Structure and location of vaccination services influence the availability of the triple viral in brazil
DOI:
https://doi.org/10.5935/1415-2762.20200062Keywords:
Measles-Mumps-Rubella Vaccine, Immunization, Primary Health Care, Health Services AccessibilityAbstract
Objective: to analyze the association of structural factors and geographical differences in the availability of the measle, mumps, and rubella vaccine in primary care services in Brazil. Methods: this is a cross-sectional study, with secondary data from the second cycle of external evaluations of the Primary Care Quality Improvement Program (Programa de Melhoria da Qualidade da
Atenção Básica - PMAQ-AB) collected from 19,752 vaccination services across the country between 2013 and 2014. We estimated the prevalence ratio (PR) and their respective 95% confidence intervals (CI 95%) using the Poisson multivariate regression technique with robust variances. Results: the MMR vaccine was always
available in 93% of the services studied, but with regional differences, with the lowest frequency observed in the North (87.4%; p <0.001). The following structural factors of the services were positively associated with the higher frequency of MMR vaccine always available: having a vaccination room (PR: 1.05; 95% CI: 1.01- 1.09), exclusive vaccination room for immunization (PR: 1.04; 95% CI 1.02-1.05), refrigerator exclusively for vaccines (PR: 1.13; 95% CI: 1.10-1.16); printed vaccination cards always available (PR: 1.12 95% CI: 1.09-1.16) and coolers for vaccines always available (PR: 1.18 95% CI: 1.14-1.21). Conclusion:
the location and structure of primary care services influenced the availability of the MMR vaccine in Brazil. Services in the North region and with a poor structure for immunization actions showed less frequency of vaccine availability
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