Analysis Of The Current Vaccination Situation And Its Impact Factors In Zhangdian District, Zibo City Of Shandong Province, China

[Objectives]This study was aimed to survey the present situation of the facilities, equipment and manpower of the urban and rural vaccination clinics in Zhangdian district of Zibo city, and to understand the knowledge, attitudes and satisfaction of vaccination clinics’staff and parents of children. All data on the impact factors for the current vaccination work were analyzed so as to provide evidences for solving current problems, formulating immunization strategy, improving vaccination services capabilities and immunization programme management level.[Methods]The study belongs to the epidemiological prevalence investigation with census and sample survey. Total all26vaccination clinics were surveyed by the questionnaire on the housing construction, infrastructure equipment, material items, cold chain equipment, human resources, clinic service frequency, number of children and other basic information service. All82full-time clinic-staff were surveyed on knowledge, attitudes and satisfaction.2villages were choiced by method of stratified random sampling each clinic by distance. Each village respectively selected5resident children and1floating children. The parents’ knowledge, attitudes, practice and satisfaction whose children were selected were surveyed.The descriptive epidemiology were used for the result analysis, and the difference between urban and rural clicnics was analyzed by the statistical tests so sa to find the outstanding problems of urban and rural vaccination clinics, and to propose targeted measures and suggestions.[Results]1. The average of town hospitals vaccination clinic’s total area is97.86M2,and the average of vaccination room’s area is49.29m2. The compliance rate of vaccination room’s area and number of houses are57.14%and85.71%in town hospitals clinics.The average of urban clinic’s total area is75M2,and the average of vaccination room’s area is31.84m2. The compliance rate of vaccination room’s area and number of houses are26.32%and63.16%in urban vaccination clinics.2. Almost all vaccination chinic had4types of medical equipment,4kinds of basic information management of equipment and first-aid medicine.57.14%of town hospitals vaccination clinics and42.11%of urban vaccination clinics were fixed the audiovisual education equipment. The refrigerato was equipmented in every vaccination chinic.Reefer-box equipped with rate of town, city clinic respectively was85.71%,26.32%.The quantity qualified rate of the cool-bag in town and urban chinics respectively was57.14%,42.11%.3. The number of actual staff who worked in vaccination chinics was inadequate,accounted for66.67%of the total number.The average of full-time staff number per chinic in town and urban respectively was4.14and2.79.The number of most vaccination chinics’full-staff is not up to the standard(<The vaccination unit construction and management standards in Shandong province (Trial)>).According to the analysis of the total number of Statistics,clinical professional, public health professionals is relatively low in proportion accounted for17.89%,23.58%,while nursing professionals was accounted for58.54%.In particular, the proportion of public health physicians accounted for only13.79%in urban vaccination chinics.Personnel qualifications (according to the highest degree) aspects,a higher proportion of bachelor degree and specialist qualifications, accounted for47.15%,42.28%.Secondary and less educated workers accounted for only10.57%.Senior titles, intermediate grade, junior title and non title personnel accounted for6.50%,41.46%,52.03%. The proportion of31to40years,41to50years,30years and under,51years and above accounted for48.78%,34.96%,10.57%,5.69%.The proportion of the town chinics’staff of41to50years-old was higher than urban,while the proportion of less than30years-old in urban chicnics was higher than the town vaccination chinics.In the age of vaccination chinic service work in10-years and below accounted for83.91%,while the town staff in this group is only50%.The proportion of working more than11years in rural chinics was higher than urban chinics.The proportion of monthly income in3000-yuan and below in town hospitals and urban outpatient rates was8.33%and50.57%.4. Iquestionnaire of employees, the number of person who satisfied with their jobs accounted for81.71%.The staff who satisfied with "present monthly disposable income" accounted for18.07%with the lowest proportion,especially in urban vaccination clinics accounted for only11.32%of this satisfaction item.19.51%investigation object thought "the government funding adequacy", only37.74%of urban chinic satff believed that "the number of personnel meet the need of clinic", than was lower than investigators in town chinics.Most thought the major difficulties were in "government subsidies or lack of funds","negative report influence the work","the masses not to be proactive vaccination".5. The parents who satisfied "the order when wait or stay in chinic","inform precautions after inoculation","the distance from home to vaccination clinics",were less than80%. More urban people thought that urban vaccination clinics didn’t respect their choice "to choose charge vaccine ". There were some low awareness of knowledge, such as"children nursery, school and studying to use vaccination certificate" awareness of75.32%,"the difference between a class II vaccine and vaccines I" awareness is only73.72percent,"resident, migrant children enjoy the same treatment ’awareness of60.90%, vaccination is one of the basic public health services,"awareness is only36.22%.Because of low awareness of vaccine knowledge, resulting in "should be the priority for children to free vaccination" and "will actively give children vaccination charge vaccine " are fewer in number.[Conclusions]1.Urban vaccination chinics were less standardization-construction than rural chinics.The issue that business houses, location,layout were unreasonable was more prominent and widespread.2.Cold chain equipment configuration was not complete, and the audiovisual education equipment ratea nd utilization rate were all lower.3.Vaccination chinics were generally lack of public health and preventive medicine professionals.4. The relative shortage of practitioners and low wages, heavy workload, resulted in immunization planning initiative, enthusiasm drops.5.Parents of children with a lower satisfaction to "the frequency of t clinic""the order at the scene "and other projects satisfaction, the awareness of vaccine-related knowledge was lower than Basic knowledge.