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Primary care practice and health professional determinants of immunisation coverage

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Summary:

During 2005–2006, these researchers surveyed a random sample of New Zealand primary care practices, with over-sampling of practices serving indigenous children, in this investigation into primary care factors associated with immunisation coverage. Practice immunisation coverage was defined as the percentage of registered children from 6 weeks to 23 months old at each practice who were fully immunised for age. A median of 71% of registered children at each of the 124 participating practices was fully immunised. In multivariate analyses, higher immunisation coverage was achieved by practices with no staff shortages (median practice coverage 76% vs 67%; p=0.004) and where doctors were confident in their immunisation knowledge (72% vs 67%; p=0.005). Coverage was lower if the children’s parents had received information antenatally, which discouraged immunisation (67% vs 73%; p=0.008). Coverage decreased as socio-economic deprivation of the registered population increased and as the children’s age and registration age increased.

Comment:
I like the fact that the researchers have chosen to examine the ‘service issues’ contributing to immunisation outcomes. The findings are not only interesting but should inform some simple solutions.
Reference: J Paediatr Child Health. 2011;47(8):541-9.
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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