The non continuity of the vaccination schedule for children registered in the family health strategy units

Objective: identifying the factors associated to non-continuity of the vaccination schedule in children under 1 year old. Method: an exploratory, cross-sectional, descriptive and of a quantitative approach carried out from January to March 2012. The sample included 130 mothers/ caretakers of children under one year old. The data collection instrument consisted of 28 questions. The research project was approved by the Research Ethics Committee, Protocol 167/11. Results: it was found in the interviews that the responsible for leading the child to the FHS was 100% female figure, where most were aged between 19-33 years old (58,46%), married (74,62) and of home (61,54%). The lack of immunobiological in the unit was responsible for 35,38% of the difficulties encountered by mothers/caregivers to vaccinate the child. Conclusion: the factors associated with non-vaccination are: the low maternal education, the lack of knowledge of them about the real importance of vaccination and low family income. Descriptors: Vaccination; Family Health Program; Nursing; Immunization Programs; Public Policies. RESUMO Objetivo: verificar os fatores associados a não continuidade do esquema vacinal em crianças menores de 1 ano. Método: estudo exploratório, transversal, descritivo, de abordagem quantitativa, realizado no período de janeiro a março de 2012. A amostra compreendeu 130 mães/cuidadoras de crianças menores de um ano. O instrumento de coleta de dados foi composto por 28 perguntas. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, Protocolo 167/11. Resultados: verificou-se nas entrevistas que o responsável por conduzir a criança até a ESF foi 100% a figura feminina, onde a maioria possuía faixa etária entre 19 a 33 anos (58,46%), eram casadas (74,62) e do lar (61,54%). A falta de imunobiológico na unidade foi responsável por 35,38% das dificuldades encontradas pelas mães/cuidadoras para vacinar a criança. Conclusão: os fatores associados a não vacinação são: a baixa escolaridade materna, falta de conhecimento das mesmas sobre a importância real da vacinação e a baixa renda familiar. Descritores: Vacinação; Programa Saúde da Família; Enfermagem; Programas de Imunização; Políticas Públicas. RESUMEN Objetivo: identificar los factores asociados a la no continuidad del programa de vacunación en niños menores de 1 año de edad. Método: un estudio exploratorio, transversal, descriptivo y de enfoque cuantitativo realizado entre enero y marzo de 2012. La muestra incluyó a 130 madres/ cuidadores de niños menores de un año. El instrumento de recolección de datos consistió en 28 preguntas. El proyecto de investigación fue aprobado por el Comité de Ética en la Investigación, Protocolo 167/11. Resultados: se encontró en las entrevistas que el responsable de dirigir al niño a la ESF fue del 100% la figura femenina, donde la mayoría tenía entre 19 a 33 años (58,46%) estaban casadas (74,62) y del hogar (61,54%). La falta de inmunobiológicos en la unidad era responsable de 35,38% de las dificultades encontradas por las madres/cuidadores para vacunar a los niños. Conclusión: los factores asociados con la no vacunación son la baja educación materna, la falta de conocimiento de las mismas sobre la verdadera importancia de la vacunación y los bajos ingresos familiares. Descriptores: Vacunación; Programa Salud de la Familia; Enfermería; Programas de Inmunización; Políticas Públicas. Egressed Nurse, Faculty ASCES. Caruaru (PE), Brazil. Email: annekaroliny_2@hotmail.com; Egressed Nurse, Faculty ASCES. Caruaru (PE), Brazil. Email: carlaquirino@yahoo.com.br; Egressed Nurse, Faculty ASCES. Caruaru (PE), Brazil. Email: gabriellylais18@gmail.com; Nurse, Master of Mother and Child Health. Caruaru (PE), Brazil. Email: weslla19@hotmail.com; Nurse, Master of Nursing. Caruaru (PE), Brazil. Email: samira.almeida@ig.com.br ORIGINAL ARTICLE Cavalcante AKM, Paula WA de, Quirino et al. The non continuity of the vaccination schedule... English/Portuguese J Nurs UFPE on line., Recife, 9(Suppl. 3):7644-55, Apr., 2015 7645 ISSN: 1981-8963 DOI: 10.5205/reuol.7049-61452-1-ED.0903supl201518 Vaccination is an integrated and routine action of health services, belonging to the primary care level and of great effect on general conditions of child health, representing one of the greatest advances in medical technology in recent decades, becoming the most cost procedure and effectiveness in the health sector. Vaccines prevent illness and death of millions of people annually, representing the intervention with more cost-effective. Nevertheless, about two million children die each year from vaccine-preventable diseases. In recent years Brazil has been showing a significant reduction with respect to infant mortality rate (IMR). A recent report published by the Brazilian Institute of Geography and Statistics (IBGE) showed that between the years 2000-2010 IMR fell from 29,7 ‰ to 15,6 ‰, representing a decrease of 47,6% over the past decade. A decrease of 58,6%, the Northeast led the decline in infant mortality rates in the country, from 44,7 to 18,5 deaths of children under one year per thousand live births, although still the region with the greatest indicator. Among the proposed interventions to reducing the infant mortality rate, stands out the immunization of children, which was developed in Brazil, the Expanded Program on Immunization (EPI), created in 1974 by the World Health Organization (WHO), being regulated in 1975, when established the National Immunization Program (NIP). PNI is a key player in the control of communicable diseases; it combines routine immunization, national immunization days, periodic campaigns and epidemiological surveillance. The child assistance programs based on immunization were reinforced by several projects developed by the Ministry of Health (MOH), for example, the Integral Assistance Program for Children's Health (PAISC), which addresses as one of its goals to increase vaccination coverage levels in accordance with the technical standards of the Ministry of Health. Vaccinate children from the first months of age is an action of specific protection against serious diseases, causing permanent or lethal damage; therefore, children of vaccination results in improved health status of a community, at her reflection in health indicators, especially in the infant mortality rate. To achieve the goal of increasing such vaccination coverage levels, there is an alternative to Primary Health Care (PHC), commonly used term to refer to the level of most elementary attention of a health care system, which provides a set of services and actions that can affect positively on most of the health needs of a population. This level of service has been considered as the "gateway" of the health system, from where it would establish relations with average levels and high complexity, taking it as an important representative of the Family Health Strategy (FHS), described as a set of health actions in the individual and collective level, covering the promotion and health protection, disease prevention, diagnosis, treatment, rehabilitation and health maintenance. Responsibility for the vaccination of the population of a region belonging to a basic health unit/ BHU, should not be restricted solely to health team members who administer the vaccines; either, the child's vaccination should occur only when the mother or guardian attends the health service for this purpose. It becomes essential that all components of a health care team should be prepared to contribute to the success of a vaccination plan; taking advantage of every opportunity to implement the level of immunization of the susceptible population makes it necessary to resort to home visits to the active search for missing cases, reintegrating them to the local immunization program. Some factors have been associated with non-continuity of the vaccine program among them shows up parental resistance due to beliefs or even fear of vaccine reactions, absence of ACS in micro-areas covered by the FHS, forgetfulness/daily difficulties of caregivers, lack of proper guidance by the health team, low socioeconomic status added yet, the large amount of children. However, scientific publications are scarce on the subject, in particular, regional studies. Against this background and in view of the contributions that this information can provide managers and health professionals justified this study. ● Checking the factors associated with the non-continuity of the vaccination schedule in children under 1 year old. Article compiled from the Work Course Conclusion << Factors associated with lack of continuity of the vaccination schedule in children under one year old enrolled in the Family Health Strategy units in the city of METHOD OBJECTIVE INTRODUCTION Cavalcante AKM, Paula WA de, Quirino et al. The non continuity of the vaccination schedule... English/Portuguese J Nurs UFPE on line., Recife, 9(Suppl. 3):7644-55, Apr., 2015 7646 ISSN: 1981-8963 DOI: 10.5205/reuol.7049-61452-1-ED.0903supl201518 Caruaru-PE >> presented at the end of the Graduate Nursing Faculty ASCES; Caruaru PE, Brazil. 2012. An exploratory, cross-sectional, descriptive and of a quantitative approach study, whose sample included 130 mothers/caregivers of children under one year assisted by FHS units resident in Caruaru-PE municipality, and addressed 91 in urban areas and 39 rural. For the sample selection, it was considered as a criterion for inclusion mothers or caretakers of children under one year old with incomplete immunization and they were registered in the units of the Family Health Strategy (FHS), and excluded those who did not have family record in these health facilities. Data collection occurred from January to March 2012 and occurred in the FHS, while the mothers /caregivers and their children wait time of a routine visit and during home visits. We used structured instrument with 28 questions which were about the socioeconomic, demographic