National immunisation days for polio eradication in Uganda: did immunisation cards increase coverage?

OBJECTIVE To analyse the effect of cards and of vitamin A supplementation on coverage for National Immunisation Days (NIDs). DESIGN A retrospective ecological study. SETTING A countrywide NIDs coverage before and after introduction of the NIDs cards and vitamin A supplementation in all districts of Uganda. METHODS NIDs for polio eradication commenced in Uganda in 1996. Two rounds, one month apart are implemented yearly. During the second round of 1998 NIDs, cards were introduced nationally and vitamin supplementation was introduced in 24 of the 45 districts. We compared NIDs coverage before and after NIDs cards and NIDs coverage in districts that implemented vitamin A to those that did not. RESULTS After introduction of NIDs cards, the national coverage rose from 97.7% to 106.9%, an increase of 9.2%. In those districts that implemented vitamin A supplementation, the NIDs coverage rose from 100.1% to 111.5%, an increase of 10.4%. In those districts that did not implement vitamin A, the NIDs coverage rose by 6.7% from 94.5% to 102.2%. Before the introduction of cards and vitamin A in 1996 and 1997, the NIDs coverage was between 92-96%. CONCLUSION NIDs cards and vitamin A supplementation could have increased the NIDs national coverage.