Tuesday, 31st of March 2015 Print

Reinhard Kaiser et al., “Measles vaccination coverage surveys”

This online first version has been peer-reviewed, accepted and edited, but not formatted and finalized with corrections from authors and proofreaders.

“Surveys of measles vaccination coverage in eastern and southern Africa: a review of quality and methods used”

Reinhard Kaiser,a

Messeret E Shibeshi,a

Jethro M Chakauya,a

Emelda Dzeka,a

Balcha G Masresha,b

Fussum Daniela

& Nestor Shivutea

aImmunization, Vaccines and Emergencies, WHO Regional Office for Africa, Inter-country Support Team for East and Southern Africa, 86 Enterprise Road, Highlands, Harare, Zimbabwe.

bImmunization, Vaccines and Emergencies, WHO Regional Office for Africa, Brazzaville, Congo.

Correspondence to Reinhard Kaiser (email:

(Submitted: 2 September 2014 – Revised version rece

ived: 18 December 2014 – Accepted: 15 January


Abstract below; full text is at


To assess the methods used in the evaluation of measles vaccination coverage, identify quality concerns and provide recommendations for improvement.


We reviewed surveys that were conducted to evaluate supplementary measles immunization activities in east and southern Africa during 2012 and 2013. We investigated the organization(s) undertaking each survey, survey design, sample size, the numbers of study clusters and children per study cluster, recording of immunizations and methods of analysis. We documented sampling methods at the level of clusters, households and individual children. We also assessed the length of training for field teams at national and regional levels, the composition of teams and the supervision provided.


The surveys were conducted in Comoros, Eritrea, Ethiopia, Lesotho, Kenya, Malawi, Mozambique, Namibia, Rwanda, Swaziland, Uganda, Zambia and  Zimbabwe. Of the 13 reports we reviewed, there were weaknesses in 10 of them for ethical clearance, 9 for sample size calculation, 6 for sampling methods, 12 for training structures, 13 for supervision structures and 11 for data analysis.


We recommend improvements in the documentation of routine and

supplementary immunization, via home-based vaccination cards or other records. For surveys conducted after supplementary immunization, a standard protocol is required.

Finally, we recommend that standards be developed for report templates and for the technical review of protocols and reports. This would ensure that the results of vaccination coverage surveys are accurate, comparable, reliable and valuable for programme improvement.

Publication: Bulletin of the World Health Organization;

Type: Research

Article ID: BLT.14.146050

Special Postings


Highly Accessed

Website Views