| BackgroundRoutine Immunization Coverage Ratesurveillanceis the basis of immunization program. True and reliable data of immunization rates is conducive to evaluate the completion of routine immunization of school age children for departments of disease control and health administrations at all levels, to find out problems timely, and then take measures to improve and maintain high levels of vaccination rate. At present, the timeliness, completeness and accuracy of the reporting rate were used to evaluate the Routine Immunization Coverage Ratesurveillance. Vaccination rate survey, the value of Difference and Ratio were used to conduct quality assessment. And, up to date, there is no comprehensive methods to assess the quality of routine immunization coverage in our country. The immunization data quality audit (DQA) and the immunization data quality self-assessment(DQS) tool recommended by WHO were used to determine the reliable of the Routine Immunization Coverage Rate monitoring system and evaluate the quality of immunization service. We aimed to solve the problem of overestimation of the routine immunization rate and inaccurate of number of people to be vaccinated, to improve the quality of Routine Immunization Coverage Rate monitoring system, and to explore a suitable quality assessment tool for specific vaccinate unite in china on the basis of the methods of DQA and DQS explored by WHO, and then to evaluate the quality of routine immunization coverage rate in China and reflect the quality accurately.ObjectTo explore the sensitivity and applicability of the evaluation indicators and obtai n proper indicators and method for our country through comprehensive assessment of surveillance data in study area.MethodsThe reports and situation of immunization coverage in our country and the application of DQA and DQS developed by WHO was collected from literature. And the proper method to evaluate immunization coverage quality was established by applying the Delphi method. After that the designed questionnaire has provided the related data of investigation area covering the Eastern, central and western provinces. And we used Excel and SAS 9.3 to disposing and analyze evaluation indicators. Finally quality of routine immunization coverage surveillance was evaluated by the method of TOPSIS in different area.Results1. The evaluation indicatorsThe research has precisely, selected eleven indicators as the evaluation index in the method of routine immunization coverage rate surveillance quality, including integrity and timeliness rates of the immunization report, verification factor, accuracy of appointment, reliability factor, reliability of immunization cards and vaccination certificate, quality Index, consistency of basis coverage information and vaccine history, drop-out rate of immunization.2. The results of the each evaluation indicators.2.1. The integrity and timeliness rates of the immunization report both are 100%.2.2 The veracity indicator of immunization coverage data is the verification factor. The values of VF rank (from high to low) was Shangyu/Xiangfang/Tongzhi, Luodian village/Luodian/Qianjiang. There were significant differences in the different villages with statistical meanings(Z=74.51, P<0.01).2.3The veracity indicator of immunization coverage is the reliability factor. The values of RF rank (from high to low) was Luodian village, Luodian/Tongzhi, Qianjiang/Xiangfang. The value of Luodian was higher than Shangyu’s. No statistically significant difference in Shangyu and other four village. There were significant differences in the different villages with statistical meanings(Z=375.50, P <0.01).2.4 The record of routine immunization coverage consist of consistency of basis coverage information, consistency of vaccine history, reliability of immunization cards and reliability of vaccination certificate.The values of consistency of basis coverage information rank (from high to low) was xiangfang/Tongzhi, Qianjiang/Luodian village, Luodian/shangyu. There were significant differences in the different villages with statistical meanings(Z=90.52,P< 0.01).The values of consistency of vaccine history rank (from high to low) was Xiangfang/Tongzhi, Qianjiang/Luodian village, Luodian and Shangyu. There were significant differences in the different villages with statistical meanings(Z=85.61, P< 0.01).The values of reliability of immunization cards rank (from high to low) was Xiangfang/Tongzhi, Qianjiang/Luodian village, Luodian and Shangyu. There were significant differences in the different villages with statistical meanings(Z=71.78, P< 0.01).The values of reliability of vaccination certificate rank (from high to low) was Xiangfang/Tongzhi, Qianjiang, Luodian village/Luodian and Shangyu. There were significant differences in the different villages with statistical meanings(Z=97.72, P< 0.01).2.6The value of drop-out rate rank (from low to high) was Shangyu, Qianjiang, Xiangfang, Tongzhi/Luodian, Luodian village. There were significant differences in the different villages with statistical meanings(Z=163.15, P<0.05).Conclusions1. The indicators including quality Index, verification factor, accuracy of appoint ment, reliability factor, drop-out rate of immunization, reliability of immunization car ds and vaccination certificate, the consistency of vaccination history and basis inform ation could detect the problem of the routine immunization coverage surveillance syst em. So these factors should into the evaluation system. And we suggest the integrity a nd timeliness rate of the immunization report were removed evaluation system, becau se the indicators could not detect the deeply problems.2.we suggest external experts assess the quality of vaccination, and the all factors of QI should use the form of quantization to assess the immunization coverage.3. TOPSIS method could applicable to the evaluation system of routine immuniz ation coverage surveillance. |
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