JMIR Publications

ABSTRACT

Background:

Immunization averts >2.5 million child deaths annually. WHO and UNICEF estimates of immunization coverage in Iraq in 2015 revealed 58% for DTP3 and 57% for measles. High-quality immunization session practices (ISPs) can ensure safer, more effective vaccination and higher coverage rates.

Objective:

To assess the impact of training of primary healthcare centers’ (PHCs) vaccinators on the quality of immunization session practices (ISPs).

Methods:

This was an interventional study conducted on ten (18%) PHCs in Wasit Governorate. Two PHCs were randomly selected from each health district. ISPs were first assessed by direct on-job observation, using modified WHO immunization session checklists. Findings were grouped into seven domains: vaccine and diluent management, cold chain management, session's equipment, registration, communication, vaccine preparation and administration and waste management. The vaccinators were enrolled in a one-day training session using WHO module “Managing an Immunization Session”. One month later, a second assessment conducted using the same tool and technique. We calculated the median differences in the domains' scores.

Results:

Forty-two vaccinators were trained, more than half of them (59.5%) were graduated from technical health institutes but only one-third (35.7%) had previous training on standard ISPs. Following training, a significant improvement was noticed in three domains: vaccines and diluents management (P= .008), cold chain management (P= .012) and vaccine preparation and administration (P= .021).

Conclusions:

Training of PHCs' vaccinators, for a single day, was effective in improving some ISPs. We recommend using this training module, or a more in-depth one, for other PHCs to improve utilization Immunization of immunization services.