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

Thursday, 23rd of June 2016

Bull World Health Organ. 2015 May 1;93(5):314-9. doi: 10.2471/BLT.14.146050. Epub 2015 Mar 10.

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

Kaiser R¹ Shibeshi ME¹ Chakauya JM¹ Dzeka E¹ Masresha BG² Daniel F¹ Shivute N¹.

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Abstract

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OBJECTIVE:

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

METHODS:

We reviewed surveys that were conducted to evaluate supplementary measles immunization activities in eastern and southern Africa during 2012 and 2013. We investigated the organization(s) undertaking each 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.

FINDINGS:

The surveys were conducted in Comoros Eritrea Ethiopia Kenya Lesotho 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.

CONCLUSION:

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.