Soeung S C, Grundy B M J, Ly C K, Samnang C, Boreland M, Brooks A, Maynard J, Biggs B A
National Immunisation Program, Ministry of Health, Phnom Penh, Cambodia.
Asia Pac J Public Health. 2006;18(1):29-38. doi: 10.1177/10105395060180010601.
In recent years, Cambodia has demonstrated significant success in specific aspects of immunization with gains through campaign efforts in measles control and polio eradication. In contrast, routine immunization rates have failed to improve over the last five years. In response, the National Immunization Program of the Ministry of Health developed a coverage improvement planning (CIP) process. This paper describes the CIP process in Cambodia, including identified barriers to and strategies for improving coverage. Immunization coverage rose in 8 of 10 pilot districts in the year following the introduction of CIP in 2003. The mean increase in DPT3 coverage across pilot districts on an annual basis was 16%, which provides encouraging early evidence for the effectiveness of the intervention. Factors associated with success in coverage improvement included: (1) development of a needs-based micro-plan, (2) application of performance-based contracting between levels of management, (3) investment in social mobilization, (4) securing finance for health outreach programs and (5) strengthened monitoring systems. Lessons learned will guide program expansion to improve immunization coverage nationally.
近年来，柬埔寨在免疫接种的特定方面取得了显著成功，通过麻疹控制和脊髓灰质炎根除运动取得了进展。相比之下，常规免疫接种率在过去五年中未能提高。作为回应，卫生部的国家免疫规划制定了一项提高覆盖率的规划（CIP）流程。本文描述了柬埔寨的CIP流程，包括确定的提高覆盖率的障碍和策略。在2003年引入CIP后的一年里，10个试点地区中有8个地区的免疫接种覆盖率有所上升。试点地区DPT3覆盖率的年均增长为16%，这为干预措施的有效性提供了令人鼓舞的早期证据。与提高覆盖率成功相关的因素包括：（1）制定基于需求的微观计划；（2）在各级管理之间应用基于绩效的合同；（3）对社会动员的投入；（4）为卫生外展项目筹集资金；（5）加强监测系统。吸取的经验教训将指导项目扩大，以提高全国的免疫接种覆盖率。
