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 The power of immunization
 

 League table: The DPT3 coverage measure

 Immunization drop-out rates signal flawed systems

The high BCG-DPT3 drop-out rates of 10% to 59% (below) spell bad news for the health of young children and present a challenge for local health delivery systems. Health systems in countries where the drop-out rate is more than 10% are considered flawed by health experts.

The figures show that caregivers had been in contact with health care systems because their young children had received an anti-tuberculosis BCG shot. They did not, however, return with their children to complete the three-dose series of diphtheria/pertussis/tetanus vaccine (DPT3). This suggests that caregivers either were dissatisfied with the services or were not even made aware that a course of DPT was needed.

These figures are important because they pinpoint deficiencies in the quality of immunization services being provided and can spark measures to correct the problems and improve DPT3 coverage within the current infrastructure at minimal additional cost.

Figures that spell trouble

BCG-DPT3 drop-out rates, 1999 (in descending order)


59% to 50% Mauritania, Somalia, Venezuela, Niger, Bolivia
49% to 40% Togo, Angola, Burkina Faso, Chad, Democratic People’s Republic of Korea
39% to 30% Mali, Cameroon, Guinea, Turkey, Djibouti, Uganda, Liberia
29% to 20% Sierra Leone, Côte d’Ivoire, Samoa, Nicaragua, Bangladesh, Gabon, Guinea-Bissau, Democratic Republic of Congo, Guatemala, Mozambique, Nigeria, South Africa, Ethiopia, Haiti, Ghana, Congo
19% to 10% Kenya, Senegal, Equatorial Guinea, Argentina, Algeria, Cambodia, Eritrea, Madagascar, Colombia, Dominican Republic, Burundi, Armenia, Zambia, Ecuador, Central African Republic, Philippines, Namibia, Bosnia and Herzegovina, Benin, Tanzania, Yemen, Nepal, Sudan, Panama, Comoros, Pakistan, Swaziland, El Salvador

Source: UNICEF, 1999.
 
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