Factors influencing the uptake of the revised expanded immunisation programme at Umlazi Township, KwaZulu-Natal Province, South Africa : maternal and child care

Abstract

The Expanded Programme on Immunisation (EPI) is one of the most powerful and cost-effective global public health programmes to improve child survival. In South Africa, the programme remained fragmented because of the system of apartheid until 1995 when the national EPI was formed through the unification of all immunisation services in the country. Since then there have been significant advances in immunisation service delivery in South Africa with numerous revisions in the schedule, last of which was in 2009. The data information system for eThekwini district reflects remarkably low immunisation coverage for children aged 6 to12 years compared to the other age groups from the time the 2009 revision was made. The aim of the study was to investigate the factors that influence the uptake of the revised EPI for children between the ages of 6 to 12 years at Umlazi Township, KwaZulu-Natal (KZN). A descriptive quantitative design was used to conduct the study. All (n=10) primary health care (PHC) clinics from Umlazi Township were included in the study. Data was collected from 1009 child caregivers (CCGs) and all (n=12) health care workers (HCWs) who were involved in EPI services using self-directed questionnaires. The study revealed that although the EPI programme was well-implemented in Umlazi Township, EPI coverage for children between 6 to 12 years old remained low. Several factors that influenced the uptake of the immunisations were identified. The positive factors which could be used to strengthen the programme were mainly in relation to how the EPI programme was implemented and a few other factors in relation to the CCGs and their access to the PHC clinics. The negative factors were in relation to emergency ordering and supply of vaccines and the knowledge of the children care givers regarding the immunisation. These highlighted a need to strengthen how the EPI was implemented.