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Missed opportunities for measles immunisation in selected western Cape hospitals
1Centre for Epidemiological Research in Southern Africa, South African Medical Research Council, Parowvallei, CP.
Insights
Many children in South Africa miss measles immunisation opportunities in hospitals. Integrating preventive and curative healthcare is crucial for improving childhood vaccination rates and reducing measles burden.
Area of Science:
- Public Health
- Epidemiology
- Childhood Infectious Diseases
Background:
- Measles remains a significant cause of childhood mortality and morbidity in South Africa.
- The World Health Organization (WHO) recommends leveraging the curative sector for immunisation opportunities.
- Fragmented healthcare systems contribute to missed vaccination opportunities.
Purpose of the Study:
- To quantify missed opportunities for measles immunisation in children attending curative healthcare facilities in the Western Cape, South Africa.
- To assess the availability of Road-to-Health cards and documented measles immunisation records.
Main Methods:
- A cross-sectional study involving exit interviews with 1,068 carers of children aged 6-59 months.
- Data collection focused on the request and availability of Road-to-Health cards and measles immunisation status.
- Analysis of immunisation documentation across primary, secondary, and tertiary curative hospitals.
Main Results:
- The percentage of carers requested to produce a Road-to-Health card varied from 2.4% to 40.7%.
- The availability of Road-to-Health cards ranged from 4.8% to 43.1%.
- Documented measles immunisation coverage ranged from 4.8% to 40.0% across different facilities, indicating substantial missed opportunities.
Conclusions:
- Significant numbers of measles immunisation opportunities are being missed in Western Cape hospitals.
- A fragmented healthcare approach hinders effective immunisation delivery.
- There is an urgent need to integrate preventive and curative healthcare services within a metropolitan primary healthcare framework.
Abstract:
Measles is still a major cause of childhood mortality and morbidity in South Africa. The World Health Organisation (WHO) has recently recommended that greater attention be paid to opportunities for immunisation in the curative sector. This study quantified the extent of missed opportunities for measles immunisation in children attending primary, secondary and tertiary level curative hospitals in the western Cape. Exit interviews of 1,068 carers of children aged between 6 and 59 months inclusive showed that 2.4-40.7% of carers had been requested to produce a Road-to-Health card, and that 4.8-43.1% of carers had a card available. The proportion of children with documented evidence of measles immunisation available ranged from 4.8% to 40.0% between facilities. The study demonstrated that a considerable number of potential opportunities to immunise children against measles are currently being missed in children attending hospitals and day hospitals in the western Cape. The study documents the effect of a fragmented approach to health care, and indicates a need for rapid integration of preventive and curative components of health care into a metropolitan-based primary health care service.