study findings indicated that there was no significant relationship (P>0.05) between planning and planning outcomes. Correlational results indicated that in terms of organization and coordination the vaccination was fairly well organized and coordinated (p<0.05) as opposed to epidemiological surveillance, training and communication and social mobilization. The study findings also indicated that there was a significant variation between the T-test score of 80% and the outcomes of the training evaluation.  The training evaluation outcomes had a positive mean difference to indicate that the variation to implied that health workers were well trained (P<0.05) while the findings indicate that 27 (77.14%) respondents said that education talks were conducted for community and social mobilization. The study concluded that planning done is not effective to enhance planning outcomes in preventing and promoting EPI vaccination at the county, organization and coordination, health facilities have not collaborated with enough stakeholders to assist them provide EPI services, that training conducted on health workers mandated to carry out EPI vaccination has been very effective and that there was non-extensive utilization of the various means of communication in to reaching people. The study recommended that; the county health department should ensure that the planning process is desirable in that, it is participatory, realistic, and flexible, so that the plan is a practical document. It also recommended that there was also need to bring on board key sectors such as community organizations and leaders, education sector, administration, private sector, church and security sectors to enhance EPI vaccination effectiveness and that county department should ensure that health facilities prioritize the use of channels that reach the largest group of people like mass media.