Factors contributing to routine immunization performance in Ethiopia, 2014.

Introduction: An increasing trend of routine immunization performance has generally been observed over the past decade in Ethiopia. However, the improvement is irregular with wide disparity among and within regions. This study analyzes health facility characteristics contribution to immunization performance in Ethiopia.

Methods: We conducted a cross-sectional study and compared characteristics of health facilities in good and poor performing zones. We used administrative coverage reports and Personal Digital Assisted (PDA) supervisory data collected by WHO EPI field officers using a standardized structured checklist. We selected 48 zones and 302 health facilities based on immunization performance data and supervisory data on potential variables.

Results: Logistics regression was used to identify independent contributors to good immunization performance. On logistics regression we found that: actions by higher levels in conducting supervision (Odds Ratio (OR) =4.15. 95% Confidence Interval (CI) = 1.85, 9.32, p value <0.01] and providing written feedback (Odds Ratio (OR) =4.35. 95% Confidence Interval (CI) = 2.27, 8.33, p value <0.01) , and provision of immunization services by the health facility itself for catchment population under each health unit (Odds Ratio (OR) =20.15. 95% Confidence Interval (CI) = 2.24, 181.38, p value =0.01) and absence of stock out of vaccines (Odds Ratio (OR) =0.44. 95% Confidence Interval (CI) = 0.23, 0.83, p value =0.01) are the likely significant factors contributing to good immunization performance in Ethiopia.

Conclusion: Ensuring availability of immunization services in all health facilities, regular supervision and written feedback and improved stock management are essential factors contributing to good immunization performance.