Table 1. Matrix for implementing the Missed Opportunities for Vaccination (MOV) Assessment, Ondo State, Nigeria, 2019.
| MOV objectives | Assessment tool components | Types of data collected |
|---|---|---|
| Identify the magnitude and causes of missed opportunities for vaccination (MOV) | Health facility exit interviews for caregivers (interviewer-administered) | • socio-demographic information; • vaccination history (routine immunization)* • awareness of opportunities for routine immunizations; • vaccination card availability and retention; • reasons for non-vaccination; and • quality of the vaccination service received. |
| Understand the underlying causes of MOV and explore potential solutions | Health worker knowledge, attitudes, and practices survey KAP (interviewer-administered) | • Knowledge about vaccination, including antigens, immunization schedules, and contraindications to vaccination. |
| Focus group discussions (with mothers/caregivers and health workers) | • Exploring causes of MOV, and potential solutions and barriers to implementation of proposed interventions. | |
| In-depth interviews (with senior staff and health administrators) | • Interviews conducted with individuals who are insightful or influential about the health facility or the community, such as the health facility heads or in-charges, directors, matrons, and administrators. This facilitates triangulation with other data elements and provides information regarding the informants’ perception of the community and health facility dynamics affecting immunization services, informant support or opposition to immunization. • Key informants were asked to explain health worker and caregiver behaviors/responses and suggest or validate/refute previously proposed interventions to reduce missed opportunities. |
|
| Identify potential interventions to reduce MOV | Workgroup brainstorming sessions | • Present preliminary assessment findings to immunization stakeholders and formulate an action plan with proposed interventions. |
* Vaccination status was determined from vaccination documentation (vaccination cards or health facility registers), where possible. The assessment did not rely on the caregivers’ recall if the required vaccination card was lost or otherwise unavailable. This is particularly important because the date of vaccination is critical in assessing MOV [4,5].