Abstract
BackgroundHealth care systems in many countries are changing for a variety of reasons. Monitoring of community-based services, especially vaccination coverage, is important during transition periods to ensure program effectiveness. In 2005, Turkey began a transformation from a “socialization of health services” system to a “family medicine” system. The family medicine system was implemented in the city of Gaziantep, in December, 2010.MethodsTwo descriptive, cross-sectional studies were conducted in Gaziantep city center; the first study was before the transition to the family medicine system and the second study was one year after the transition. The Lot Quality Technique methodology was used to determine the quality of vaccination services. The population studied was children aged 12–23 months. Data from the two studies were compared in terms of vaccination coverage and lot service quality to determine whether there were any changes in these parameters after the transition to a family service system.ResultsA total of 93.7% of children in Gaziantep were fully vaccinated before the transition. Vaccination rates decreased significantly to 84.0% (p <0.005) after the family medicine system was implemented. The number of unacceptable vaccine lots increased from 5 lots before the transition to 21 lots after the establishment of the family medicine system.ConclusionsThe number of first doses of vaccine given was higher after family medicine was implemented; however, the numbers of second, third, and booster doses, and the number of children fully vaccinated were lower than before transition. Acceptable and unacceptable lots were not the same before and after the transition. Different health care personnel were employed at the lots after family medicine was implemented. This result suggests that individual characteristics of the health care personnel working in a geographic area are as important as the socioeconomic and cultural characteristics of the community.
Highlights
Health care systems in many countries are changing for a variety of reasons
A representative sample was selected by the Lot Quality (LQ) technique to decide whether one or more health service units is meeting the standard of performance and to measure vaccination coverage
For Bacille Calmette Guerin (BCG), we examined if he or she had a BCG scar (Additional file 1)
Summary
Health care systems in many countries are changing for a variety of reasons. Monitoring of community-based services, especially vaccination coverage, is important during transition periods to ensure program effectiveness. Health care systems in many countries are changing, for a variety of reasons. This brings both opportunities and threats for public health professionals. Change offers the possibility to challenge existing arrangements and maximize the contribution of health services to population health. In 2005, Turkey began a transformation from a “socialization of health services” system to a “family medicine” system. The pilot system was implemented in Düzce, Turkey, and was introduced throughout the country at the end of 2010. The family medicine system was implemented in the city of Gaziantep, in December, 2010
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