Evaluation of Reference Centers for Special Immunobiologicals implementation

Abstract

OBJECTIVE: To describe the Reference Centers for Special Immunobiologicals and evaluate their implementation considering formal regulations.METHODS: We conducted a program evaluation, of evaluative research type. From August 2011 to January 2012, a questionnaire was applied to the 42 Reference Centers for SpecialImmunobiologicals existing in the Country, approaching the structure, human resources,and developed activities dimensions. We conducted a descriptive analysis of data and used aclustering for binary data with the squared Euclidean distance, by the farthest neighbor method,to aggregate services with similar features.RESULTS: We observed great diversity among the services in the three dimensions. The clusteringresulted in five service profiles, named according to their characteristics. 1) Best structure:12 Reference Centers for Special Immunobiologicals with the highest proportion of serviceswith the minimum of rooms recommended, purpose-built vaccine refrigerators, preventivemaintenance of the cold chain, and oxygen source. 2) Immunobiologicals distributor: six ReferenceCenters for Special Immunobiologicals that distributed more than applied immunogens;no doctor present for more than half of the working hours and no purpose-built vaccinerefrigerators. 3) Incipient implementation: five Reference Centers for Special Immunobiologicalswith inadequate structure, such as absence of purpose-built vaccine refrigerators, preventivemaintenance of the cold chain and oxygen source; none had computer. 4) Vaccination rooms:13 Reference Centers for Special Immunobiologicals, everyone did routine immunization, mostparticipated in vaccination campaigns. 5) Teaching and research: six services, all inserted intoteaching hospitals, developed researches and received trainees; most had doctors in more thanhalf of the working hours.CONCLUSIONS: The evaluation of the Reference Centers for Special Immunobiologicalsimplementation was based on the profiles found and considered the official regulations: servicescategorized as “better structure” and “teaching and research” were considered implemented;“immunobiologicals distributor” and “vaccination room” services, partially implemented, and theones with the “incipient implementation” profile, not implemented. The results of this evaluationcan contribute to the reformulation of the services, considering the current context