Effectiveness of Monitoring Mechanisms in Reducing Immunization Dropouts Among Infants in Health Facilities of Maridi County, South Sudan

Abstract

Introduction: Immunization is one of the most efficient and successful health interventions for reducing child morbidity and mortality. Although global performance of immunization in 2019 was 86%, the coverage reduced to 84%. Despite the efforts employed to improve the immunization coverage, remained below 85%. Dropout rates continue to be an obstacle towards high vaccination coverage. Objectives: The study aimed to ascertain the effectiveness of monitoring mechanisms in reducing immunization dropouts among infants in the health facilities. The study targeted vaccinators in the health facilities of Maridi county. A prospective cohort study design with stratified random sampling technique was used for sampling eligible participants. A semi-structured interview guide and observation checklist were used to collect quantitative and qualitative data from respondents. Data was analyzed using descriptive statistics, bivariable, multivariable regression analyses was used to determine association between variables and chi square test to answer the research questions and hypotheses. Results: The results showed that 21% of health facilities did not have monitoring charts, 28.6% had more than 10% dropout rate and only 50% had desired dropout rate of less than 10%. 57% of the health facilities checked their monitoring chart at least 3 times in a quarter. 64% of health facilities had BHWs attached in their catchment area. The study observed a drop in the number of health facilities with high dropout by 9.6%. Lack of efforts from health workers to identify and link defaulters, lack of monitoring charts, absence of BHWs in some health facilities, no referrals from BHWs were associated with high dropout rates. Conclusion: The study concluded and recommended that monitoring mechanisms in health facilities were effective in reducing the rates of infant dropping out of the immunization program hence health workers should use monitoring tools. Scale up boma health initiative to health facilities without boma health workers.