81 percent in 1994. As of 2000, providers who participate in VFC are administering 70 percent of immunizations in the area, but coverage rates have dropped to 71.5 percent. In 1997, a state-sponsored pilot study demonstrated that VFC providers in El Paso were not assessing immunization coverage accurately and also were not documenting children’s immunization histories. Since 1997, the health district has worked with limited numbers of providers who participate in VFC to conduct systematic record assessments using CDC’s AFIX (assessment, feedback, incentives, exchange) program strategy, which includes use of the Clinic Assessment Software Application. With these assessments, immunization rates among participating providers rose from as low as 40 percent in 1997 to 90 percent or higher in 2000.

The assessment program requires considerable staff time and therefore creates a need for funding. Initially, state funds supported the work of three El Paso health district staff members on the assessment program. To respond to a growing demand for assessment services, Dr. Magaña obtained additional funding by turning to a local foundation, the El Paso del Norte Health Foundation. The foundation made a 2-year grant through the El Paso County Medical Society for a collaborative effort with the health district. The assessment program has been effective in raising immunization rates in El Paso and in helping the health district build partnerships in the community and with the state health department. Dr. Magaña emphasized, however, that foundation funding was only a short-term means of supporting the assessment program and that other funding solutions are necessary to sustain those activities.



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