title: Improving hepatitis B vaccine timely birth dose coverage: lessons from five demonstration projects in China, 2005-2009.
abstract: BACKGROUND
  Delivery of a timely (within 24h) hepatitis B vaccine birth dose (TBD) is essential to prevent the long-term complications of hepatitis B virus (HBV) infection. China made substantial progress in hepatitis B immunization coverage, however, in 2004, TBD coverage was lower in Western, poorer provinces.
  
  
  METHODS
  We reviewed five demonstration projects for the promotion of TBD in rural counties in Qinghai, Gansu and Ningxia. Interventions consisted of (1) work to increase TBD coverage in hospitals, including training of health-care workers, (2) information, education and communication [IEC] with the population and (3) micro-plans to deliver TBD for home births. We evaluated outcome through measuring TBD coverage for home and hospital births.
  
  
  RESULTS
  These projects were implemented in the context of national efforts to promote institutional deliveries that lead to increases ranging from 10% to 17% to reach 43-97% proportion of institutional births at the end of the projects. Among institutional births, TBD coverage increased by 2% to 13% to reach post implementation coverage ranging from 98% to 100%. Among home births, TBD coverage increased by 7% to 56% to reach post implementation coverage ranging from 29% to 88%. Overall, TBD coverage increased by 4% to 36% to reach post implementation coverage ranging from 82% to 88%.
  
  
  CONCLUSIONS
  Demonstration projects based on combined interventions increased TBD coverage. Increases in institutional births amplified the results obtained. Use of standardized indicators for such projects would facilitate evaluation and identify intervention components that are most effective.
authors: WHO China Country Office, Beijing, China. Electronic address: Yvan.hutin@ecdc.europa.eu.
authors: Yvan
authors: Y
authors: Hutin
authors: WHO Western Pacific Regional Office, Manila, Philippines.
authors: Karen
authors: K
authors: Hennessey
authors: WHO China Country Office, Beijing, China.
authors: Lisa
authors: L
authors: Cairns
authors: Qinghai Province CDC, Xining, China.
authors: Yongji
authors: Y
authors: Zhang
authors: Gansu Province CDC, Gansu, China.
authors: Hui
authors: H
authors: Li
authors: Guyuan City CDC, Guyuan, Ningxia, China.
authors: Lianfei
authors: L
authors: Zhao
authors: China CDC, Beijing, China.
authors: Fuqiang
authors: F
authors: Cui
authors: WHO China Country Office, Beijing, China.
authors: Lisa
authors: L
authors: Lee
authors: WHO China Country Office, Beijing, China.
authors: Vivian
authors: V
authors: Tan
authors: WHO China Country Office, Beijing, China.
authors: Yoshihiro
authors: Y
authors: Takashima
authors: WHO China Country Office, Beijing, China.
authors: Shuyan
authors: S
authors: Zuo
authors: WHO China Country Office, Beijing, China.
authors: Stephen
authors: S
authors: Hadler
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000517:prevention & control; D002681:China; D004517:Education, Professional; D005260:Female; D006266:Health Education; D006509:Hepatitis B / Q000150:complications / Q000517:prevention & control*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage* / Q000600:supply & distribution; D006761:Hospitals; D006801:Humans; D007231:Infant, Newborn; D008103:Liver Cirrhosis / Q000150:complications / Q000517:prevention & control; D008113:Liver Neoplasms / Q000517:prevention & control; D011247:Pregnancy; D012424:Rural Population; D013997:Time Factors; D014611:Vaccination / Q000379:methods* / Q000706:statistics & numerical data
chemical_list: D017325:Hepatitis B Vaccines
keywords: Cirrhosis; Hepatitis B; Hepatocellular carcinoma; Micro-planning