The government of Ethiopia has been delivering routine immunization services through static, outreach, and mobile strategies since 1980. Moreover, programs including Supplemental Immunization Activities (SIAs), Reaching Every District (RED), and Enhanced Routine Immunization Activities (ERIA) have been implemented to further expand vaccination services. Despite the huge efforts made over the decades, the access and utilization of immunization remain low with wide regional variations and unacceptably high drop-out rates. A national consensus has also been reached that vaccination coverage is stagnating in Ethiopia. The Last Ten Kilometers (L10K) Project of the John Snow, Inc. (JSI) Research and Training Institute is supporting the Federal Ministry of Health (FMoH) in implementing the routine immunization improvement plan in seven selected zones with high numbers of unvaccinated children. Population-based information regarding vaccination status and the reasons for no or incomplete vaccination are essential for monitoring the Expanded Program on Immunization (EPI). As such, this study was conducted to establish baseline vaccination levels and inform the implementation of the project. Therefore, cross-sectional household and facility surveys were conducted as the baseline for a pretest-posttest only evaluation design. A total of 1,597 mothers of children from 12-23 months of age and 1,586 mothers of children 0-11 months of age were interviewed regarding vaccination coverage from December 2014 to January 2015. The facility survey included data collected from health facilities serving the selected kebeles of the household survey. In each kebele, the health post and its supervising health center were assessed.
Finding from this study indicated that, the majority of the health facilities (99% of health posts and 96% of health centers) were providing routine vaccination services at the time of the survey. However, only 37% of functional health centers were providing EPI services on a daily basis. More than a quarter of health facilities missed at least one EPI session in the previous six months. Almost all health centers and one-third of health posts had at least one refrigerator for EPI activities. However, refrigerators were not functional in 32% of health centers and 71% of health posts at the time of the survey. Moreover, at least two-thirds of facilities encountered a breakdown of their vaccine refrigerators in the previous three months. Among facilities that stock vaccines overnight, 67% of health centers and 40% of health posts experienced a shortage of vaccines in the past six months. The overall vaccination coverage among children aged 12-23 months for each vaccine was as follows: BCG 86%; Penta1 89%; Penta3 79%; measles 80%; and fully vaccinated 69%. Timely vaccination coverage, as defined by vaccination by 12 months of age and evidenced by the written record was as follows: BCG 81%; Penta1 82%; Penta3 72%; measles 68%; and fully vaccinated 60%. Approximately 85% of mothers received at least one antenatal care visit during their most recent pregnancy. More than two-thirds (70%) of infants were protected against neonatal tetanus at birth. 
In a significant proportion of facilities, cold chain management was suboptimal which may reduce vaccine potency. Observations and close monitoring of EPI sessions need to be performed to improve the quality of services. Refresher training is equally important to enhance the knowledge and skills of vaccinators. There is a need to establish an appropriate and uninterrupted vaccine delivery strategy.

• EPI
• Coverage
• Zones
• Baseline
• L10K's
• Vaccination
• cross-sectional
• Children
• Household
• Facility
• Survey
• Neonatal tetanus
• Cluster- sampling

No suggested citation.

This dataset is produced by cross-sectional household and facility surveys amongst the 1,597 mothers of children from 12-23 months of age and 1,586 mothers of children 0-11 months of age were interviewed regarding vaccination coverage from December 2014 to January 2015 in selected seven Zones. The dataset holds information on Health Facility Assessments: Health facility providing EPI service, EPI service provisions and interruptions: Frequency of vaccination sessions, Service delivery strategies of facilities and EPI service interruption in the last 6 months, EPI defaulter tracing mechanism: Defaulter tracing mechanism, Persons involved for defaulter tracing, Cold chain management of health facilities: Availability of vaccine refrigerator, Reasons for non‐use of vaccine refrigerator, Temperature of the refrigerator currently in use, Vaccine stock management of health facilities:  Facilities that experienced stock‐out of vaccines in the last 6 months, Mean duration of stock‐out of antigens in the last 6 months, Supervisory visit, Written feedback, EPI in‐service training Related to Child Vaccination: Socio-demographic characteristics of mothers and children: educational status, zone, parity, residence, marital status, age, mothers education, religion, child’s sex,  parity and wealth quintile, distance from vaccination cite, vaccination coverage: vaccinated at any time before the survey and vaccinated by 12 months, dropout rate.
The standard WHO and Ethiopian Demographic and Health Survey (EDHS) EPI questions were used. Mothers were asked to show vaccination cards for the child or TT vaccination, and the dates of vaccination were read and recorded. If vaccination cards were lost, the maternal report of vaccinations was recorded and verified from facility registers. The presence of a BCG scar was recorded in surveyed children. Reasons for not being immunized were also recorded. The survey questionnaires were administered in three local languages - Amharic (in Afar, Amhara, and SNNP), Oromigna (in Oromia), and Tigrigna (in Tigray). In cases when respondents couldn’t speak their local languages, interviewers translated them into local languages. Generally, the objective of the study was to set benchmark levels of vaccine use in order to measure progress in project implementation in the targeted zones in Ethiopia. 

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