Vaccination coverage of children aged 12-23 months in Gaziantep, Turkey: comparative results of two studies carried out by lot quality technique: what changed after family medicine?

Vaccination coverage survey - Publication

abstract: Background Health care systems in many countries are

changing for a variety of reasons. Monitoring of community-based

services, especially vaccination coverage, is important during

transition periods to ensure program effectiveness. In 2005, Turkey

began a transformation from a “socialization of health services”

system to a “family medicine” system. The family medicine system

was implemented in the city of Gaziantep, in December, 2010.

Methods Two descriptive, cross-sectional studies were conducted in

Gaziantep city center; the first study was before the transition to

the family medicine system and the second study was one year after

the transition. The Lot Quality Technique methodology was used to

determine the quality of vaccination services. The population

studied was children aged 12–23 months. Data from the two studies

were compared in terms of vaccination coverage and lot service

quality to determine whether there were any changes in these

parameters after the transition to a family service system. Results

A total of 93.7% of children in Gaziantep were fully vaccinated

before the transition. Vaccination rates decreased significantly to

84.0% (p <0.005) after the family medicine system was

implemented. The number of unacceptable vaccine lots increased from

5 lots before the transition to 21 lots after the establishment of

the family medicine system. Conclusions The number of first doses

of vaccine given was higher after family medicine was implemented;

however, the numbers of second, third, and booster doses, and the

number of children fully vaccinated were lower than before

transition. Acceptable and unacceptable lots were not the same

before and after the transition. Different health care personnel

were employed at the lots after family medicine was implemented.

This result suggests that individual characteristics of the health

care personnel working in a geographic area are as important as the

socioeconomic and cultural characteristics of the

community.