Assessment of vaccination competency among health workers in health facilities in East Wollega, Oromia, Western Ethiopia: An observational study.

Abstract

Vaccination competency is a critical determinant of immunization quality and safety. However, limited evidence exists on the practical skills of frontline providers in Ethiopia. A facility-based observational study assessing vaccination competency among health care providers involved in routine childhood immunization. A total of 34 providers were observed while administering 10 vaccine doses each, resulting in 340 observed vaccination encounters. Competency was assessed using a structured checklist covering patient/parent education, medical and office protocols, vaccine preparation, vaccine administration, and record-keeping. A composite competency score was calculated for each provider and expressed as a percentage. Domain-specific competency scores were summarized using descriptive statistics, and providers scoring ≥80% were classified as competent. We observed 340 vaccination procedures performed by healthcare providers in 34 health facilities. Most providers were aged 30-39 years (19/34), male (22/34), held a Bachelor of Science (23/34), and had 6-10 years of work experience (20/34). Competency varied across domains, with the highest performance in vaccine administration (71%) and the lowest in record-keeping (22%). The overall mean competency score was 50%, below the predefined 80% competence threshold. Moderate technical skills but failure in infection control, patient communication, and documentation resulted in weak practical competency, were observed from this study. Data indicate a gap between knowledge-based practice and actual performance. To improve immunization service, it is essential to enhance supervision and mentorship, focus on vaccine information system usage, and provide regular competency-based training for EPI providers. Strengthening routine monitoring and supportive supervision is critical, along with further research to identify barriers and assess training effectiveness. Addressing these gaps is vital for enhancing the quality and coverage of immunization services.