title: Surveys of measles vaccination coverage in eastern and southern Africa: a review of quality and methods used.
abstract: OBJECTIVE
  To assess the methods used in the evaluation of measles vaccination coverage, identify quality concerns and provide recommendations for improvement.
  
  
  METHODS
  We reviewed surveys that were conducted to evaluate supplementary measles immunization activities in eastern and southern Africa during 2012 and 2013. We investigated the organization(s) undertaking each survey, survey design, sample size, the numbers of study clusters and children per study cluster, recording of immunizations and methods of analysis. We documented sampling methods at the level of clusters, households and individual children. We also assessed the length of training for field teams at national and regional levels, the composition of teams and the supervision provided.
  
  
  RESULTS
  The surveys were conducted in Comoros, Eritrea, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Swaziland, Uganda, Zambia and Zimbabwe. Of the 13 reports we reviewed, there were weaknesses in 10 of them for ethical clearance, 9 for sample size calculation, 6 for sampling methods, 12 for training structures, 13 for supervision structures and 11 for data analysis.
  
  
  CONCLUSIONS
  We recommend improvements in the documentation of routine and supplementary immunization, via home-based vaccination cards or other records. For surveys conducted after supplementary immunization, a standard protocol is required. Finally, we recommend that standards be developed for report templates and for the technical review of protocols and reports. This would ensure that the results of vaccination coverage surveys are accurate, comparable, reliable and valuable for programme improvement.
authors.affiliation: Immunization, Vaccines and Emergencies, WHO Regional Office for Africa, Inter-country Support Team for East and Southern Africa, 86 Enterprise Road, Highlands, Harare, Zimbabwe .
authors.forename: Reinhard
authors.initials: R
authors.lastname: Kaiser
authors.affiliation: Immunization, Vaccines and Emergencies, WHO Regional Office for Africa, Inter-country Support Team for East and Southern Africa, 86 Enterprise Road, Highlands, Harare, Zimbabwe .
authors.forename: Messeret E
authors.initials: ME
authors.lastname: Shibeshi
authors.affiliation: Immunization, Vaccines and Emergencies, WHO Regional Office for Africa, Inter-country Support Team for East and Southern Africa, 86 Enterprise Road, Highlands, Harare, Zimbabwe .
authors.forename: Jethro M
authors.initials: JM
authors.lastname: Chakauya
authors.affiliation: Immunization, Vaccines and Emergencies, WHO Regional Office for Africa, Inter-country Support Team for East and Southern Africa, 86 Enterprise Road, Highlands, Harare, Zimbabwe .
authors.forename: Emelda
authors.initials: E
authors.lastname: Dzeka
authors.affiliation: Immunization, Vaccines and Emergencies, WHO Regional Office for Africa, Brazzaville, Congo .
authors.forename: Balcha G
authors.initials: BG
authors.lastname: Masresha
authors.affiliation: Immunization, Vaccines and Emergencies, WHO Regional Office for Africa, Inter-country Support Team for East and Southern Africa, 86 Enterprise Road, Highlands, Harare, Zimbabwe .
authors.forename: Fussum
authors.initials: F
authors.lastname: Daniel
authors.affiliation: Immunization, Vaccines and Emergencies, WHO Regional Office for Africa, Inter-country Support Team for East and Southern Africa, 86 Enterprise Road, Highlands, Harare, Zimbabwe .
authors.forename: Nestor
authors.initials: N
authors.lastname: Shivute
mesh_terms: D000351:Africa, Eastern; D000353:Africa, Southern; D015982:Bias; D002675:Child, Preschool; D005260:Female; D006293:Health Promotion; D006306:Health Surveys / Q000379:methods / Q000592:standards*; D006801:Humans; D007223:Infant; D008297:Male; D008457:Measles / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D008458:Measles Vaccine