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. 2023 Mar 27;23(1):568.
doi: 10.1186/s12889-023-15499-w.

Impact of a performance monitoring intervention on the timeliness of Hepatitis B birth dose vaccination in the Gambia: a controlled interrupted time series analysis

Alieu Sowe  1   2 , Fredinah Namatovu  3 , Bai Cham  4   5 , Per E Gustafsson  3
Affiliations

Impact of a performance monitoring intervention on the timeliness of Hepatitis B birth dose vaccination in the Gambia: a controlled interrupted time series analysis

Alieu Sowe et al. BMC Public Health. .

Abstract

Introduction: The Hepatitis B virus that can cause liver cancer is highly prevalent in the Gambia, with one in ten babies at risk of infection from their mothers. Timely hepatitis B birth dose administration to protect babies is very low in The Gambia. Our study assessed whether 1) a timeliness monitoring intervention resulted in hepatitis B birth dose timeliness improvements overall, and 2) the intervention impacted differentially among health facilities with different pre-intervention performances.

Methods: We used a controlled interrupted time series design including 16 intervention health facilities and 13 matched controls monitored from February 2019 to December 2020. The intervention comprised a monthly hepatitis B timeliness performance indicator sent to health workers via SMS and subsequent performance plotting on a chart. Analysis was done on the total sample and stratified by pre-intervention performance trend.

Results: Overall, birth dose timeliness improved in the intervention compared to control health facilities. This intervention impact was, however, dependent on pre-intervention health facility performance, with large impact among poorly performing facilities, and with uncertain moderate and weak impacts among moderately and strongly performing facilities, respectively.

Conclusion: The implementation of a novel hepatitis B vaccination timeliness monitoring system in health facilities led to overall improvements in both immediate timeliness rate and trend, and was especially helpful in poorly performing health facilities. These findings highlight the overall effectiveness of the intervention in a low-income setting, and also its usefulness to aid facilities in greatest need of improvement.

Keywords: Birth dose; Hepatitis B; Intervention; Timeliness; Vaccination.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Study period showing pre- and post-intervention times for both intervention and control health facilities
Fig. 2
Fig. 2
A comparison of mean hepatitis B vaccination timeliness in intervention and control health facilities, 2019—2020
Fig. 3
Fig. 3
Graphs of hepatitis B vaccination timelines intervention and control health facilities, February 2019 – December 2020, The Gambia
See this image and copyright information in PMC

References

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