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Background: Many vaccines are given more than once, at different ages, and in combinations. Parents are expected to retain immunization cardsfor their children, however in Ethiopia, the retention of child immunization cardsis minimal. For example, the 2005 and 2011 Ethiopian Demographic and Health Surveys showed that 37% and 29% of immunization cards, respectively, were retained. The CORE Group Polio Project developed an innovative approach to keeping home vaccination records for a long time and safely, in the form of a plastic bag designed to hold the immunization card. The pilot project for this innovation was held in GambellaRegion and AssosaZone, Benishangul-Gumuz Region since 2015. Objective: Evaluate the contribution of plastic bagsfor holding and retaining child immunization cards in Gambella Region and Assosa Zone, Benishangul-Gumuz Region. Methods: The study was a household-based cross-sectional survey and the target population was households with at least one child aged under 2 years who had received at least one vaccination dose. A sample of 239 households (120 from Gambella Region and 119 from Assosa Zone in Benishangul-Gumuz Region) were selected randomly from immunization registration records. Up to 12 kebeles were included from each region, with at least 10 children per kebele. Data were collected using an Amharic language questionnaire and analyzed with STATA version 13.0. Results: Of all 239 respondents, 139 (58.2%) received the plastic bag for retaining immunization cards, while 100 (41.8%) did not receive the bag. Of the139 respondents who received immunization cards, 125 (89.9%) utilized the plastic bag. Of those that utilized the bags to hold immunization cards, 50.4% were from Gambella Region and 49.6% were from Benishangul-GumuzRegion. A total of 125 (58.7%) respondents were presented with the immunization card inside the plastic bag, and 88 (41.3%) respondents received the immunization card with no accompanying plastic bag. However, of all respondents who received the plastic bag, 14 (10%) did not put the card inside it. The reasons given byrespondents were that it was difficult to put the card inside the plastic bag(seven cases, (58.3%)) and that itwas lost/damaged or used for some other purpose (five cases, (41.7%)).A total of 145(70%) respondents reported thatthey placed the plastic bag that contains the immunization card in a secure place, such as in a box, and 53 (25.6%) hung it ona wall. Conclusion: In general, there was 89.5% card retention; 90% of respondents utilized the plastic bag, and 88% of mothers said they would advise others to use the plastic bag.[Ethiop .J. Health Dev. 2019; 33(Special issue):31-36] Key words: Plastic bag, Immunization Card, Retention, Gambella and Benishangul Gumuz

Contribution of plastic bags to the retention of child immunization cards in Gambella Region and Assosa Zone, Benishangul-Gumuz Region, Ethiopia