Public attitude towards acceptability, availability and accessibility of immunization services in Riyadh

A study of accessibility, availability, and acceptability of immunization was carried out by interviewing 1422 parents selected randomly from the catchment areas of 15 health care centers in Riyadh. The parents were included if they had children who were under two years or who had not completed the essential immunizations necessary for issuing birth certificates. The demographic data of parents and children were also obtained. The majority, 1270 [89.3%] parents said they would immunize their children to protect them against diseases while only 25 [1.8%] of the parents said they immunized their children to obtain the birth certificate. Of all parents, 87.3% strictly followed the immunization schedule. Mothers in the younger age group, with higher education and whose husbands are in the higher occupational category had higher compliance rates than others. Various reasons were given for this failure. Parents [21.4%] attributed failure to attend the scheduled immunizations to inaccessibility to the service, for example the distance which needed transport, or non-availability of father to accompany the family to the health center. Other reasons for failure were due to false perception of the necessity, the indications and the contraindications of immunization. It was found that parents who failed to comply with the immunization schedule were more likely to have more than the average number of children

quality of referral letters in two health centers in Riyadh

A review of 100 referral letters and reports randomly selected from two health centers in Riyadh identified that the main reason for referral was general therapeutic advice [43.2%], general diagnostic evaluation [24.8%], and routine specialist examination [11.7%]. Of the total referrals 82. 1% were seen within a week in the specialist clinic. Important clinical information was lacking from both referral letters and feedback reports. For instance, past medical history, current therapy, final diagnosis, and decision on future care were omitted in 75%, 86%, 24.2%, and 56% of the letters and reports, respectively. Moreover, consultants' recommendations were specific and clear in only 56.9%. A quantitative evaluation of the quality of letters revealed that 26% of the referral letters and 47% of the feedback reports were poor. The referral process needs tremendous improvement if the quality of patient care is to be guaranteed