High coverage of vitamin A supplementation and measles vaccination during an integrated Maternal and Child Health Week in Sierra Leone

Int Health. 2015 Jan;7(1):26-31. doi: 10.1093/inthealth/ihu073. Epub 2014 Oct 14.


Background: In May 2012, the twice-yearly Maternal and Child Health Week (MCHW) integrated vitamin A supplementation (VAS) and supplementary measles vaccination to reach all children 6-59 months in Sierra Leone. Following the MCHW, a post event coverage survey was conducted to validate VAS coverage and assess adverse events following immunization.

Methods: Using the WHO Expanded Program on Immunization sampling methodology, 30 clusters were randomly selected using population proportionate to size sampling. Fourteen caregivers of children 6-59 months were interviewed per cluster for precision of ±5%. Responses were collected via mobile phones using EpiSurveyor.

Results: Overall VAS and measles coverage was 91.9% and 91.6%, respectively, with no significant differences by age group, sex, religion or occupation. Major reasons given for not receiving VAS and measles vaccination were not knowing about the MCHW or being out of the area. Significantly more mild adverse events (fever, pain at injection site) were reported via the post event coverage survey (29.1%) than MCHW (0.01%) (p<0.0001).

Conclusion: The MCHW reached >90% of children in Sierra Leone with equitable coverage. Increased reporting of mild adverse events during the survey may be attributed to delayed onset after measles vaccination and/or direct inquiry from enumerators. Even mild adverse events following immunization requires strengthened reporting during and after vaccination campaigns.

Keywords: Adverse events; Coverage; Episurveyor; Measles; Vaccination; Vitamin A supplementation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child Welfare / trends
  • Child, Preschool
  • Cluster Analysis
  • Dietary Supplements
  • Health Promotion / methods*
  • Humans
  • Immunization Programs / statistics & numerical data*
  • Infant
  • Infant, Newborn
  • Information Dissemination
  • Maternal Welfare / trends
  • Measles / prevention & control*
  • Measles Vaccine / administration & dosage*
  • Sierra Leone / epidemiology
  • Vitamin A / administration & dosage*
  • Vitamin A Deficiency / epidemiology
  • Vitamin A Deficiency / prevention & control*


  • Measles Vaccine
  • Vitamin A