IS THERE AN ASSOCIATION BETWEEN LOCAL HEALTH DEPARTMENT ORGANIZATIONAL AND ADMINISTRATIVE FACTORS AND CHILDHOOD IMMUNIZATION COVERAGE RATES?

Abstract

This paper qualitatively characterizes local health department (LHD) immunization programs and specific organizational factors underlying immunization service delivery (ISD) performance challenges and successes related to community childhood immunization coverage rates. Case studies were conducted in a convenience sample of 17 geographically and demographically diverse LHDs, predicated on each LHD's childhood immunization coverage rates per data from the National Immunization Survey and/or Kindergarten Retrospective Survey. NACCHO staff selected LHDs with high, moderate, and low coverage rates. Supporting documents from each LHD immunization program were also collected for inclusion in the analysis. Content and thematic analyses of interview transcripts and supporting documents were conducted. Two thematic dimensions and six key factors emerged from the data. The dimensions of the themes were success and challenge elements. The organizational factors that were associated with success and/or challenges with regard to improving childhood immunization coverage rates included: leadership; resources; politics; community engagement/coalitions and partnerships; credibility; and cultural competency of LHD staff.