Cutts F T, Glik D C, Gordon A, Parker K, Diallo S, Haba F, Stone R
Division of Immunization, Centers for Disease Control, Atlanta, GA 30333.
Bull World Health Organ. 1990;68(6):769-76.
During 1988-89, studies were conducted to evaluate the immunization system in Conakry, Guinea. The first, a health facility survey, found that health staff screened the vaccination status of only 30% of children who presented for curative care. A sterile syringe and needle were used for less than half of the injections. In the second survey, key informant interviews with vaccinators and health centre chiefs showed that there were minimal lines of communication between health workers and the community, but that health workers did not perceive this to be a problem. Focus group discussions in the community revealed a high level of general knowledge about vaccine-preventable diseases. However, mothers did not know how many vaccinations their children should receive or by what age they should be completed. They complained of long waiting times in health centres, the high costs of vaccination, poor rapport with health workers, and the occurrence of abscesses after vaccination. The final study, a "knowledge, attitudes, and practice" community survey, showed that missed immunization opportunities and inappropriately timed vaccinations reduced potential vaccine coverage by almost 30% among children with vaccination cards. Higher socioeconomic status, delivery in hospital, and whether mothers perceived the vaccinations to be affordable affected whether the child began the immunization series. Once a child had entered the immunization system, completion of the series was determined by the mother's education level, employment status, and experience with vaccination services.
1988年至1989年期间，在几内亚科纳克里开展了多项研究，以评估当地的免疫接种系统。第一项研究是对医疗机构进行调查，结果发现，医护人员仅对30%前来接受治疗的儿童的疫苗接种状况进行了筛查。不到一半的注射使用了无菌注射器和针头。在第二项调查中，对接种人员和卫生中心主任进行的关键信息人访谈显示，卫生工作者与社区之间的沟通渠道极少，但卫生工作者并不认为这是一个问题。在社区进行的焦点小组讨论表明，人们对疫苗可预防疾病的常识水平较高。然而，母亲们不知道自己的孩子应该接种多少剂疫苗，也不知道应该在什么年龄完成接种。她们抱怨在卫生中心等待时间过长、疫苗接种费用高昂、与医护人员关系不佳，以及接种后出现脓肿。最后一项研究是一项“知识、态度和行为”社区调查，结果显示，错过免疫接种机会和接种时间不当使持有接种卡的儿童的潜在疫苗接种覆盖率降低了近30%。较高的社会经济地位、在医院分娩，以及母亲是否认为疫苗接种费用可承受，都会影响孩子是否开始接种疫苗系列。一旦孩子进入免疫接种系统，接种系列的完成情况则取决于母亲的教育水平、就业状况以及接种服务的体验。
