Pulse polio immunization in district Panipat: a process evaluation.

Area of Science:

• Public Health
• Immunization Programs
• Health Systems Strengthening

Background:

• Sub-national immunization days (SNIDs) are critical for achieving high vaccination coverage.
• Effective implementation of SNIDs relies on well-trained and motivated health personnel.
• Previous evaluations of SNIDs have highlighted operational challenges.

Purpose of the Study:

• To comprehensively evaluate all operational aspects of pulse polio immunization during a special sub-national immunization day.
• To identify bottlenecks and areas for improvement in the immunization process.
• To assess the preparedness and performance of health workers involved in SNIDs.

Main Methods:

• A probability proportionate to size (PPS) sampling technique was employed to select 120 vaccination booths from a total of 662.
• Data collection likely involved observation, surveys, or interviews with health workers and supervisors.
• The evaluation focused on various stages of the immunization process on the designated SNID.

Main Results:

• Low attendance (30%) was noted at district-level meetings preceding the immunization day.
• A significant proportion of workers (34%) were new to their roles and lacked prior training.
• Vaccinator performance deviated from micro-plans, with 40% not adhering to the plan, and supervision was found to be deficient.

Conclusions:

• Sustaining health personnel interest and motivation is crucial for long-term immunization programs like the Intensified Pulse Polio Immunization (IPPI).
• The study underscores the necessity of continuous re-orientation and training to maintain health worker motivation and update their skills.
• Addressing training gaps and improving supervision are key to enhancing the effectiveness of SNIDs.