RESUMO
BACKGROUND: Inadequate vaccination coverage with increased risk of vaccine preventable disease outbreaks remain a problem in Africa. The aim of this study was to assess the vaccination coverage levels under the Expanded Program on Immunization (EPI) in a health area and to identify factors that affect vaccination coverage in view of providing valuable data for disease prevention. METHODS: A cross-sectional household survey was conducted in August 2017 in the Mbonge health area, Southwest Cameroon. Clustered sampling technique was used to select study communities and a purposive sampling design was used to select households. An interviewer-administered questionnaire was used to obtain information from consenting caregivers of children aged 9-23 months. Vaccination coverage was assessed by consulting the vaccination cards and parents' recall. In households with more than one child aged 9-23months, the youngest was chosen. RESULTS: Overall, 300 caregivers were enrolled into the study. The average vaccination coverage for the past three years (2014-2016) was 34.0%. Two hundred and fifty-five (85%) children had vaccination cards. Amongst the children, 143 (47.7%) had taken all vaccines as recommended while 30 (10%) had not received a single dose. Factors significantly associated with incomplete vaccination status included: occupation (being a farmer) (p-value=0.011), marital status (married) (p-value=0.048), caregiver's utilization of health facility (p-value=0.003), low levels of mothers' utilization of antenatal care (ANC) services (p-value=0.000), and low knowledge on vaccination (p-value=0.000). CONCLUSION AND GLOBAL HEALTH IMPLICATIONS: Adequate vaccination coverage can be attained through good sensitization and health education for primary caregivers. Targeting families living far away from vaccination centers, using appropriate communication and vaccination strategies may improve vaccination coverage in the Mbonge Health Area of South West Region, Cameroon.
RESUMO
INTRODUCTION: Burnout or burnout syndrome is a public health problem in Cameroon. It manifests itself by emotional exhaustion, depersonalization, and diminished personal accomplishment of the subject. It affects most healthcare workers (HCW) and the consequences are numerous. In Cameroon in general, and Yaounde Central Hospital (HCY) in particular, in recent years, healthcare workers have continued to express dissatisfaction with their working conditions through strikes and threats of various kinds. The care of patients is suboptimal with sometimes dramatic consequences and ethical concerns. METHODS: Our cross-sectional study aimed to determine the factors that are associated with burnout among healthcare personnel (HCW) of HCY. To do this, for one month, we administered to these HCWs our questionnaire designed according to the theoretical models of MASLACH and SIEGRIST. We were able to obtain information from 104 caregivers; data entry and analysis was done with SPSS 20. RESULTS: The results show that HCWs of four departments of HCY have similar manifestations to those found in the literature and the prevalence of burnout syndrome amon HCWs of HCY was 63%. Seven factors were statistically significantly associated with burnout syndrome among HCWs in HCY: the department (care unit) the HCW was assigned to (OR = 3.93, 1.16-13.24, p-value = 0.027); marital status (OR: 2.56, 1.22 - 5.39, p-value = 0.049); the effort-reward imbalance (OR: 2.31, 1.10 - 4.84, p-value = 0.026); having received been threatened physically or verbally (OR: 3.75, 1.49 - 9.41, 0.005); maintaining the balance between private and professional life (OR: 3.41, 1.19- 10.7, p-value = 0.038); frequency of forgetfulness (OR: 4.25 -1.33, 7.91, p-value = 0.002) and attribution of errors to working conditions (OR: 2.05, 1.52 - 24.0; -value = 0.011). CONCLUSION: Burnout is common among HCWs of HCY and is likely to keep increasing if nothing is done. Prevention and promotion strategies for occupational health are strongly needed in aspects of improving working conditions; making good political and managerial decisions; improving relationships between caregivers and caregivers-hierarchy and constant research, monitoring and control of risk factors.