| Objectives1. To find out the rate of vaccination after certificate inspectingof new sutdents in primary school in Panzhihua City and the knowedge, attitude, practice(KAP) about vaccination certificate inspectingof the guardians.2. Explore the effect factors about vaccination after vaccination certificate checking,3. Put forward some suggestions about policies and measures.MethodsPrevalence survey was carried out, quantitative research and qualitative research were used in the investigation.1. Quantitative research:Stratified and cluster sampling was used in the quantitative questionnaire survey among guardians of grade one students of primary school in West District and Miyi county in 2010. Semi-closed questionnaire was designed by the researcher and was used in the investigation of the guardians.Different vaccination certificate inspecting modes were earried out in West District and Miyi County. A approach that schools inspected vaccination certificate and vaccine was replanted for children in the vaccination units (called Distributed Inoculation Mode)had been adopted in West District, while Miyi county used Centralized Inoculation Mode that the vaccination units inspected vaccination certificate in schools and set up temporary school inoculation points for regular catch-up vaccination.2. Qualitative research:Group interview were carried out among disease prevention and health care workers from country medical units. Personal interview were carried out among school doctors and class teachers who in charge of vaccination certificate checking, and the officers in charge of immune planning sections of the CDPC in the two counties were also interviewed.Results725 guardians were investigated,678 effective questionnaires were taken back. Among them 334 come from West District,344 from Miyi county. Two groups of disease prevention and health care workers from country medical units (17 persons) and 3 school doctors from West District,4 class teachers from Miyi county and 2 officers in charge of immune planning sections of the CDPC were interviewed.1.95.82% of guardians thought vaccination certificate inspection was necessary, and 91.67% of them thought vaccination was essential for preventing disease, and 79.44% thought the state should guarantee the safety of vaccine that must be inoculated to children.98.57% of the guardians expressed their willingness to bring children to replant vaccine, however, only 70.50% of them had actually done that.93.95% of guardians had showed vaccination certificate on school enrollment.2.534 of investigated children should be replanted once, and 370 of them completed the catch-up vaccination procedure, and the proportion was 69.29%.144 children should be replanted over 2 times, and 63 of them (43.75%) got the complete replant.607 of respondents'guardians had received the catch-up vaccination notice,89.53% of all, and 433 of them completed the catch-up vaccination procedure,71.33% of noticed guardians.3. The catch-up vaccination ratio in Distributed Inoculation Mode was relevant to the profession of guardians (χ2=6-318, P=0.012). The chief reasons that children hadn' t got the catch-up vaccination were un-noticed and time conflict between vaccination clinic schedule and guardian work hours.。4. The catch-up vaccination ratio in Centralized Vaccination Mode was relevant to residence location, relationship between children and their guardians (χ2=7.499, P=0.006;χ2=4.393, P=0.036). The chief reasons that children hadn't got the catch-up vaccination were un-noticed and "our children are too old to be inoculated, so it's not on our mind".5. Bivariate variables were analyzed with multiple logistic regression to describe the relationship of catch-up vaccination result and 3 factors(inspection and catch-up vaccination model, profession, needed replant doses).6. Seven school doctors were interviewed, result of the interview indicated that problems of vaccination certificate inspection and catch-up vaccination consisted of the lack of information of children vaccination, few attention of guardians, and that children catch-up vaccination detail could not be received timely. Seventeen country doctors said that education department showed no concern for vaccination certificate inspection, and that public health sector can't give enough support and there were conflicts between the vaccination time and the guardians' working time or the children's study time. Two officers of CDPC thought the lack of assessment and supports from the administrative departments were the chief difficults of vaccination certificate inspection.Conclusions1. The mode of certificate inspectingand vaccination is the chief factor that effects the rate of vaccination. The mode the medical units help the schools to check the certificates, a temporary vaccination spot and a specific time being set in the school can impove the rate of vaccination after certificate checking.2. The factors the guardians are indigene, have steady job, being the parents effects the rate of vaccination positively.3. When considering the conflict between the vaccination time and the guardians' working time or the children's study time, the guardians' view about the utility and safety of the vaccines, contradiction often happen between attitudes and behaviors in those who hold positive attitudes to the vaccination after certificate checking.4. The times of the vaccination after certificate inspectingeffect the rate of vaccination. As the times of vaccination after certificate inspectingarising, the rate of vaccination decreases.5. The schools do not communicate with the vaccination units adequately, that lead to the late feedback. This is also a factor that affects the rate of vaccination.Because the education department do not attach enough importance to the certificate inspectingand vaccination, the assessments by the educational administrative department becomes a mere formality, the schools are not initiative or careful about the work.6. The vaccination information and the certificate losing, acquiring multiple certificates at different places, these factors make inaccurate vaccination informations. It also leads to low rate of vaccination.7. The level the education administrative department pay attention to the work about certificate inspecting affects the activity of the school. The supports the health administrative department gives affect the attitude of the workers at the basic vaccination units.SuggestionsThe division of labor during the vaccination certification inspectingshould be improved between the education and health departments. The laws and regulations need perfection, to ensure the carrying out of the measures about vaccination certificate inspection. The united assessing system should be set up. The indexes of quality assessing should be established. The certificate inspecting and vaccination are suggested to carry out at the period of school entrance preparing. |
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