RESUMEN
PIP: In November 1988, nursing students at Khon Kaen University in northeast Thailand conducted a baseline survey in 16 villages before a retraining program for village health workers began. It consisted of a 1-week intensive training program and meetings between officers and village health workers. The goal was to achieve full immunization coverage for children under 5. After retraining, the workers implemented their health education and immunization recruitment programs with a refresher course 4 months later. The nursing students conducted a follow-up survey in June 1989 so researchers could compare the effects of the 8 intervention villages with data collected in the 8 control villages. The intervention indeed brought about improvement in immunization coverage, mother's and health worker's knowledge, and health worker participation in program planning and coordination in the case villages. For example, full immunization coverage among children under 1 increased from 65% to 89% while in the control villages it remained at 56%. It also increased among children over 5 (30-81%) but in the control villages it only rose slightly (23-31%). The percentage of mothers who were very knowledgeable about infectious diseases increased from 1% to 8% yet in the control villages it decreased from 2% to 0. Mothers with high level of knowledge about immunization was higher in the 2nd survey in both groups, but the increase was greater in the intervention villages (12-33% vs. 14-21%). High level of knowledge about infectious diseases among health workers grew considerably (3-72%) in the case villages but in the control villages it decreased from 10% to 2%. In addition, health workers in the case villages improved their contact with health officers but not those in the control villages (47-64% vs. 70-36%). Program participation increased in the intervention villages (11-36%) but fell in the control villages (22-13%).^ieng
Asunto(s)
Agentes Comunitarios de Salud/educación , Inmunización , Preescolar , Educación en Salud , Humanos , Lactante , Manuales como Asunto , Madres/educación , TailandiaRESUMEN
PIP: As every year 5 million children die in developing countries because of infectious diseases, the government of Thailand in 1976 initiated an expanded program for immunization. Although vaccine coverage of the under 1 year of age population with BCG, diphtheria, pertussis, and tetanus is over 80%, the dropout rates are high and over 40% are without complete immunization. The availability and accessibility of immunization and the efficacy of health care delivery is analyzed. Group sessions were carried out with mothers of children under 4, with village health communications (VHCs) and village health volunteers (VHVs). 2 provinces with the highest immunization coverage and 2 with the lowest were selected. 608 women from 16 villages provided the sample as well as a total of 128 VHVs and VHCs. Distance to health center showed a significant relationship with completion of immunization (in contrast to travel time). The rate of complete immunization was higher for those who received regular information from VHVs and VHCs and who themselves contacted this personal than for those who never contacted the VHVs and VHCs. The most important factor of completion of immunization was the VHV/VHC contact. High immunization areas were highly correlated with high level of VHV/VHC knowledge about infectious diseases. The frequency of VHV/VHC reporting to subdistrict health officers also increased immunization coverage. Household visits were utilized by 54.6% of VHVs and VHCs in high immunization areas and by 15/7% only in low average areas. In high coverage areas, 13% of them were not instructed about dissemination of information as compared with 27.4% of them in low immunization areas. The 2nd phase of the study will consist of the measurement of intervention impact on immunization acceptance.^ieng