Evaluation of the National Vaccination Crusade 1985

Context:

In 1985, the second National Vaccination Crusade in Colombia was carried out. An analysis of the achievements reached in 1984 showed coverage superior to 80% with Polio, Measles and DPT vaccines in children two and three years old. There was however, persistence of immunisation-preventable diseases included in the Expanded Programme on Immunisation (EPI) in general in children under five years old. The Ministry of Health set the 1985 vaccination goals at 80% of the susceptible children under two years old for Polio, Measles and DBT and at 30% of the women of fertile age in endemic zones for Neonatal Tetanus, corresponding to 343,499 women of 15 to 44 years old.



Methodology:

The responsibility and direction of the assessment of the National Days of Vaccination of 1985 were under the auspices of the Office of Planning of the Ministry of Health, which formed for this aim an integrated operations group, with functionaries from the Directors of Investigations, Epidemiology, Medical Attention and Office of Planning.

In order to compile the information for the evaluation, a system of data collection through several standard forms was designed. This facilitated the identification of problems and difficulties during the evaluation process in order to make the corrective measures necessary to improve the operation of the future Crusades in all the aspects. Surveys were distributed to the members of the committees, the coordinators of the Crusade and the vaccination services users.

The system of data collection included the flow of the initial data directly from the local and sectional level, to the central level where the information was processed and consolidated.

With the purpose of identifying the influence of media on the spreading of the information about the Crusade, the degree of knowledge of the community about the vaccination and the behaviour related to the regular programme, some specific questions were included in an opinion survey that was offered to the intended population only during the third day of the Crusade.

Knowledge of the community on vaccination:

Education on the importance of vaccination in order to avoid diseases was high. 82.3% of the population considered it important (78.8% of the residents of rural areas and 82.9% for the urban zone). This was in contrast to those who declared they did not know what vaccines were for: 2.7% for the total, 2.4% in urban zone and 4.2% in the rural area.



Behaviour of the community about routine vaccination:

Regarding the main reasons the community did not use the ordinary service of vaccination offered by the health agencies, the results of the survey show diverse opinions. In the countryside, the difficulty of accessibility stood out, as well as the availability of time and the distance to the vaccination locations, as well as the lack of vaccines in the institutions.



Fulfilment of goals:

In children younger than one year the achievement of the goals was less than 50%, being at national level 43.5% for DPT, 44.5% for Polio and 33.5% for Measles vaccines. Several departments did achieve greater than 70%, with all three vaccines in Huila and Guainía, with DPT and Polio vaccines in Guajira and Magdalena and with Polio vaccines in Caldas.



In the group of children one year old, the situation is very similar at the national level, except with respect to the Measles vaccine, which was just 58.9% of the goal. More than 70% of the one year old population was reached with the three vaccines by departments of Atlantic, Bolivar, Huila, Magdalena and Sucre.

Although the fulfilment of the goal with Tetanic Toxoide in endemic zones was acceptable at a national level (70.2%), this result is not homogenous in different Sections; the departments of Atlantic and Norte de Santander exceeded 100% considerably, elevating the national average, whereas others like Cordoba, Chocó, Nariño and Tolima did not reach 30%.



In the rest of the zones of the country, the fulfilment was an average of 97% with variations from 31.1% in Guaviare, to 160.9% in Bolivar.