Missed opportunities of vaccination in primary health care establishments in Ecuador

Abstract

Objective

Evaluate the attributable causes that originate missed opportunities of vaccination (OPDV) in the centres of attention level of the District of Health of the city of Quito.

Material and methods

This cross-sectional study was based on an exit survey to 368 caregivers of children 5 years old and under in all the primary care establishments in district 17D05 in Quito in 2017. We performed a univariate and bivariate analysis to describe the population and any related risk factors.

Results

A total of 368 children had their vaccination card, out of which 123 (33.4%) had an incomplete vaccination scheme for their age; 44 (35.7%) were candidates for possible vaccination during their visit to the health centre, but only 21 (44.7%) were vaccinated. The main causes attributed to the lack of vaccination were that the caregiver had not taken the child to the health centre for vaccination (76.2%) and causes related to the knowledge of the health professionals (19%). The only statistically significant risk factor found that was related to a higher probability of missing a vaccination opportunity was the caregivers age.

Conclusions

The OPDV were mainly attributed to causes related to the demand of the service, that is, to reasons generated from the parents or caregivers and to a lesser extent to the attitudes of the health personnel studied from the point of view of the user.

Resumen

Objetivo

Evaluar las causas atribuibles que originan oportunidades perdidas de vacunación (OPDV) en centros de primer nivel de atención de un Distrito de Salud de la ciudad de Quito.

Material y métodos

Se realizó un estudio transversal de las OPDV a través de una encuesta a 368 padres o cuidadores de niños de 5 años o menores en el año 2017, en los centros de salud de primer nivel de atención del Distrito 17D05 de la ciudad de Quito, Ecuador. Se llevó a cabo un análisis univariado y bivariado para la descripción de la población del estudio y los posibles factores de riesgo relacionados.

Resultados

De los 368 niños con carné de vacunación, 123 (33,4%) tenían carné de vacunación incompleto, y 44 (35,7%) de estos fueron susceptibles de ser vacunados, pero solo 21 (44,7%) fueron vacunados. Las causas atribuibles a no vacunación fueron que el padre o cuidador refiere no haber traído a vacunar (76,2%) y causas atribuibles a los conocimientos del personal de salud (19%). Al evaluar los factores de riesgo para OPDV, la edad del cuidador resultó como el único factor estadísticamente significativo.

Conclusiones

Las OPDV se atribuyeron principalmente a causas relacionadas con la demanda del servicio, es decir, a motivos generados de los padres o cuidadores, y en menor medida a las actitudes del personal de salud estudiadas desde el punto de vista del usuario.