Comparison of variation of vaccination application places for 0-23 month children in Edirne during health care reform in Turkey

Aim of this study was to investigate the effect of this practition on the vaccination services and changes in vaccination places(VP) during Health Care Reform(HCR). 
Research was conducted in a sample of 0-23 months children representing Edirne, by using Lot Quality Tecnique. Data collection were performed on December 2006, the beginning of HCR pilot application, and February 2008. This is a cross-sectional study with the level of accuracy as ±5 and level of confidence as 95%. Sample size was 400 children. In the study, revealed following results: BCG vaccine was applied in health centres(HC) and dispensaries with the ratios of 55,6% and 39,2%, respectively, in 2006. In 2008, the ratios were 47,1% and 37,7% for Family Practitionary Offices(FPO) and dispensaries, respectively. Mobile health services were incresed from 0,9% to 9,2%, in 2008. In 2006, the common vaccine application place(VAP) for DPT and OPV/IPV were HCs with the ratio between 86,5%-89,3%, while those were FPOs in 2008 with the ratios between 91,7%-93,5%. The ratio of hospitals as HBV1 AP is higher than others and incresed from 38,7%, in 2006 to 75,8%, in 2008. The ratios of HCs for HBV2 and HBV3 according to AP were 89,4% and 91,5%, respectively, in 2006. The most common AP were FPOs in 2008 for HBV2 ve HBV3 vaccines, and ratios were 92,7% and 95,6%, respectively. The ratio of HCs for measles vaccine was 89,2%  in 2006, while the most common places were FPOs in 2008, with the ratio of 99,0%.

Vaccination services are one of the important criteria for the evaluation of performance of a FP in Turkey. Decrease of the vaccination ratio of a FP causes  a  deduction of income, so the increased ratio of FPOs as VAP may be related with this issue of fact. 

KEY WORDS: Health Reform, Lot Quality Tecnique, EPI