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TRAINING NEEDS FOR MID-LEVEL MANAGERS AND IMMUNISATION COVERAGE IN WESTERN KENYA
Abstract
ABSTRACT
Objectives: To determine the current status of immunisation coverage in Western Kenya before
intervention, to identify strengths and weaknesses of the existing programme in order to design
educational interventions that could improve the services provided and find out the training needs
of the mid-level managers of Kenya Expanded Programme of Immunisation.
Design: Cross-sectional descriptive study.
Setting: All thirty nine districts in Rift Valley, Western and Nyanza provinces.
Subjects: Mid-level managers of Kenya Expanded Programme on Immunisation in the 39 districts
and the provinces. These included Provincial Logisticians, Provincial Medical Officers of Health,
District Medical Officers of Health, District Public Health Nurses, District Records and Health
Information Officers, District Disease Surveillance Officers, and District Public Health Officers.
Main outcome measures: Number of staff trained on EPI, coverage rates and perceived training
needs of the mid-level managers.
Results: A total of eighty eight mid-level managers participated in the interviews. Most of these
were District Public Health Nurses (40.9%) and District Health Information and Records Officers
(23.9%). Only 49 (25%) of the District Health Management Team members had undergone training at
the supervisory level. Eighteen districts (43.6%) had no member of the District Health Management
Team that had ever been trained at the supervisory level. Using rates of Pentavalent 1 and measles
coverage, Nyanza Province had the highest immunisation dropout rate (Pentavalent 1 – measles)
whereas Rift Valley Province had the lowest. The annual cumulative coverage for all the provinces
by antigen was 80% for Pentavalent 1 and 2 and 60% for measles. The most requested need for
inclusion in the training curriculum was maintenance of the cold chain equipment.
Conclusions: Most of the members in the study area have not been trained on Expanded Programme
on Immunisation and may be ill-equipped to manage the complicated programmes needed to
maximise delivery of services. The immunisation coverage in this area is low while the dropout
rates are high. We therefore recommend that all the mid-level managers of Expanded Programme
on Immunisation in this area be trained comprehensively through the Merck Vaccine Network
- Africa programme using the World Health Organisation approved mid-level managers course.
Objectives: To determine the current status of immunisation coverage in Western Kenya before
intervention, to identify strengths and weaknesses of the existing programme in order to design
educational interventions that could improve the services provided and find out the training needs
of the mid-level managers of Kenya Expanded Programme of Immunisation.
Design: Cross-sectional descriptive study.
Setting: All thirty nine districts in Rift Valley, Western and Nyanza provinces.
Subjects: Mid-level managers of Kenya Expanded Programme on Immunisation in the 39 districts
and the provinces. These included Provincial Logisticians, Provincial Medical Officers of Health,
District Medical Officers of Health, District Public Health Nurses, District Records and Health
Information Officers, District Disease Surveillance Officers, and District Public Health Officers.
Main outcome measures: Number of staff trained on EPI, coverage rates and perceived training
needs of the mid-level managers.
Results: A total of eighty eight mid-level managers participated in the interviews. Most of these
were District Public Health Nurses (40.9%) and District Health Information and Records Officers
(23.9%). Only 49 (25%) of the District Health Management Team members had undergone training at
the supervisory level. Eighteen districts (43.6%) had no member of the District Health Management
Team that had ever been trained at the supervisory level. Using rates of Pentavalent 1 and measles
coverage, Nyanza Province had the highest immunisation dropout rate (Pentavalent 1 – measles)
whereas Rift Valley Province had the lowest. The annual cumulative coverage for all the provinces
by antigen was 80% for Pentavalent 1 and 2 and 60% for measles. The most requested need for
inclusion in the training curriculum was maintenance of the cold chain equipment.
Conclusions: Most of the members in the study area have not been trained on Expanded Programme
on Immunisation and may be ill-equipped to manage the complicated programmes needed to
maximise delivery of services. The immunisation coverage in this area is low while the dropout
rates are high. We therefore recommend that all the mid-level managers of Expanded Programme
on Immunisation in this area be trained comprehensively through the Merck Vaccine Network
- Africa programme using the World Health Organisation approved mid-level managers course.
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