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A study of the factors influencing participation in national immunization days (NID) in Kumasi, Ghana was carried out between the April and June of 1999. Polio-immunization coverage during NID was assessed among children aged < 5 years; > 90% of these children had received polio vaccinations on both of the two previous NID. The mothers who participated most in the NID tended to be those who were better educated and Ghanaian. Mothers who were salaried workers participated fully in NID. Radio and television played a major role in public education about NID, whereas the attitude of health workers was a strong factor that prevented many mothers/caregivers from bringing their children to be immunized. The coverage of the Expanded Programme on Immunization (EPI) was assessed in children aged 12-23 months; nearly 70% of these children were fully immunized. BCG had the highest coverage (97.0%) and measles the lowest (79%). Again, full coverage of the children of mothers who had been educated beyond primary level was higher than that of the other children (75.9% v. 65.2%), and coverage of the children of Ghanaian women was higher than that of the others (70.8%. v. 50.0%). Although the mothers/caregivers raised concerns about the costs of the routine immunizations, these charges apparently did not prevent them from taking their children to be immunized. NID complement the routine EPI-associated work in Ghana, increasing overall polio-immunization coverage. The results of this study will be used to improve the overall performance of immunization programmes, especially in the Kumasi metropolis. Hopefully, sustained, increased polio-immunization coverage will contribute positively towards polio eradication in Ghana.

Focus group discussions, key informant interviews and structured community interviews were used to describe the perceptions of caretakers of pre-school children in a predominantly rural district in Ghana. Over 75% considered ARI important in the community and there are a variety of local terms of describe various ARI illness entities. The perception of signs of severe ARI in children above two months of age was reasonably high; over 88% could mention at least one of two cardinal signs for severe ARI (difficulty in breathing, rapid breathing). The same cannot be said of their perception of signs for children less than two months of age. There was also a favourable perception of cause; a few misconceptions were however identified. There was no significant difference in perception between locality, age groups and educational levels. A high correlation between perception of cause and prevention of ARI was found. Health education programmes should re-enforce positive perceptions and address misconceptions. The difference in presentation of signs of severe ARI between older children and younger ones should also be stressed.