Assessment of immunization session practices in primary health care centers in Al-Najaf province
Accepted: 9 July 2023
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Background. Immunization has played a vital role in improving global health by reducing the transmission of infectious diseases. To ensure the successful implementation of immunization programs, it is crucial to thoroughly examine various elements within the Primary Health Care Centers, including immunization session management, cold-chain and logistics management, supervision, and reporting.
Objective. The study aims to assess the immunization session practices in selected primary healthcare centers in Al-Najaf governorate.
Methods. A descriptive cross-sectional study was conducted at 26 primary healthcare centers, selected using simple random sampling, across six districts in Najaf governorate. A total of 143 healthcare workers, comprising 122 vaccinators and 21 doctors, were included in the study. questionnaires were utilized to assess immunization session practices. Data collection commenced on December 2, 2022, and concluded on March 2, 2023.
Results. Immunization session practices were evaluated as having poor vaccine and diluent management, fair cold chain management, communication with clients and caregivers, vaccine preparation and administration practices, and waste management practices. However, immunization session equipment availability, as well as card review and registration during immunization, received good evaluations. The overall assessment of immunization session practices was determined to be fair. In addition, the study identified significant associations between immunization practices and the number of non-vaccinators working in the immunization unit (P=0.035), and the average number of daily vaccine recipients in primary healthcare centers (P=0.046).
Conclusion. The immunization session practices achieved a fair level of assessment, The increased number of daily visitors to the immunization unit and the number of health workers who are non-vaccinator in the unit affected negatively the immunization session practices.
Nadeem AY, Shehzad A, Islam SU, Al-Suhaimi EA, Lee YS. MosquirixTM RTS, S/AS01 vaccine development, immunogenicity, and efficacy. Vaccines (Basel). 2022;10(5):713. DOI: https://doi.org/10.3390/vaccines10050713
Organization WH. Immunization as an essential health service: guiding principles for immunization activities during the COVID-19 pandemic and other times of severe disruption, 1 November 2020.
Organization WH. Working for a brighter, healthier future: how WHO improves health and promotes well-being for the world’s adolescents. 2021.
Karlsson LC, Lewandowsky S, Antfolk J, Salo P, Lindfelt M, Oksanen T, et al. The association between vaccination confidence, vaccination behavior, and willingness to recommend vaccines among Finnish healthcare workers. PLoS One. 2019;14(10):e0224330. DOI: https://doi.org/10.1371/journal.pone.0224330
Excler JL, Saville M, Berkley S, Kim JH. Vaccine development for emerging infectious diseases. Nat Med. 2021;27(4):591–600. DOI: https://doi.org/10.1038/s41591-021-01301-0
Nanayakkara S. Global Immunization Programs: A Summary and Consideration of Polio Vaccine Programs. 2022.
Goodson JL, Alexander JP, Linkins RW, Orenstein WA. Measles and rubella elimination: learning from polio eradication and moving forward with a diagonal approach. Expert Rev Vaccines. 2017;16(12):1203–16. DOI: https://doi.org/10.1080/14760584.2017.1393337
Patel N, Unadkat S, Sarkar A, Rathod M, Dipesh P, Patel N. Assessment of cold chain maintenance for routine immunization in Jamnagar district, Gujarat. Int J Med Sci Public Health. 2018;7:1–5. DOI: https://doi.org/10.5455/ijmsph.2018.1130419112017
Oladeji O, Campbell P, Jaiswal C, Chamla D, Oladeji B, Ajumara CO, et al. Integrating immunization services into nutrition sites to improve immunization status of internally displaced persons’ children living in Bentiu protection of civilian site, South Sudan. Pan African Medical Journal. 2019;32(1). DOI: https://doi.org/10.11604/pamj.2019.32.28.15464
della Polla G, Napolitano F, Pelullo CP, de Simone C, Lambiase C, Angelillo IF. Investigating knowledge, attitudes, and practices regarding vaccinations of community pharmacists in Italy. Hum Vaccin Immunother. 2020;16(10):2422–8. DOI: https://doi.org/10.1080/21645515.2020.1720441
Thompson SK. Estimating Proportions, Ratios, and Subpopulation Means. In: Sampling Third Edition. Hoboken, NJ, United States: Wiley; 2012. p. 59–60.
Organization WH, Immunization WHOrganizationD of. Immunization in practice: a practical guide for health staff. World Health Organization; 2015.
Jasem FM, Al-Hafidh AH. Evaluation of Vaccination Session in Al-Diwanyia Governorate, Iraq. Ann Rom Soc Cell Biol. 2021;25(6):12630–40.
Rogie B, Berhane Y, Bisrat F. Assessment of cold chain status for immunization in central Ethiopia. Ethiop Med J. 2013;51(Suppl 1):21–9.
Biradar SM, Biradar MK. Session sites monitoring of routine immunization program in Bijapur district. Int J Life Sci Biotechnol Pharma Res. 2013;2(4):232–6.
Johnson A, WK, & DL (2022). Assessment of cold chain management in vaccine distribution. Vaccine Research Journal. 2022;47(3):215-230.
Amily A, Lami F. Assessment of Immunization Session Practices in Primary Healthcare Centers-Wasit Province, Iraq, 2016-17. Iproceedings. 2018;4(1):e10622. DOI: https://doi.org/10.2196/10622
Swarnkar M, Baig VN, Soni SC, Shukla US, Ali J. Assessment of knowledge and practice about immunization among health care providers. National Journal of Community Medicine. 2016;7(04):281–5.
Singh A, Chaudhari A, Mansuri S, Talsania N. Process evaluation of special immunization weeks in rural areas of Ahmedabad district. Int J Sci Study. 2015;3(4):111–4.
Amily AS, Lami F, Khader Y. Impact of Training of Primary Health Care Centers’ Vaccinators on Immunization Session Practices in Wasit Governorate, Iraq: Interventional Study. JMIR Public Health Surveill. 2019;5(4):e14451.
Jahangiri M, Rostamabadi A, Hoboubi N, Tadayon N, Soleimani A. Needle stick injuries and their related safety measures among nurses in a university hospital, Shiraz, Iran. Saf Health Work. 2016;7(1):72–7. DOI: https://doi.org/10.1016/j.shaw.2015.07.006
El-Hamadi MR, Burshan NM, Abugalia MO, Abdel-Azeem AM, Lapez RM. COLD CHAIN STATUS AND VACCINATION ACTIVITIES AT VACCINATION CENTERS IN TRIPOLI, LIBYA 2015.
Chaudhuri SB, Ray K. Safe injection practices in primary health care settings of Naxalbari Block, Darjeeling district, West Bengal. J Clin Diagn Res. 2016;10(1):LC21. DOI: https://doi.org/10.7860/JCDR/2016/15668.7132
Jasem FM, Al-Hafidh AH. Evaluation of Vaccination Session in Al-Diwanyia Governorate, Iraq. Ann Rom Soc Cell Biol. 2021;25(6):12630–40.
Singh A, Chaudhari A, Mansuri S, Talsania N. Process evaluation of special immunization weeks in rural areas of Ahmedabad district. Int J Sci Study. 2015;3(4):111–4.
Bogale HA, Amhare AF, Bogale AA. Assessment of factors affecting vaccine cold chain management practice in public health institutions in east Gojam zone of Amhara region. BMC Public Health. 2019;19(1):1–6. DOI: https://doi.org/10.1186/s12889-019-7786-x
Zayer JAR, Chiad IA. Evaluation of Application of Effective Vaccine Management in Wassit Governorate, Iraq.
Al-Abri SS, Al-Rawahi B, Abdelhady D, Al-Abaidani I. Effective vaccine management and Oman’s healthcare system’s challenge to maintain high global standards. J Infect Public Health. 2018;11(5):742–4. DOI: https://doi.org/10.1016/j.jiph.2018.04.015
Parmar S, Puwar T, Saxena D, Shukla S, Pandya AK. Health Workers’ Approach Toward Adverse Events following Immunization–An Insight From Madhya Pradesh. Indian J Community Med. 2020;45(4):567. DOI: https://doi.org/10.4103/ijcm.IJCM_52_20
Amily AS, Lami F, Khader Y. Impact of Training of Primary Health Care Centers’ Vaccinators on Immunization Session Practices in Wasit Governorate, Iraq: Interventional Study. JMIR Public Health Surveill. 2019;5(4):e14451. DOI: https://doi.org/10.2196/14451
Amare G, Seyoum T, Zayede T, Tazebew A, Teklu A, Mekonnen ZA, et al. Vaccine safety practices and its implementation barriers in Northwest Ethiopia: A qualitative study. Vol. 35. 2021.
Copyright (c) 2023 the Authors

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.