Browsing by Author "Kwaw, William Bangoto"

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    Knowledge, attitudes, and practices (KAP) of vaccinators in government health clinics in Khayelitsha
    (Stellenbosch : Stellenbosch University, 1999-12) Kwaw, William Bangoto; Burger, A. P. J.; Stellenbosch University. Faculty of Economic and Management Sciences. Dept. of School of Public Leadership.
    ENGLISH SUMMARY: Immunization against the major killer diseases of childhood: measles, polio, diphtheria, whooping cough, tetanus, hepatitis B and tuberculosis remains the most cost effective, health intervention presently known. Immunization is the most precious gift that a health 'worker can give to a child. However there are times when a child who needs vaccination visits a health facility but is not immunized by the health staff a missed opportunity. Though reasons such as non-availability of vaccines and lack of integration of services can be blamed, more important reasons are misconceptions about contra-indications and provider failure to administer vaccines simultaneously. important in peri-urban squatter This is particularly settlements where immunization coverage tends to be low. the time has come to fill in the gap It is felt that that is to research an important forgotten link in the immunization chain - the vaccinator who is in an manage the immunization process marginalised areas. ideal position to in previously All vaccinators in government health Khayelitsha (a total of 40) were surveyed. obtain information on knowledge, attitudes clinics in This was to and practice concerning vaccination in order to plan an appropriate health intervention programme such as focused retraining with view to improving immunization services in the area. The response rate was 82.5%. Important findings included the following: 84.8% were registered professional nurses; 54.5% had 5 or more years experience in vaccinating children; the majority (90.9%) knew the routine immunization Department of Health: children while only schedule recommended by the 93.9% knew the measles policy for 15.2% knew the tetanus policy for mothers: important misconceptions and myths about. contraindications to vaccinations were· found in typical clinical situations; 97% received supervision from senior professional nurses of which 63.5% worked in the same clinic: performance feedback (45.5%) was the most popular method used by supervisors to upgrade skills of vaccinators; important job problems included staff shortages (75.8%), mothers not bringing children to clinic (63.3%), lack of supplies (27.3%) and training (18.2%), lack of integrated one stop service (27.3%): 48.5% had plans in place to learn about newborns or new immigrant children: 21.2% kept a register of all children in catchment areas: 30.3% routinely calculated drop-out rates however none could quote last figure calculated; all. (100%) participated in suggesting reasons to explain why some children may not receive vaccinations at the correct age and 93.9% contributed ideas towards improving immunization coverage in the area. It was found that the vaccinator wants to be an active participant in the immunization policy process. Recommendations for improved vaccination services in the area are the following: - Provision of immunisation at every health care contact. - Colour coding of vaccination schedule to make it more useful to illiterate mothers. Provision of information preferably in the mother tongue of the target population - for a more meaningful participation in the immunisation policy process. - Implementation of a one-stop-shop clinic concept where all promotive and preventive immunisation curative and rehabilitative services are provided. - Implementation of the child-to-child concept to help in identifying new immigrant children and in tracing immunization drop outs. This will ensure that children become active partners in their own health promotion and care. - Greater use of conventional media (radio, television and opinion leaders (including traditional healers to convey immunisation messages and to motivate parents. - Organization of workshops and seminars (as short term measure) aimed at addressing misconceptions and myths concerning contra-indications to immunisation. Inclusion of courses (as long term measure) in curricula of nursing training institutions to equip nurses to be effective vaccinators before graduation. - Greater advocacy role by vaccinators, to ensure that the immunisation policy agenda is firmly placed within the general framework of the human development process. This will ensure that more resources are committed for immunisation of children.