Many developed and developing countries have achieved the 1990 uel target.rnHowever ,few countries, like Ethiopia, have neither achieved nor maintained it. Therncoverage in Western Gojjam in 19956 for three doses of DPT was below 40%, farrnbelow the coverage level expected to bring morbidity and mortality reduction.rnA cross-sectional health facility based study to assess the quality ofrnimmunization service delivery using qualitative and quantitative methods wasrnconducted from March to May 1997 in 10 districts of Western Gojjam zone. Allrnhospitals and health centres in the zone and randomly selected health stations werernincluded in the study . Exit interview, observations of client-provider interaction,rndocument review, inventory of equipment, interview with service providers, and focusrngroup discussions with service providers and mothers were the techniques uti! ized.rnThough the geographical access is satisfactory, vaccine shqrtage, lack ofrnincentives and transport facilities , delayed replacement of needles and syringes werernamong the structural factors that affect the quality of service delivery , while poorrncommunication, lack of aseptic procedure, lack of proper screening, weakrnsupervision, and absence of EPI target disease surveillance were weakness in thernprocess of service delivery.rnMore than 98 % satisfaction rate was reported by clients of the service duringrnthe exit interview on the dichotomous scale. But the finding was not consistent withrnthe FGDs and the specific items addressed to assess the satisfaction.rnTherefore, it is concluded that quality of service delivery in immunization wasrnnot satisfactory and hence need improvement to have an effect on coverage andrnmortality and morbidity reduction targets