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National Primary Health Care Development Agency Plot 681/682, Port Harcourt Crescent, Off Gimbiya Street, Area 11, Garki, FCT, Abuja, Nigeria.
BMC Health Serv Res. 2019 Sep 14;19(1):664. doi: 10.1186/s12913-019-4514-2.
Health workers (HWs) providing routine immunization (RI) services play a crucial role in influencing vaccine uptake, a key determinant of improved immunization coverage. Over the years, Training Needs Assessments (TNAs) have not been routinely utilized in Nigeria to determine unmet needs of health workers offering immunization services and what approaches should be adopted to meet their training needs. The objective was to assess the level of Expanded Program on Immunization (EPI) knowledge among RI service providers and tutors in pre-service institutions in three Nigerian states, to identify unfulfilled training needs and their implications. It also sought HWs perception on a pilot training approach, where tutors will be used for in-service training.
TNA survey tools were designed to obtain knowledge-based information on the fundamental EPI concepts through key informant interviews and focus group discussions with 90 HWs and 27 pre-service tutors. Quantitative data was also obtained, hence utilizing a mixed method approach for the study.
In spite of several previous trainings, HWs knowledge on basic immunization concepts including Reaching Every Ward (REW) strategy was varied and suboptimal. 83% of the HWs could not differentiate between the live attenuated and killed vaccines. In addition, pre-service tutors knowledge of fundamental EPI concepts, as well as HW perception of the new training approach also varied across the states.
TNAs are valuable in determining specific training approaches to improve HWs skills needed to implement strategies required to increase vaccine uptake. However, EPI managers must be mindful of contextual factors beyond training needs such as finance and security, that can affect HW performance.
提供常规免疫（RI）服务的卫生工作者（HWs）在影响疫苗接种率方面发挥着至关重要的作用，疫苗接种率是提高免疫覆盖率的关键决定因素。多年来，尼日利亚并没有常规利用培训需求评估（TNA）来确定提供免疫服务的卫生工作者的未满足需求，以及应采取何种方法来满足他们的培训需求。目的是评估三个尼日利亚州的 RI 服务提供者和职前机构中的讲师在扩大免疫规划（EPI）方面的知识水平，以确定未满足的培训需求及其影响。它还旨在了解卫生工作者对试点培训方法的看法，即利用讲师进行在职培训。
TNA 调查工具旨在通过与 90 名 HWs 和 27 名职前讲师进行关键人物访谈和焦点小组讨论，获得关于基本 EPI 概念的基于知识的信息。还获得了定量数据，因此该研究采用了混合方法。
尽管进行了多次培训，但 HWs 对基本免疫概念的知识（包括“到达每个病房”（REW）战略）差异较大，且并不理想。83%的 HWs 无法区分减毒活疫苗和灭活疫苗。此外，职前讲师对基本 EPI 概念的知识，以及 HW 对新培训方法的看法，在各州之间也存在差异。
TNA 可用于确定特定的培训方法，以提高 HWs 实施提高疫苗接种率所需策略的技能。然而，EPI 管理人员必须注意培训需求以外的背景因素，如财务和安全，这些因素会影响 HW 的绩效。
