Reducing missed opportunities for vaccination in Mozambique: findings from a cross-sectional assessment conducted in 2017

Objective Missed opportunities for vaccination (MOV) are a significant contributor to low vaccination coverage. To better understand the magnitude and underlying causes of MOV among children aged 0–23 months in Mozambique, we conducted an assessment and developed a roadmap for strengthening the coun...

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Main Authors: Bvudzai Priscilla Magadzire, Graça Matsinhe, Gabriel Joao, Ruth Bechtel, Laura Nic Lochlainn
Format: Article
Language:English
Published: BMJ Publishing Group 2021-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/12/e047297.full
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author Bvudzai Priscilla Magadzire
Graça Matsinhe
Gabriel Joao
Ruth Bechtel
Laura Nic Lochlainn
author_facet Bvudzai Priscilla Magadzire
Graça Matsinhe
Gabriel Joao
Ruth Bechtel
Laura Nic Lochlainn
author_sort Bvudzai Priscilla Magadzire
collection DOAJ
description Objective Missed opportunities for vaccination (MOV) are a significant contributor to low vaccination coverage. To better understand the magnitude and underlying causes of MOV among children aged 0–23 months in Mozambique, we conducted an assessment and developed a roadmap for strengthening the country’s childhood immunisation programme.Setting Three provinces in North, South and Central Mozambique.Methods The assessment applied a mixed-method approach. From a sample of 41 health facilities, we conducted exit interviews with caregivers of children aged 0–23 months (n=546), surveys with health workers (n=223), focus group discussions with caregivers (n=6) and health workers (n=5), and in-depth interviews with health facility managers (n=9). We analysed the data to assess the magnitude of MOV and to identify causes of MOV and ways of preventing them.Results Vaccination records were available for 538 children. Sixty per cent (n=324) were eligible for vaccination on arriving for their health facility visit. Of these, 76% (n=245) were not fully vaccinated, constituting MOV. Our analysis shows that these MOV were most frequently attributable to practices of caregivers and health workers and also to health systems reasons. Inadequate information about vaccination among both caregivers and health workers, poor or poorly understood health facility practices, inadequate integration of curative and preventative services, inadequate tracking systems to identify children due for vaccination and, less often, limited supply of vaccines, syringes and other related supplies at service points resulted in MOV.Conclusions The results of the assessment informed the development of roadmaps for reducing MOV that may be applicable to other settings. The global immunisation community should continue to invest in efforts to reduce MOV and thereby make health service visits more effective and efficient for vaccination.
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spelling doaj-art-e5072bb4d10147988e56236c9b841e0c2025-08-20T01:56:17ZengBMJ Publishing GroupBMJ Open2044-60552021-12-01111210.1136/bmjopen-2020-047297Reducing missed opportunities for vaccination in Mozambique: findings from a cross-sectional assessment conducted in 2017Bvudzai Priscilla Magadzire0Graça Matsinhe1Gabriel Joao2Ruth Bechtel3Laura Nic Lochlainn4Health Systems, VillageReach, Cape Town, South AfricaExpanded Program on Immunization, Ministry of Health (Ministro da Saude), Maputo, MozambiqueMozambique Country Program, VillageReach, Maputo, MozambiqueMozambique Country Program, VillageReach, Maputo, MozambiqueDepartment of Immunization, Vaccines and Biologicals (IVB), World Health Organization, Geneva, SwitzerlandObjective Missed opportunities for vaccination (MOV) are a significant contributor to low vaccination coverage. To better understand the magnitude and underlying causes of MOV among children aged 0–23 months in Mozambique, we conducted an assessment and developed a roadmap for strengthening the country’s childhood immunisation programme.Setting Three provinces in North, South and Central Mozambique.Methods The assessment applied a mixed-method approach. From a sample of 41 health facilities, we conducted exit interviews with caregivers of children aged 0–23 months (n=546), surveys with health workers (n=223), focus group discussions with caregivers (n=6) and health workers (n=5), and in-depth interviews with health facility managers (n=9). We analysed the data to assess the magnitude of MOV and to identify causes of MOV and ways of preventing them.Results Vaccination records were available for 538 children. Sixty per cent (n=324) were eligible for vaccination on arriving for their health facility visit. Of these, 76% (n=245) were not fully vaccinated, constituting MOV. Our analysis shows that these MOV were most frequently attributable to practices of caregivers and health workers and also to health systems reasons. Inadequate information about vaccination among both caregivers and health workers, poor or poorly understood health facility practices, inadequate integration of curative and preventative services, inadequate tracking systems to identify children due for vaccination and, less often, limited supply of vaccines, syringes and other related supplies at service points resulted in MOV.Conclusions The results of the assessment informed the development of roadmaps for reducing MOV that may be applicable to other settings. The global immunisation community should continue to invest in efforts to reduce MOV and thereby make health service visits more effective and efficient for vaccination.https://bmjopen.bmj.com/content/11/12/e047297.full
spellingShingle Bvudzai Priscilla Magadzire
Graça Matsinhe
Gabriel Joao
Ruth Bechtel
Laura Nic Lochlainn
Reducing missed opportunities for vaccination in Mozambique: findings from a cross-sectional assessment conducted in 2017
BMJ Open
title Reducing missed opportunities for vaccination in Mozambique: findings from a cross-sectional assessment conducted in 2017
title_full Reducing missed opportunities for vaccination in Mozambique: findings from a cross-sectional assessment conducted in 2017
title_fullStr Reducing missed opportunities for vaccination in Mozambique: findings from a cross-sectional assessment conducted in 2017
title_full_unstemmed Reducing missed opportunities for vaccination in Mozambique: findings from a cross-sectional assessment conducted in 2017
title_short Reducing missed opportunities for vaccination in Mozambique: findings from a cross-sectional assessment conducted in 2017
title_sort reducing missed opportunities for vaccination in mozambique findings from a cross sectional assessment conducted in 2017
url https://bmjopen.bmj.com/content/11/12/e047297.full
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