Building on community outreach for childhood vaccination to deliver maternal and child health services in Laos: A feasibility assessment

摘要

Outreach services for vaccination present a useful vehicle to deliver maternal and child health (MCH) care to hard-to-reach women and children. In Laos, uptake of MCH services inversely correlates with distance from a health facility; hence, the concurrent delivery of MCH services during community vaccination outreach has been promoted. Here we assess factors affecting delivery of MCH services during vaccination outreach in six districts of three provinces. We conducted 58 in-depth interviews with representatives of district and provincial health offices, health centre staff and village health volunteers. Vaccination outreach sessions by health centre staff were observed in eight villages, and 12 focus group discussions were held with 120 mothers on their perceptions of these sessions. The regularity and frequency of outreach sessions and the number of integrated vaccination/MCH services varied widely between sites. Availability of external financial and technical support was the major determinant of optimal delivery of integrated services, with implications for future policy. To enable concurrent delivery of a range of MCH services during vaccination outreach, the number of these services should gradually be increased in tandem with additional financial and technical support. At the same time, ways need to be found to ensure remote villages are reached and coverage of children and women receiving services increased, to reduce inequity.