Journal Article

Implementing WHO guidance on conducting and analysing vaccination coverage cluster surveys: Two examples from Nigeria

Okposen, Bassey, Wagai, John Ndegwa, Prier, Mary, Trimmer, Mary Kay, Cutts, Felicity, Adeniran, Adeyemi, Oteri, Joseph, Clary, Caitlin B., Danovaro-Holliday, Carolina, Rhoda, Dale

2021

Overview

In 2015, the World Health Organization substantially revised its guidance for vaccination coverage cluster surveys (revisions were finalized in 2018) and has since developed a set of accompanying resources, including definitions for standardized coverage indicators and software (named the Vaccination Coverage Quality Indicators—VCQI) to calculate them.–The current WHO vaccination coverage survey manual was used to design and conduct two nationally representative vaccination coverage surveys in Nigeria–one to assess routine immunization and one to measure post-measles campaign coverage. The primary analysis for both surveys was conducted using VCQI. In this paper, we describe those surveys and highlight some of the analyses that are facilitated by the new resources. In addition to calculating coverage of each vaccine-dose by age group, VCQI analyses provide insight into several indicators of program quality such as crude coverage versus valid doses, vaccination timeliness, missed opportunities for simultaneous vaccination, and, where relevant, vaccination campaign coverage stratified by several parameters, including the number of previous doses received. The VCQI software furnishes several helpful ways to visualize survey results. We show that routine coverage of all vaccines is far below targets in Nigeria and especially low in northeast and northwest zones, which also have highest rates of dropout and missed opportunities for vaccination. Coverage in the 2017 measles campaign was higher and showed less geospatial variation than routine coverage. Nonetheless, substantial improvement in both routine program performance and campaign implementation will be needed to achieve disease control goals.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Biology and Life Sciences / Charities / Child, Preschool / Cluster Analysis / Clusters / Disease control / Epidemiology / Evaluation / Guidelines as Topic / Humans / Hygiene / Immunization / Immunization Programs - methods / Immunization Programs - standards / Indicators / Infant / Infectious diseases / Laws, regulations and rules / Mathematical analysis / Measles / Measles - prevention & control / Measles Vaccine - administration & dosage / Medicine and Health Sciences / Nigeria / People and Places / Polls & surveys / Practice guidelines (Medicine) / Primary care / Public health / Quality control / Research and Analysis Methods / Software / Surveys and Questionnaires / Vaccination / Vaccination Coverage - methods / Vaccination Coverage - standards / Vaccines / World Health Organization