Immunization service providers' knowledge, attitude and practice in primary health care units in pastoral and semi-pastoral areas of Ethiopia: CORE Group Polio Project

ABSTRACT

Background: Adequate knowledge is key for immunization service provision and related practices, such as providing the right vaccine at the right time, keeping vaccines potent, and to prevent vaccine failures. This study was conducted to assess the knowledge, attitude and practices of immunization service providers in primary health care units in pastoral and semi-pastoral areas of Ethiopia. Methods:A facility-based cross-sectional study was conducted of 1,280 health workers drawn from health centers (233) and health posts(632)in five regions of Ethiopia Somali, Gambella, Benishangul-Gumuz, Oromiya and SNNPR. Data were collected using a self-administered questionnaire prepared in English and translated into three local languages, and analyzed using STATA version 13.0. Descriptive statistics and binary logistic regression analysis were carried out to determine the magnitude of, and identify associated factors for,knowledge, attitude and practice.A p-value of less than 0.05 was used to declare statistical significance. Results: Of all health center respondents,389 (61.3%) had a good knowledge of the vaccination schedule; 403 (63.5%) had poor practices relating to vaccine placement in refrigerators;and 321(54%) had poor attitudes in relation to vaccines and vaccination. With respect to the vaccination schedule, midwives and Health officers/Medical Doctors were 0.28(95% CI0.08-0.95) times less knowledgeable than nurses; and health workers with more than five years'work experience were 2.78 (95% CI 1.54-5.01) times more knowledgeable than health workers who had three years'work experience.Conclusions and recommendations: In this study, gaps were observed in health service providers' knowledge, attitudes and practices in relation to immunization. Support to address these gaps ­through training, supervision, monitoring and other mechanisms should focus on HEWs whose education is less than or equal to grade 12 at health post level, and on midwives and Health Officers (HOs)/MDs at the health center level. Similarly, attention should be given to enhance the vaccine and vaccination knowledge of semi-pastoral health facility service providers. The government, immunization working partners and other responsible bodies should give attention and take corrective measuresto use maximum vaccine preventive potency