This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Ashenafi T. Amare
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2923-468X
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Supportive supervision is one of five essential components of the WHO’s Reaching Every District strategy, an operational approach to reach 90%, immunization coverage. However, it is not mostly practiced based on the standard schedule because of capacity and low number of staffs in the health system. When it is practiced after long interval, it focuses more on inspection and finding lacunas. Taking into account the 54 universities in Ethiopia, the fundamental idea in this implementation science research is to test the feasibility and effectiveness of a Capacity Building and Mentorship Program in Immunization (CBMPI) by medical and health science colleges aimed at supplementing the current approach.
Methods: This study applied a pre-post quasi experimental research design. The study included health workers of 30 health facilities (15 intervention and 15 control) followed for six months. To assess effectiveness on immunization coverage and a change in reaching every district strategy implementation difference in difference analysis was used to estimate the effect of the intervention implementation over time. Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework was used to evaluate the implementation process.
Results: The findings of the study indicated that the intervention package has a statistically significant effect (P=0.0001) in the overall implementation of Reaching Every District (RED) outcomes. The difference in difference analysis also indicated that health facilities in the intervention district have shown a higher Penta III coverage (17.4%) and complete vaccination coverage (16.6%) that is attributable to the intervention package. Similarly, knowledge and skills of health workers improved significantly (P<0.05) after the intervention in most of the performance measures. During the qualitative evaluation, the key informants mentioned that the CBMPI program was effective and the new approach was acceptable by health workers for integration in the routine EPI program.
Conclusions: In conclusion, capacity building and mentorship by well-trained personnel with the appropriate knowledge and skills have positive effects on immunization program indicators. Thus, it is recommended to do implementation study within the framework of national immunization program to facilitate policy adoption and readiness for routine use in large scale. This work was supported by the Bill & Melinda Gates Foundation, Grant Number OPP1191298
Keywords
CBMPI, Capacity Building, Immunization, Medical University, Vaccination, Ethiopia
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research
Ashenafi T. Amare
Corresponding Author
ORCiD: https://orcid.org/0000-0003-2923-468X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 24 Jan, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Health Economics & Outcomes Research
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Supportive supervision is one of five essential components of the WHO’s Reaching Every District strategy, an operational approach to reach 90%, immunization coverage. However, it is not mostly practiced based on the standard schedule because of capacity and low number of staffs in the health system. When it is practiced after long interval, it focuses more on inspection and finding lacunas. Taking into account the 54 universities in Ethiopia, the fundamental idea in this implementation science research is to test the feasibility and effectiveness of a Capacity Building and Mentorship Program in Immunization (CBMPI) by medical and health science colleges aimed at supplementing the current approach.
Methods: This study applied a pre-post quasi experimental research design. The study included health workers of 30 health facilities (15 intervention and 15 control) followed for six months. To assess effectiveness on immunization coverage and a change in reaching every district strategy implementation difference in difference analysis was used to estimate the effect of the intervention implementation over time. Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework was used to evaluate the implementation process.
Results: The findings of the study indicated that the intervention package has a statistically significant effect (P=0.0001) in the overall implementation of Reaching Every District (RED) outcomes. The difference in difference analysis also indicated that health facilities in the intervention district have shown a higher Penta III coverage (17.4%) and complete vaccination coverage (16.6%) that is attributable to the intervention package. Similarly, knowledge and skills of health workers improved significantly (P<0.05) after the intervention in most of the performance measures. During the qualitative evaluation, the key informants mentioned that the CBMPI program was effective and the new approach was acceptable by health workers for integration in the routine EPI program.
Conclusions: In conclusion, capacity building and mentorship by well-trained personnel with the appropriate knowledge and skills have positive effects on immunization program indicators. Thus, it is recommended to do implementation study within the framework of national immunization program to facilitate policy adoption and readiness for routine use in large scale. This work was supported by the Bill & Melinda Gates Foundation, Grant Number OPP1191298
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