Document Detail


Integration of routine vaccination and hygiene interventions: a comparison of 2 strategies in Kenya.
MedLine Citation:
PMID:  22315389     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hygiene interventions reduce child mortality from diarrhea. Vaccination visits provide a platform for delivery of other health services but may overburden nurses. We compared 2 strategies to integrate hygiene interventions with vaccinations in Kenya's Homa Bay district, 1 using community workers to support nurses and 1 using nurses.
METHODS: Homa Bay was divided into 2 geographical areas, each with 9 clinics. Each area was randomly assigned to either the nurse or community-assisted strategy. At infant vaccination visits hygiene kits were distributed by the nurse or community member. Surveys pre- and post-intervention, measured hygiene indicators and vaccination coverage. Interviews and focus groups assessed acceptability.
RESULTS: Between April 2009 and March 2010, 39 158 hygiene kits were distributed. Both nurse and community-assisted strategies were well-accepted. Hygiene indicators improved similarly in nurse and community sites. However, residual chlorine in water changed in neither group. Vaccination coverage increased in urban areas. In rural areas coverage either remained unchanged or increased with 1 exception (13% third dose poliovirus vaccine decrease).
CONCLUSIONS: Distribution of hygiene products and education during vaccination visits was found to be feasible using both delivery strategies. Additional studies should consider assessing the use of community members to support integrated service delivery.
Authors:
Tove K Ryman; Elizabeth C Briere; Emily Cartwright; Karen Schlanger; Kathleen A Wannemuehler; Elizabeth T Russo; Steve Kola; Ibrahim Sadumah; Benjamin L Nygren; Cliff Ochieng; Robert Quick; Margaret L Watkins
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of infectious diseases     Volume:  205 Suppl 1     ISSN:  1537-6613     ISO Abbreviation:  J. Infect. Dis.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-08     Completed Date:  2012-03-22     Revised Date:  2012-05-14    
Medline Journal Info:
Nlm Unique ID:  0413675     Medline TA:  J Infect Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S65-76     Citation Subset:  AIM; IM    
Affiliation:
Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-A05, Atlanta, GA 30307, USA. tryman@cdc.gov
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MeSH Terms
Descriptor/Qualifier:
Acquired Immunodeficiency Syndrome / prevention & control
Community Health Services
Delivery of Health Care, Integrated* / economics
Humans
Hygiene*
Kenya
Quality of Health Care
Vaccination*
Water Quality

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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