Remainder Imunisasi Pada Sistem Informasi Posyandu untuk Memantau Kelengkapan Imunisasi Rutin Anak di Masa Pandemi Covid-19

Pandemi Covid-19 membuat banyak orang tua telat bahkan tidak memberikan imunisasi rutin kepada anaknya karena takut akan terpapar virus jika mendatangi tempat pemberian imunisasi. Sesuai surat edaran Kemenkes 24 Maret 2020, pemerintah mewajibkan agar seluruh pelayanan kesehatan seperti Puskesmas dan Posyandu melaksanakan kegiatan pemberian imunisai sesuai dengan ketentuan dan proteksi kesehatan.Untuk membantu bidan dan kader posyandu dalam memantau imunisasi rutin anak,dibuatkanlah remainder imunisasi pada Sistem Informasi Posyandu. Metode Forward Chainning digunakan sebagai pelacak imunisasi dan Best First Search sebagai pencari penentuan keputusan untuk memunculkan remainder imunisasi secara otomatis. Rule imunisasi yang digunakan untuk pelacakan sesuai dengan aturan imunisasi rutin anak yang dikeluarkan oleh IDAI dan konsultasi dengan bidan sebagai pakar. Tanggal lahir anak digunakan sebagai acuan pelacakan sesuai dengan rule imunisasi rutin anak untuk memunculkan remainder imunisasi anak. Ujicoba yang dilakukan pada Sistem menggunakan blackbox testing dengan hasil semua fitur berfungsi dengan baik. Remainder imunisasi anak dapat membantu bidan dan kader untuk memantau imunisasi rutin anak di Posyandu khususnya saat pandemi Covid-19. Abstract The Covid-19 pandemic has made many parents late even not giving routine immunizations to their children for fear of being exposed to the virus if they come to the immunization site. According to the Ministry of Health circular letter March 24, 2020, the government requires that all health services such as Puskesmas and Posyandu carry out immunization activities in accordance with health provisions and protection. To assist midwives and posyandu cadres in monitoring routine child immunizations, immunization remainder are made in the Posyandu Information System. The Forward Chainning method is used as an immunization tracker and the Best First Search as a decision-making search to bring up the immunization remainder automatically. The immunization rules used for tracking are in accordance with the routine immunization rules for children issued by IDAI and consultation with midwives as experts. The child's date of birth is used as a tracking reference according to the routine child immunization rule to bring up the child immunization remainder. Tests carried out on the system use blackbox testing with the results of all features functioning properly. Child immunization remainder can help midwives and cadres to monitor routine immunizations for children at Posyandu, especially during the Covid-19 pandemic.

Impact of Eastern Congo Ebola Outbreak on Child Health Services Delivery: Decline of Routine Child Immunization and Need for Vaccine Supplementation

Background An Ebola disaster, the deadliest in the history of Ebola in the Democratic Republic of Congo (DRC), is unfolding in North Kivu and Ituri provinces. An interdisciplinary research team investigated the impact of the Ebolavirus disease (EVD) outbreak on vital health services delivery under the coordination of DRC National Vaccination Program, Ministry of Health. We report on the impact of the ongoing Eastern Congo EVD outbreak on routine child immunization in the EVD-affected in North Kivu province, DRC. Methods This was a retrospective longitudinal study consisting in a time-trend analysis that was conducted in 40 public health facilities that organize routine child immunization in four of the 34 ‘Health Zones’ of the North Kivu province, namely Beni, Butembo, Katwa and Mabalako. Data were collected during two distinct 3-month periods: the “pre-Ebola period” (1 May through July 2018) and the “Ebola period” (1 August through October 2018), to compare the vaccination trends. Mean number of vaccine doses administered in pre-Ebola and Ebola periods were compared (unpaired t test). Results Compared to the “pre-Ebola period”, overall monthly mean vaccines uptake dropped during the “Ebola period”: BCG (157.1 ± 150.3 vs. 227.5 ± 138.4; p<0.0001), Oral polio (OPV: 505.1 ± 474.6 vs. 631.3 ± 353.9; p<0.001), Measles vaccine (147.6 ± 126.7 vs. 184.7 ± 102.5; p<0.001), pneumoccocal vaccine (PCV13: 445.8 ± 395.5 vs. 554.3 ± 299.8; p<0.001) and inactivated polio vaccine (IPV: 183.9 ± 141 vs. 153.9 ± 146.6; p<0.01). Furthermore, when considering the trend in child immunization in each of the four Health Zones during ‘Ebola period’, vaccine uptake shrank considerably in most health zones, whereas a complete disruption of vaccine delivery was observed in Mabalako health zone where the epicenter of this outbreak is located. Conclusion The ongoing Ebola outbreak has a negative impact on child health services, routine vaccination in particular. Supplementary immunization coupled with the strengthening of routine child vaccination services should be implemented to address gaps in immunity among children in affected provinces and reduce the risk of other infectious diseases outbreaks. Keywords: Democratic Republic of Congo; Ebola virus disease; Child immunization; Outbreak.

Impact of Eastern Congo Ebola Outbreak on Child Health Services Delivery: Decline of Routine Child Immunization and Need for Vaccine Supplementation

Background An Ebola disaster, the deadliest in the history of Ebola in the Democratic Republic of Congo (DRC), is unfolding in North Kivu and Ituri provinces. An interdisciplinary research team investigated the impact of the Ebolavirus disease (EVD) outbreak on vital health services delivery under the coordination of DRC National Vaccination Program, Ministry of Health. We report on the impact of the ongoing Eastern Congo EVD outbreak on routine child immunization in the EVD-affected in North Kivu province, DRC. Methods This was a retrospective longitudinal study consisting in a time-trend analysis that was conducted in 40 public health facilities that organize routine child immunization in four of the 34 ‘Health Zones’ of the North Kivu province, namely Beni, Butembo, Katwa and Mabalako. Data were collected during two distinct 3-month periods: the “pre-Ebola period” (1 May through July 2018) and the “Ebola period” (1 August through October 2018), to compare the vaccination trends. Mean number of vaccine doses administered in pre-Ebola and Ebola periods were compared (unpaired t test). Results Compared to the “pre-Ebola period”, overall monthly mean vaccines uptake dropped during the “Ebola period”: BCG (157.1 ± 150.3 vs. 227.5 ± 138.4; p<0.0001), Oral polio (OPV: 505.1 ± 474.6 vs. 631.3 ± 353.9; p<0.001), Measles vaccine (147.6 ± 126.7 vs. 184.7 ± 102.5; p<0.001), pneumoccocal vaccine (PCV13: 445.8 ± 395.5 vs. 554.3 ± 299.8; p<0.001) and inactivated polio vaccine (IPV: 183.9 ± 141 vs. 153.9 ± 146.6; p<0.01). Furthermore, when considering the trend in child immunization in each of the four Health Zones during ‘Ebola period’, vaccine uptake shrank considerably in most health zones, whereas a complete disruption of vaccine delivery was observed in Mabalako health zone where the epicenter of this outbreak is located. Conclusion The ongoing Ebola outbreak has a negative impact on child health services, routine vaccination in particular. Supplementary immunization coupled with the strengthening of routine child vaccination services should be implemented to address gaps in immunity among children in affected provinces and reduce the risk of other infectious diseases outbreaks. Keywords: Democratic Republic of Congo; Ebola virus disease; Child immunization; Outbreak.

Impact of Eastern Congo Ebola Outbreak on Child Health Services Delivery: Decline of Routine Child Immunization and Need for Vaccine Supplementation

Background An Ebola disaster, the deadliest in the history of Ebola in the Democratic Republic of Congo (DRC), is unfolding in North Kivu and Ituri provinces. An interdisciplinary research team investigated the impact of the Ebolavirus disease (EVD) outbreak on vital health services delivery under the coordination of DRC National Vaccination Program, Ministry of Health. We report on the impact of the ongoing Eastern Congo EVD outbreak on routine child immunization in the EVD-affected in North Kivu province, DRC.Methods This was a longitudinal study conducted in 40 public health facilities that organize routine child immunization in four of the 34 ‘Health Zones’ of the North Kivu province, namely Beni, Butembo, Katwa and Mabalako. Data were collected during two distinct 3-month periods: the “pre-Ebola period” (1 May through July 2018) and the “Ebola period” (1 August through October 2018), to compare the vaccination trends. Mean number of vaccine doses administered in pre-Ebola and Ebola periods were compared (unpaired t test).Results Compared to the “pre-Ebola period”, overall monthly mean vaccines uptake dropped during the “Ebola period”: BCG (157.1 ± 150.3 vs. 227.5 ± 138.4; p<0.0001), Oral polio (OPV: 505.1 ± 474.6 vs. 631.3 ± 353.9; p<0.001), Measles vaccine (147.6 ± 126.7 vs. 184.7 ± 102.5; p<0.001), pneumoccocal vaccine (PCV13: 445.8 ± 395.5 vs. 554.3 ± 299.8; p<0.001) and inactivated polio vaccine (IPV: 183.9 ± 141 vs. 153.9 ± 146.6; p<0.01). Furthermore, when considering the trend in child immunization in each of the four Health Zones during ‘Ebola period’, vaccine uptake shrank considerably in most health zones, whereas a complete disruption of vaccine delivery was observed in Mabalako health zone where the epicenter of this outbreak is located.Conclusion The ongoing Ebola outbreak has a negative impact on child health services, routine vaccination in particular. Supplementary immunization coupled with the strengthening of routine child vaccination services should be implemented to address gaps in immunity among children in affected provinces and reduce the risk of other infectious diseases outbreaks. Keywords: Democratic Republic of Congo; Ebola virus disease; Child immunization; Outbreak.

Reasons for the Low Male Involvement in Routine Child Immunization in Hoima District Uganda using the Attitude, Social Influence and Self Efficacy Model

Millions of children continue to miss immunizations each year despite global increases in financing and advances in vaccine technology. Male involvement in routine child immunization activities could improve and sustain coverage but is rarely emphasized in immunization programs or research. This study identified factors associated with male involvement in routine child immunization using the attitude, social influence and self-efficacy model.A household cluster survey was conducted among 460 fathers aged 18 years or more, with children aged 10-23 months. A semi-structured interviewer-administered questionnaire was used to collect data. Prevalence Risk Ratios (PRRs) were used to measure associations with level of involvement using generalized linear models with Poisson family, log link and robust standard errors in STATA 12. Our findings show that half (51%, 236/460) of the respondents were aged 25-34 years; 36% (166/460) had completed eight or more years of formal education. Although90% (415/460) of the respondents were willing to be involved, only 29% (133/460) were highly involved in routine child immunization. Highly involved fathers had a positive attitude towards involvement in routine child immunization (adj. PRR 2.3, 95% CI 1.18 – 4.98) and were ≥45 years adjusted prevalence risk ratio (adj. PRR) 2.0, 95% confidence interval (CI) 1.15 - 3.76. Traders had a lower involvement compared to those engaged in other occupations (adj. PRR 0.55, 95% CI: 0.37 - 0.82). In conclusion, few fathers were involved in routine child immunization. Strategies to improve fathers’ positive attitude such as health education are needed to increase their involvement, specifically targeting younger fathers and traders.