Immunization coverage in Mozambique: From concepts to decision-making

• Published in: Health policy (Amsterdam) 2006-11, Vol.79 (1), p.92-100
• Main Authors: de Timóteo Mavimbe, João Carlos, Muquingue, Humberto Nelson, Braa, Jørn, Bjune, Gunnar
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Community Health Planning - organization & administration; Community health services; Data analysis; Data Collection; Data Interpretation, Statistical; Databases, Factual; Decision making; Decision Making, Organizational; Demography; EPI; Health administration; Health Facility Administrators - education; Health Facility Administrators - organization & administration; Health Facility Administrators - psychology; Health Knowledge, Attitudes, Practice; Health management; Health Planning - organization & administration; Health Policy; Health Services Needs and Demand; Health Services Research; Humans; Immunization; Immunization - statistics & numerical data; Immunization coverage; Immunization Programs - organization & administration; Mozambique; Organizational Innovation; Organizational Objectives; Policy Making; Population; Population data sources; Professional Role - psychology; Program Evaluation; Public health; Quality Indicators, Health Care; Rural Health Services - organization & administration; Supply and demand; Surveys and Questionnaires; Targets achievement; Vaccination and vaccines
• ISSN: 0168-8510; 1872-6054
• DOI: 10.1016/j.healthpol.2005.12.002

Immunization is an effective strategy to reduce morbidity and mortality among children. This recognition has led many countries to concentrate efforts in establishing desirable achievements in the form of immunization coverage figures. However, less focus has been placed on effort made by different countries to attain high immunization coverage. During August 2002, 14 district health directors in a remote province of Mozambique (Niassa) were interviewed. The objective was to ascertain the construction of immunization coverage and how they implement the desired program strategies in order to improve the health status of the region. We found that most managers regarded the immunization coverage as data and thus high coverage as an end in itself, rather than as a reflection of the reality. We also found that there are uncertainties in population data which makes it difficult to plan activities bellow the level of a district. We argue further that the innovative distinction between the views proposed on the immunization coverage, provided us with an insight of the different challenges that district health directors face as leaders of the district health management team in Niassa. Clues on the implications of certain views of immunization coverage for policy and local decision-making in the national and global pursuit of immunization targets are provided.