Onta S R, Sabroe S, Hansen E H
Institute of Medicine, Tribhuvan University, Kathmandu, Nepal.
Health Policy Plan. 1998 Jun;13(2):131-9. doi: 10.1093/heapol/13.2.131.
Reported high immunization coverage achieved in Nepal over the last ten years is expected to reduce child mortality in the country. The present study, carried out in hill district in mid-west Nepal, aimed to assess the quality of immunization data in Nepal. The number of children who received different vaccines during one year was obtained from three sources: 1) the Immunization REgister of three Primary Health Care Service Outlets (PHCSOs) where each immunized child is recorded; 2) monthly PHC Reports, which are based on the Immunization Register; 3) monthly DHO Reports, which are based on the above PHC Reports (the DHO reports are the source of official statistics). The number of children in the PHC Reports was higher than the number in the Immunization REgisters for all vaccines. The number of immunizations in the DHO Reports was higher than the number in the PHC Reports for BCG, DPT, and measles; the number was lower for poliomyelitis. The overall number of immunizations was higher in the DHO Reports than in the Immunization Registers, by 31% for BCG, 44% for DPT, 155% for polio, and 71% for measles. We conclude that the official report overestimates the immunization coverage in the district. The immunization programme, therefore, might not result in the expected reduction of morbidity and mortality despite the investment in the programme and reported high coverage.
据报道，尼泊尔在过去十年中实现了较高的免疫接种覆盖率，预计这将降低该国的儿童死亡率。本研究在尼泊尔中西部的山区进行，旨在评估尼泊尔免疫接种数据的质量。一年内接受不同疫苗接种的儿童数量来自三个来源：1）三个初级卫生保健服务点（PHCSO）的免疫接种登记册，每个接种疫苗的儿童都有记录；2）每月的初级卫生保健报告，该报告基于免疫接种登记册；3）每月的地区卫生办公室（DHO）报告，该报告基于上述初级卫生保健报告（DHO报告是官方统计数据的来源）。对于所有疫苗，初级卫生保健报告中的儿童数量均高于免疫接种登记册中的数量。在DHO报告中，卡介苗、白百破疫苗和麻疹疫苗的接种数量高于初级卫生保健报告中的数量；脊髓灰质炎疫苗的接种数量则较低。DHO报告中的总体接种数量高于免疫接种登记册中的数量，卡介苗高出31%，白百破疫苗高出44%，脊髓灰质炎疫苗高出155%，麻疹疫苗高出71%。我们得出结论，官方报告高估了该地区的免疫接种覆盖率。因此，尽管在该计划上投入了资金且报告的覆盖率较高，但免疫接种计划可能无法带来预期的发病率和死亡率下降。
