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Use of Telephone Calls in Reduction of Dropout Rate of Routine Immunization in a Tertiary Health Facility in South Eastern Nigeria

Received: 1 February 2015     Accepted: 19 February 2015     Published: 13 March 2015
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Abstract

Background: In Federal Medical Centre (FMC) Umuahia, DPT dropout rate has been high above 10% (2009 18% and 2010 16% source immunization unit Federal Medical centre, Umuahia) which indicates poor utilization of the Health Facility. It was therefore necessary to use recall telephone system to see if it could be reduced. Objectives: To determine the use of recall on and causes of immunization dropout. Methodology: This was an interventional study, in which all the children immunized in April 2011 who were given BCG to start the immunization regimen, were followed up until they completed the immunization with measles at nine months. Prior to this, dropout rate was calculated for three preceding months using the immunization register. The reason for dropout was obtained from the caregivers. The dropout rate was also calculated for the month of May. Result: The dropout rate reduced when compared with the previous months. Total number of children immunized with BCG in April 2011 was 119 and those who received DPT1 107, DPT2 96, DPT3 92 and measles 73. The cumulative DPT dropout rate in April was 14% while it was 20.8% in March. The most important cause of dropout was distance. Conclusion/ Recommendation: The recall improved the dropout rate, though not less than 10%. This showed that if the caregivers are recalled some will come back for immunization. The cause of the dropout was mainly distance. FMC Umuahia being a tertiary health facility with experts, many women put to birth in that hospital and their babies will be given BCG at birth and DPTI when they come for 6 weeks post natal and then dropout. Recall system should be instituted in all the health facilities to improve utilization. A column should be provided in the child immunization register for writing the caregivers phone number.

Published in European Journal of Preventive Medicine (Volume 3, Issue 3)
DOI 10.11648/j.ejpm.20150303.11
Page(s) 39-43
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2015. Published by Science Publishing Group

Keywords

Drop-Out, Telephone Calls, Immunization

References
[1] Centre for Global Development: Making Markets for vaccines: from ideas to actions. Centre for Global Development; Washington DC; 2005.
[2] Vaccine Reminder Recall Systems: A Practical Guide for Pediatric Practices http://practice.aap.org/content.aspx?aid=2674 accessed on 7th of April 2011
[3] Immunization Dropout- HMIS News. Htm. Sept 22 2011 pg 1
[4] S.S. Trivedi, C.R. Mundada & R.K. Chudasama: Evaluation and impact of various factors affecting Universal Immunization Programme (UIP) coverage in Surat. The Internet Journal of Epidemiology. 2009; 6:2
[5] Kathleen Marker, RN. Successful Implementation of Practice-based Reminder/Recall Systems. Implementation of a Vaccine Reminder/Recall System: A Successful Pilot Project in Pennsylvania
[6] Mc Dowell, Newell C., Rosser W. Comparism of methods of recalling influenza vaccination. Canadian Medical Journal 1986; 135:991-997.
[7] Muhammad J H, Peter F, and Kevin F. Effectiveness of Telephone Reminders in Improving Rate of Appointments Kept at an Outpatient Clinic: A Randomized Controlled Trial .J Am Board Fam Med. 2001;14(3)
[8] Reekie D, Devlin H. Preventing failed appointments in general dental practice: a comparison of reminder methods. Br Dent J 1998; 185:472- 4.
[9] O'Brien G, Lazebnik R. Telephone call reminders and attendance in an adolescent clinic. Pediatrics 1998; 101:E6.
[10] Koren ME, Bartel JC, Corliss J. Interventions to improve patient appointments in an ambulatory care facility. J Ambulatory Care Manage 1994;17:76
[11] Grover S, Gagnon G, Flegel KM, Hoey JR. Improving appointment-keeping by patients new to a hospital medical clinic with telephone or mailed reminders. Can Med Assoc J 1983;129:1101-3
[12] Cohen AJ, Weinstein P, Wurster C. The effects of patient-initiated phone confirmation strategies on appointment keeping at a hospital dental clinic. J Public Health Dent 1980;40:64 -8.
[13] Szilagyi P, Vann J, et al. interventions aimed at improving immunization rates. http://www.ncbi.nlm.nih.gov/pubmed/12519624. Assessed 30/1/13.
[14] Ahlers-Schmidts CR, Chesser AK, NguyenT. Feasibility of a Randomized Controlled Trial to evaluate Text Reminders for immunization Compliance in Kids. (TRICKs) http://www.ncbi.nlm.nih.gov/pubmed/22750044. Assessed on 4/2/2013.
[15] Berhane Y, Pickering J. Are reminder stickers effective in reducing immunization dropout rates in Addis Ababa, Ethiopia? http://www.ncbi.nlm.nih.gov/pubmed/8505766
[16] Daley MF, Steiner JF, Brayden RM, et al. Immunization registry-based recall for a new vaccine. Ambul Pediatr. 2002;2:438–443.CrossRefMedlineWeb of Science
[17] Kalamawei Itimi, Paul O Dienye, Best Ordinioha. Community participation and childhood immunization coverage: A comparative study of rural and urban communities of Bayelsa State, south-south Nigeria. Nigerian Medical Journal, Year 2012, Volume 53, Issue 1 [p. 21-25]
[18] Phukan RK, Barman MP, Mahanta J. factors associated with immunization coverage of children in Assam, India: over the first year of life. http://www.ncbi.nlm.nih.gov/pubmed/18450821. Assessed on 4/2/2013.
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  • APA Style

    Nwokeukwu Huldah Ijeoma, Emma-Ukaegbu Uloaku, Ajuogu Eno, Osunkwo Damaris, Asinobi Adanze. (2015). Use of Telephone Calls in Reduction of Dropout Rate of Routine Immunization in a Tertiary Health Facility in South Eastern Nigeria. European Journal of Preventive Medicine, 3(3), 39-43. https://doi.org/10.11648/j.ejpm.20150303.11

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    ACS Style

    Nwokeukwu Huldah Ijeoma; Emma-Ukaegbu Uloaku; Ajuogu Eno; Osunkwo Damaris; Asinobi Adanze. Use of Telephone Calls in Reduction of Dropout Rate of Routine Immunization in a Tertiary Health Facility in South Eastern Nigeria. Eur. J. Prev. Med. 2015, 3(3), 39-43. doi: 10.11648/j.ejpm.20150303.11

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    AMA Style

    Nwokeukwu Huldah Ijeoma, Emma-Ukaegbu Uloaku, Ajuogu Eno, Osunkwo Damaris, Asinobi Adanze. Use of Telephone Calls in Reduction of Dropout Rate of Routine Immunization in a Tertiary Health Facility in South Eastern Nigeria. Eur J Prev Med. 2015;3(3):39-43. doi: 10.11648/j.ejpm.20150303.11

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  • @article{10.11648/j.ejpm.20150303.11,
      author = {Nwokeukwu Huldah Ijeoma and Emma-Ukaegbu Uloaku and Ajuogu Eno and Osunkwo Damaris and Asinobi Adanze},
      title = {Use of Telephone Calls in Reduction of Dropout Rate of Routine Immunization in a Tertiary Health Facility in South Eastern Nigeria},
      journal = {European Journal of Preventive Medicine},
      volume = {3},
      number = {3},
      pages = {39-43},
      doi = {10.11648/j.ejpm.20150303.11},
      url = {https://doi.org/10.11648/j.ejpm.20150303.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejpm.20150303.11},
      abstract = {Background: In Federal Medical Centre (FMC) Umuahia, DPT dropout rate has been high above 10% (2009 18% and 2010 16% source immunization unit Federal Medical centre, Umuahia) which indicates poor utilization of the Health Facility. It was therefore necessary to use recall telephone system to see if it could be reduced. Objectives: To determine the use of recall on and causes of immunization dropout. Methodology: This was an interventional study, in which all the children immunized in April 2011 who were given BCG to start the immunization regimen, were followed up until they completed the immunization with measles at nine months. Prior to this, dropout rate was calculated for three preceding months using the immunization register. The reason for dropout was obtained from the caregivers. The dropout rate was also calculated for the month of May. Result: The dropout rate reduced when compared with the previous months. Total number of children immunized with BCG in April 2011 was 119 and those who received DPT1 107, DPT2 96, DPT3 92 and measles 73. The cumulative DPT dropout rate in April was 14% while it was 20.8% in March. The most important cause of dropout was distance. Conclusion/ Recommendation: The recall improved the dropout rate, though not less than 10%. This showed that if the caregivers are recalled some will come back for immunization. The cause of the dropout was mainly distance. FMC Umuahia being a tertiary health facility with experts, many women put to birth in that hospital and their babies will be given BCG at birth and DPTI when they come for 6 weeks post natal and then dropout. Recall system should be instituted in all the health facilities to improve utilization. A column should be provided in the child immunization register for writing the caregivers phone number.},
     year = {2015}
    }
    

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  • TY  - JOUR
    T1  - Use of Telephone Calls in Reduction of Dropout Rate of Routine Immunization in a Tertiary Health Facility in South Eastern Nigeria
    AU  - Nwokeukwu Huldah Ijeoma
    AU  - Emma-Ukaegbu Uloaku
    AU  - Ajuogu Eno
    AU  - Osunkwo Damaris
    AU  - Asinobi Adanze
    Y1  - 2015/03/13
    PY  - 2015
    N1  - https://doi.org/10.11648/j.ejpm.20150303.11
    DO  - 10.11648/j.ejpm.20150303.11
    T2  - European Journal of Preventive Medicine
    JF  - European Journal of Preventive Medicine
    JO  - European Journal of Preventive Medicine
    SP  - 39
    EP  - 43
    PB  - Science Publishing Group
    SN  - 2330-8230
    UR  - https://doi.org/10.11648/j.ejpm.20150303.11
    AB  - Background: In Federal Medical Centre (FMC) Umuahia, DPT dropout rate has been high above 10% (2009 18% and 2010 16% source immunization unit Federal Medical centre, Umuahia) which indicates poor utilization of the Health Facility. It was therefore necessary to use recall telephone system to see if it could be reduced. Objectives: To determine the use of recall on and causes of immunization dropout. Methodology: This was an interventional study, in which all the children immunized in April 2011 who were given BCG to start the immunization regimen, were followed up until they completed the immunization with measles at nine months. Prior to this, dropout rate was calculated for three preceding months using the immunization register. The reason for dropout was obtained from the caregivers. The dropout rate was also calculated for the month of May. Result: The dropout rate reduced when compared with the previous months. Total number of children immunized with BCG in April 2011 was 119 and those who received DPT1 107, DPT2 96, DPT3 92 and measles 73. The cumulative DPT dropout rate in April was 14% while it was 20.8% in March. The most important cause of dropout was distance. Conclusion/ Recommendation: The recall improved the dropout rate, though not less than 10%. This showed that if the caregivers are recalled some will come back for immunization. The cause of the dropout was mainly distance. FMC Umuahia being a tertiary health facility with experts, many women put to birth in that hospital and their babies will be given BCG at birth and DPTI when they come for 6 weeks post natal and then dropout. Recall system should be instituted in all the health facilities to improve utilization. A column should be provided in the child immunization register for writing the caregivers phone number.
    VL  - 3
    IS  - 3
    ER  - 

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Author Information
  • Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria

  • Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria

  • Department of Community Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria

  • Department of Internal Medicine, National Hospital Abuja, Federal Capital Territory, Abuja, Nigeria

  • Department of Pediatrics, University College Hospital, Ibadan, Oyo State, Nigeria

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