Department of Community Medicine, University of Zimbabwe, Health Studies Office, Harare, Zimbabwe.
Disasters. 2012 Jan;36(1):161-73. doi: 10.1111/j.1467-7717.2011.01246.x. Epub 2011 May 31.
Gokwe South, a rural district in Midlands Province, Zimbabwe, reported the lowest rate of immunisation coverage in the country in 2005: 55 per cent of children vaccinated with three doses of diphtheria/pertussis/tetanus vaccine (DPT3) and 35 per cent dropout between the first and third dose of DPT. In January 2007, the authors assessed local barriers to immunisation and proposed strategies to improve immunisation rates in the district, in the face of nationwide economic and political challenges. A situational analysis was performed to assess barriers to immunisation using focus-group discussions with health workers, key informant interviews with health management and community leaders, and desk reviews of records. Responses were categorised and solutions proposed. Health workers and key informants reported that immunisation service delivery was hampered by insufficient availability of gas for cold-chain equipment, limited transport and fuel to conduct basic activities, and inadequate staff and supervision. Improving coverage will require prioritising gas for vaccine cold-chain equipment, identifying reliable transportation or alternative transportation solutions, and increased staff, training and supervision. Local assessment is critical to pinpointing site-specific barriers, and innovative strategies are needed to overcome existing contextual challenges.
津巴布韦中部省的戈奎南地区在 2005 年报告了全国最低的免疫接种率：只有 55%的儿童接种了三剂白喉/百日咳/破伤风疫苗（DPT3），并且在第一和第三剂 DPT 之间有 35%的儿童流失。2007 年 1 月，作者评估了该地区免疫接种面临的当地障碍，并提出了在全国经济和政治挑战面前提高免疫接种率的策略。使用与卫生工作者的焦点小组讨论、与卫生管理和社区领导的关键信息访谈以及对记录的桌面审查，进行了情况分析以评估免疫接种障碍。对回应进行了分类并提出了解决方案。卫生工作者和关键信息提供者报告说，由于冷链设备的气体供应不足、进行基本活动的运输和燃料有限以及工作人员和监督不足，免疫服务的提供受到了阻碍。提高覆盖率需要优先考虑用于疫苗冷链设备的气体，确定可靠的运输或替代运输解决方案，并增加工作人员、培训和监督。当地评估对于确定特定地点的障碍至关重要，需要创新策略来克服现有的背景挑战。
