National immunisation days for polio eradication in Uganda: did immunisation cards increase coverage?

Abstract

Objective: To analyse the effect of cards and of vitamin A supplementation on coverage for National Immunisation Days (NIDs).

Design: A retrospective ecological study.

Setting: A countrywide NIDs coverage before and after introduction of the NIDs cards and vitamin A supplementation in all districts of Uganda.

Methods: NIDs for polio eradication commenced in Uganda in 1996. Two rounds, one month apart are implemented yearly. During the second round of 1998 NIDs, cards were introduced nationally and vitamin supplementation was introduced in 24 of the 45 districts. We compared NIDs coverage before and after NIDs cards and NIDs coverage in districts that implemented vitamin A to those that did not.

Results: After introduction of NIDs cards, the national coverage rose from 97.7% to 106.9%, an increase of 9.2%. In those districts that implemented vitamin A supplementation, the NIDs coverage rose from 100.1% to 111.5%, an increase of 10.4%. In those districts that did not implement vitamin A, the NIDs coverage rose by 6.7% from 94.5% to 102.2%. Before the introduction of cards and vitamin A in 1996 and 1997, the NIDs coverage was between 92-96%.

Conclusion: NIDs cards and vitamin A supplementation could have increased the NIDs national coverage.

PIP: A retrospective ecological study was carried out to analyze the effect of cards and vitamin A supplementation on coverage for National Immunization Days (NIDs) in Uganda. Commenced in 1996, NIDs for polio eradication in Uganda are implemented twice a year, one month apart. During the second round of 1998 NIDs, cards were introduced nationally and vitamin A supplementation was introduced in 24 of the 45 districts. NIDs coverage before and after the introduction of cards and NIDs coverage in districts implementing and those not implementing vitamin A supplementation were compared. After introduction of NID cards, the national coverage increased by 9.2% (from 97.7% to 106.9%). In those districts that implemented vitamin A supplementation, a 10.4% rise in NIDs coverage was noted (from 100.1% to 111.5%). NIDs coverage in those districts that did not implement vitamin A supplementation rose from 94.5% to 102.2%, an improvement of 6.7%. Based on these findings, it was concluded that NIDs cards and vitamin A supplementation could have increased the NIDs national coverage.