Deivanayagam N, Nedunchelian K, Mala N, Ashok T P, Rathnam S R, Ahmed S S
Advanced Centre for Clinical Epidemiological Research and Training (ACCERT), Madras Medical college.
Indian Pediatr. 1995 Jan;32(1):51-7.
A cross-sectional survey was done to assess the missed opportunity for immunization (MOI) in children under two years of age attending Medical Outpatient, Newborn Follow-up Service and Immunization Clinic of Institute of Child Health and to evaluate interventions. Baseline survey phase-I was done and two interventions: (i) education and awareness of immunization among health personnel; and (ii) attaching immunization slip to the outpatient form were done. After each intervention phase-II and phase-III surveys were carried out. The data from the different phases were analyzed for the effect of interventions. The total number of children surveyed were 634; 423 from Medical Outpatients, 108 from Newborn Follow-up Service and 103 from immunization Clinic. MOI was 35.5%, 23.1% and 9.7% in the above health facilities, respectively. After intervention I, the MOI was 24.5% and 12.2% in Medical Outpatient and Newborn Follow-up Service and none in Immunization Clinic. After intervention-II there was an improvement in immunization of 18.4%, 30.4% and 16.0% in the three health facilities mentioned above. MOI was avoided because the medical officers advised immunization in the above children. The difference in the MOI among Medical Outpatient and Immunization Clinic between baseline, phase-I and phase-II were significant (p < 0.001). It is concluded that MOI can be brought down by creating awareness periodically and that attaching an immunization schedule to the outpatient forms is an effective method of reducing MOI.
开展了一项横断面调查，以评估在儿童健康研究所的门诊、新生儿随访服务和免疫诊所就诊的两岁以下儿童的免疫接种错失机会（MOI），并评估干预措施。进行了基线调查第一阶段，并实施了两项干预措施：（i）对卫生人员进行免疫接种教育和提高认识；（ii）在门诊表格上附上免疫接种单。在每次干预后进行了第二阶段和第三阶段调查。分析了不同阶段的数据以评估干预措施的效果。调查的儿童总数为634名；其中423名来自门诊，108名来自新生儿随访服务，103名来自免疫诊所。上述医疗机构的MOI分别为35.5%、23.1%和9.7%。干预措施I实施后，门诊和新生儿随访服务的MOI分别为24.5%和12.2%，免疫诊所为零。干预措施II实施后，上述三个医疗机构的免疫接种率分别提高了18.4%、30.4%和16.0%。由于医务人员为上述儿童建议了免疫接种，MOI得以避免。门诊和免疫诊所在基线、第一阶段和第二阶段之间的MOI差异具有统计学意义（p < 0.001）。得出的结论是，通过定期提高认识可以降低MOI，并且在门诊表格上附上免疫接种时间表是降低MOI的有效方法。
