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Hodges M.H.,Helen Keller International Sierra Leone | Sesay F.F.,Helen Keller International Sierra Leone | Kamara H.I.,Helen Keller International Sierra Leone | Nyorkor E.D.,Helen Keller International Sierra Leone | And 11 more authors.
Maternal and Child Health Journal | Year: 2015

Since 2004, twice-yearly mass vitamin A supplementation (VAS) has equitably reached over 85 % of children 6–59 months old in Sierra Leone. However infants who turn 6 months after the event may wait until they are 11 months old to receive their first dose. The effectiveness of integrating VAS at 6 months into the Expanded Program of Immunization (EPI) in a revised child health card was studied. Health facilities matched according to staff cadre and work load were assigned to provide either a ‘mini package’ of VAS and infant and young child feeding (IYCF), a ‘full package’ of VAS, IYCF and family planning (FP), or ‘child health card’ only. 400 neonates were enrolled into each group, caregivers given the new child health card and followed until they were 12 months old. More infants in the full: 74.5 % and mini: 71.7 % group received VAS between 6 and 7 months of age compared with the new CH card only group: 60.2 % (p = 0.002, p < 0.001 respectively). FP commodities were provided to 44.5 % of caregivers in the full compared with <2.5 % in the mini and new child health card only groups (p < 0.0001). Integration of VAS within the EPI schedule achieved >60 % coverage for infants between 6 and 7 months of age. Provision of FP and/or IYCF further improved coverage. Funding was provided by the Canadian Department of Foreign Affairs, Trade and Development who had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript. © 2015, The Author(s).


Sesay F.F.,Helen Keller International | Hodges M.H.,Helen Keller International | Kamara H.I.,Helen Keller International | Turay M.,Helen Keller International | And 9 more authors.
International Health | Year: 2014

Background: In May 2012, the twice-yearly Maternal and Child Health Week (MCHW) integrated vitamin A supplementation (VAS) and supplementary measles vaccination to reach all children 6-59 months in Sierra Leone. Following the MCHW, a post event coverage survey was conducted to validate VAS coverage and assess adverse events following immunization. Methods: Using the WHO Expanded Program on Immunization sampling methodology, 30 clusters were randomly selected using population proportionate to size sampling. Fourteen caregivers of children 6-59 months were interviewed per cluster for precision of+5%. Responseswere collected via mobile phones using EpiSurveyor. Results: Overall VAS and measles coveragewas 91.9% and 91.6%, respectively, with no significant differences by age group, sex, religion or occupation. Major reasons given for not receiving VAS and measles vaccination were not knowing about the MCHW or being out of the area. Significantly more mild adverse events (fever, pain at injection site) were reported via the post event coverage survey (29.1%) than MCHW (0.01%) (p,0.0001). Conclusion: The MCHW reached.90% of children in Sierra Leone with equitable coverage. Increased reporting of mild adverse events during the survey may be attributed to delayed onset after measles vaccination and/or direct inquiry from enumerators. Even mild adverse events following immunization requires strengthened reporting during and after vaccination campaigns. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.


PubMed | World Health Organization, Ministry of Health and Sanitation Sierra Leone, Helen Keller International, Child Health and Expanded Program on Immunization and 3 more.
Type: Journal Article | Journal: International health | Year: 2015

In May 2012, the twice-yearly Maternal and Child Health Week (MCHW) integrated vitamin A supplementation (VAS) and supplementary measles vaccination to reach all children 6-59 months in Sierra Leone. Following the MCHW, a post event coverage survey was conducted to validate VAS coverage and assess adverse events following immunization.Using the WHO Expanded Program on Immunization sampling methodology, 30 clusters were randomly selected using population proportionate to size sampling. Fourteen caregivers of children 6-59 months were interviewed per cluster for precision of 5%. Responses were collected via mobile phones using EpiSurveyor.Overall VAS and measles coverage was 91.9% and 91.6%, respectively, with no significant differences by age group, sex, religion or occupation. Major reasons given for not receiving VAS and measles vaccination were not knowing about the MCHW or being out of the area. Significantly more mild adverse events (fever, pain at injection site) were reported via the post event coverage survey (29.1%) than MCHW (0.01%) (p<0.0001).The MCHW reached >90% of children in Sierra Leone with equitable coverage. Increased reporting of mild adverse events during the survey may be attributed to delayed onset after measles vaccination and/or direct inquiry from enumerators. Even mild adverse events following immunization requires strengthened reporting during and after vaccination campaigns.

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