Training needs for mid-level managers and immunisation coverage in Western Kenya

Area of Science:

• Public Health
• Vaccinology
• Health Systems Management

Background:

• Immunisation coverage is crucial for reducing child mortality.
• Effective management of immunisation programmes relies on trained mid-level personnel.
• The Kenya Expanded Programme on Immunisation (EPI) aims to improve vaccine access and uptake.

Purpose of the Study:

• Assess current immunisation coverage in Western Kenya before interventions.
• Identify strengths and weaknesses in the existing EPI programme.
• Determine training needs for EPI mid-level managers to enhance service delivery.

Main Methods:

• A cross-sectional descriptive study was conducted across 39 districts in Rift Valley, Western, and Nyanza provinces.
• Data were collected from mid-level managers involved in the Kenya Expanded Programme on Immunisation.
• Key outcome measures included staff training status, immunisation coverage rates, and perceived training needs.

Main Results:

• Only 25% of District Health Management Team members had supervisory-level training; 43.6% of districts lacked such trained personnel.
• Nyanza Province exhibited the highest immunisation dropout rate (Pentavalent 1 to measles), while Rift Valley had the lowest.
• Annual cumulative coverage reached 80% for Pentavalent 1 and 2, but only 60% for measles; cold chain equipment maintenance was the top training priority.

Conclusions:

• A significant proportion of EPI mid-level managers in the study area lack adequate training, potentially hindering effective programme management.
• Low immunisation coverage and high dropout rates indicate systemic issues within the programme.
• Comprehensive training for all EPI mid-level managers is recommended, utilizing WHO-approved curricula, possibly through the Merck Vaccine Network--Africa programme.