National EPI coverage survey report in Ethiopia, 2006

Background: Routine EPI reports have shown an upward trend in immunization coverage in recent years in Ethiopia, however, regional disparities exist. Objective: To determine regional coverage of child and TT immunization and assess reasons for not utilizing immunization services. Methods: The revised 2005 WHO-EPI regional coverage cluster survey method was used to determine the sample size for the study. Regional immunization status of 12-23 months of children and mothers with 0-11 months of infants for child immunization and TT immunization respectively were taken as the unit of analysis. A sample of 6,903 children between 12-23 months and 6,952 mothers with infants between 0-11 months from 468 clusters in 11 regions of the country were surveyed in June 2006. Results: The weighted national immunization coverage assessed by card plus history for children aged 12-23 months vaccinated before the age of one year was BCG 83.4%, DPT1 84.3%, DPT3 66.0%, measles 54.3%, and fully immunized children 49.9%. The weighted national TT2+ coverage and rate of Protection at Birth (PAB) assessed by card plus history was 75.6% and 63.0% respectively. Conclusion: The survey showed a 10 percentage point of increment in DPT3 coverage compared to 2001 survey coverage. However, progress was not uniform in all regions of the country. Despite the improvement in the access to immunization in the country, DPT3 coverage was less than 30% and dropout rate remained very high in three emerging regions. Effective behavioral change communication (BCC) strategies need to be designed and implemented to tackle high dropout rate in the program. Besides, health workers training program on interpersonal communication and Reaching Every District (RED) approach should be fully implemented to increase and sustain high level of immunization coverage in Ethiopia. [Ethiop.J.Health Dev. 2008;22(2):148-157]