The preventive program for children under 5 years of age in Saudi Arabia includes a series of well-baby clinic visits and immunizations. Vaccines have to be given on schedule to maximize protection. For assurance of the parents and early identification of children health problems, children under 5 years are advised to visit the well-baby clinic regularly, according to a recommended number of visits per year. The objectives of this study were: to determine the proportion of children who were up to date (UTD) on recommended vaccines and the proportion of children who were age-appropriately immunized (AAI) with the recommended vaccines; to estimate the frequency of well-baby clinic visits and the activities done in these visits (recording of weight, height, head circumference, and growth chart plotting and examination of children by a physician in each visit).
Methodology
A Retrospective cohort study for children born in 1415 H was conducted at the primary health care centers (PHCC) in Al Khobar city. Immunization registries, medical records, and well-baby clinic registries were reviewed from 1415 H through 1419 H. A random sample proportionate to the number of children in each PHCC was selected. A total of 116 children were enrolled in the study. A data collection form was developed and filled.
Results
By the end of the first birthday 69.8 % of children completed the primary immunization series while only 19 % of children were age-appropriately immunized (AAI). By the end of the second birthday 58.6 % of children completed the primary immunization series and the first booster doses of DPT & OPV while only 10.3 % of children were age-appropriately immunized (AAI) with these vaccines. By the end of the fifth birthday 30 % of children completed the primary immunization series and both the first and the second booster doses of DPT & OPV while only 7.8 % of children were age-appropriately immunized (AAI) with these vaccines. For individual vaccines, the (UTD) children at 12 months of age ranged from 100 % in BCG as the highest to 3.4 % for MMR as the lowest. The corresponding figure for (AAI) ranged from 97 % in BCG to 33.6 % in hepatitis B. The (UTD) children at 24 months of age ranged from 100 % in BCG as the highest to 59.5 % for DPT & OPV as the lowest. The corresponding figure for (AAI) ranged from 97 % in BCG to 15.5 % in DPT & OPV. The (UTD) children at 60 months of age ranged from 100 % in BCG as the highest to 31.9 % for DPT & OPV as the lowest. The corresponding figure for (AAI) ranged from 97 % in BCG to 9.5 % in DPT & OPV. The children achieved 90.4 % of the recommended visits to well-baby clinic in the first year of life, 61 % in the second year of life, and only 28 % of the recommended visits in the fifth year of life. Stricter measurement criteria lowered the utilization level further.
Conclusion
This study demonstrated a wide gap between the proportion of children who were (UTD) on vaccination at a particular age and the proportion (AAI) with these vaccines. It also showed that the utilization level of well-baby clinic is much lower than recommended, except in the first year of life. Health care for children decreased substantially as their age increased. Immunization schedule has to be strictly followed to maximize the protection from vaccines and a particular attention has to be paid to children after they complete their first birthday.