SAMJ: South African Medical Journal
On-line version ISSN 2078-5135
JACOB, N and COETZEE, D. Missed opportunities for immunisation in health facilities in Cape Town, South Africa. SAMJ, S. Afr. med. j. [online]. 2015, vol.105, n.11, pp. 917-921. ISSN 2078-5135. http://dx.doi.org/10.7196/SAMJ.2015.V105I11.10194.
BACKGROUND: Childhood immunisations are a cost-effective public health intervention for prevention of infectious diseases. Immunisation coverage is still suboptimal, however, which may result in disease outbreaks. Immunisation at every contact with a health facility is a strategy developed by the World Health Organization in order to improve immunisation coverage. OBJECTIVES: To estimate the prevalence of missed opportunities for immunisation at different levels of healthcare in the Western Cape Province, South Africa, and assess factors associated with missed opportunities. METHODS: The study included a health facility-based cross-sectional exit survey of caregivers with children up to 5 years of age, followed by a qualitative exploration of staff attitudes towards immunisation. RESULTS: The overall prevalence of missed opportunities for immunisation was 4.6%; 81.3% of caregivers brought Road-to-Health booklets (RTHBs) to consultations; and 56.0% of health workers asked to see the RTHBs during consultations. Children attending primary level facilities were significantly more likely to have their RTHBs requested than children attending a tertiary level facility. Lack of training and resources and heavy workloads were the main challenges reported at secondary/tertiary level facilities. CONCLUSION: Missed opportunities for immunisation at health facilities in Cape Town were low, probably reflecting good immunisation coverage among children accessing health facilities. Increased health worker support, particularly at secondary/tertiary levels of care, is needed to improve the use of RTHBs to provide immunisation.