The Current Situation Of Immunization Services In China

BackgroundImmunization service is an important content in essential public health service.It is also the main part of disease prevention and control work.The quality of immunization service is directly related to prevention and control effect of immune planning related infectious diseases.In recent years,immunization service work has made great progress in our country.And the major infectious diseases prevention and control work has made significant progress.However,there are also some problems,For example,some children do not vaccination timelyor even missing species.Some parents do not attach importance to vaccination or do not believe it.Understanding the practical problems existing in the immunization service plays an important role in improving the vaccination work.In 2015,the national health and Family Planning Commission CDC bureau authorized the national health and Family Planning Commission to research the disease control project of state's basic public health services.Based on the investigation of the disease control project in the essential public health service in 2015,this paper screened out the contents of the vaccination service,and studied the vaccination service in 6 regions of China.The rate of vaccination and the prevention and control of related diseases are important indicators for evaluation of vaccination services.The related facilities and equipment and the quality of the medical staff at the basic level are the important factors affecting the quality of vaccination.Understanding the situation of vaccination service and the satisfaction of the parents have great importance to find out problems in vaccination service.Therefore,this article aims to research our country vaccination service workfrom the above several aspectsmainly..ObjectTo understand the current situation of vaccination in China,including the current situation of vaccination,disease prevention and control,the difficulties and challenges faced by the grassroots vaccination institutions,immunization of children and children's parents satisfaction,etc.To find the problems and shortcomings of immunization service in our country,and to put forward some policy suggestions for improving vaccination service.Data and MethodPurposive sampling method was used in our study.We selected Beijing,Guangdong,Hubei China,Jilin,Yunnan,Xinjiang Province as the research sites,according to the administrative division,geographical distribution and the level of economic development,One county from each province was selected according to the level of GDP.Questionnaires,seminars and other methods were used to investigate the relevant institutions(the health and family planning administrative departments,technical guidance agencies,community health service centers/stations,township hospitals,village clinics)and the vaccination practitioners.A total of 1550 persons were investigated by a questionnaire which was about the quality of vaccination service and the satisfaction of parents of children,by the method of quality assurance sampling.EpiData3.02 was used to establish database.SPSS20.0 andExcel2013were used for data collation and statistical analysis.We used the rate or constituent ratio for the statistical description of enumeration data.?2 test was used for comparisonpercentages of different groups and t test or analysis of variance was used to compare mean values between different groups.Logistic regression was used to analysis the factors influencing children unvaccinated and parents' satisfaction of vaccination.Results1.The timely vaccination rate of the first dose of hepatitis B vaccine in newborn had fluctuations.Xinjiang was 5.35 percentage points lower than that in 2014,and Guangdong and Hubei were also slightly lower in 2014.Children's hepatitis B vaccine coverage rate of 6 provinces has reached more than 99%since 2012.The rate of measles vaccine containing second times in 6 provinces has reached more than 99%since 2013.Except Yunnan,there was a significant decline in the incidence of hepatitis B,but the incidence of hepatitis B in Guangdong(.146.81/100thousand),Hubei(104.91/100 thousand)and Xinjiang(166.62/100 thousand)is still high.In recent years,the incidence of measles is still showing a rising trend.The number of reported cases increased significantly,especiallythe rapid rise in the incidence of measles were more than 11/100 thousand in Beijing and Jilin in 2014,.In 2014,the classification rate of the investigation and diagnosis of the suspected abnormal reaction of vaccination in the province was much higher than that in the year of 2009,especially in Yunnan Province,which increased from 88.60%in 2009 to about 99.58%.2.Of the 34 institutions surveyed,the 82.35%was standardized outpatient department.The average housing area is 87.22 square meters among the six proviences,of which Jilin with the largest area of 120 square meters and Yunnan with the lowestarea of 60.5 square meters.On average,every institution has 4.06 refrigerators,1.18 ice lockers and 9.35 coolbags.3.82.25%of medical personnel engaged in vaccination were female.71.02%aged between 26 and 45;Post aspect,was consist of doctors(33.33%),nurses(14.49%),public health workers(41.67%)and others(10.51%).65.94%of the medical personnel engaged in vaccination had junior professional titles or no title,and 43.84%had qualifications of college education.We also found54.35%of medical personnel had3000yuanmonthly incomeand below.20.65%of medical personnel only engaged in preventive services while37.68%engaged in more than 6 kinds of public health services.Besides,18.48%of medical personnel thought guidanceof the higher institutions was lack or a serious shortage.There were 15.22%staff with low enthusiasm for services or even some conflict.4.Therate of building vaccination certificate among children was 98.97%.The vaccination card rate was 98.52%.97.81%pf the vaccination certificate and card were consistent.In6 research sites,the vaccination certificate rate,the vaccination card rate and the coincidence rate were all above 95%,but the three rate was the lowest in Hubei province.5.There were 184 cases of children in the 6 areas without vaccination,accounting for 11.87%.Theproportion of children with no vaccination was highest in Xinjiang(19.02%).Chi square test showed that the respondents' age,education,occupation,investigation type,building vaccination certificate or not,having vaccination card or not were factors influencing the2-6 years old children with no vaccination.Multivariate analysis showed that the respondents' age,occupation,having vaccination certificate or not,having vaccination card or not were factors influencing 2-6 years old children unvaccinated.6.Parental satisfaction with vaccination was highest in Xinjiang,but lowest in Hubei.From each item,thescore of overall satisfaction was highest(4.26 ±0.52),While the score of distance between home and the vaccination clinic(4.13 ±0.61)and the satisfaction of vaccination(4.13 ±0.63)was lowest.From the perspective of urban and rural areas,the overall satisfaction of parents in rural areas was higher than that in urban areas.Single factor analysis showed that the respondents' relationship with children,household register,notice of vaccination,waiting time,the time walk to the vaccination clinic,whether the medical staff tell the attention or not were the factors affecting the overall satisfaction of vaccination.The results of multivariate analysis showed that waiting time,and whether the medical staff tell the attention or not were the factors that affected the overall satisfaction of parents' vaccination services.SuggestionsAccording to the statistical analysis and research results,the author puts forward the following suggestions:1.Implementing multiple measuressimultaneously to reduce the phenomenon of vaccine leakage,and further improve the vaccination rate.2.Further playing the guiding role of professional institutions.3.Further enhancing the service ability.4.Strengthening the use and management of immunization vaccines and cold chain equipment to ensure the quality of vaccine.5.Accelerating the construction and management of vaccination information.6.Increasing the intensity of vaccination services.