Challenges of immunization in the African region

Mihigo, Richard; Okeibunor, Joseph; Anya, Blanche-Philomene Melanga; Mkanda, Pascal; Zawaira, Felicitas

doi:10.11604/pamj.supp.2017.27.3.12127

Cited by 52 publications

(53 citation statements)

References 9 publications

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“…This could provide a foundation for building stronger services post-COVID. At health facilities and outreach sites, increased attention and funding is needed to implement strategies to diagnose and remedy causes of missed opportunities for vaccination [ 46 ] and other barriers to utilization of services such as stockouts and cancellation of sessions due to lack of transport or human resources [ 47 ]. The COVID-19 pandemic has led to a re-emphasis on administering MCV (and other missed vaccination doses) to eligible children older than 12 months [ 48 ], and this message needs reinforcement after the pandemic to enhance routine MCV1 and MCV2 coverage.…”

Section: Discussionmentioning

confidence: 99%

Vaccination strategies for measles control and elimination: time to strengthen local initiatives

Cutts

Ferrari

Krause

et al. 2021

BMC Med

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Background Through a combination of strong routine immunization (RI), strategic supplemental immunization activities (SIA) and robust surveillance, numerous countries have been able to approach or achieve measles elimination. The fragility of these achievements has been shown, however, by the resurgence of measles since 2016. We describe trends in routine measles vaccine coverage at national and district level, SIA performance and demographic changes in the three regions with the highest measles burden. Findings WHO-UNICEF estimates of immunization coverage show that global coverage of the first dose of measles vaccine has stabilized at 85% from 2015 to 19. In 2000, 17 countries in the WHO African and Eastern Mediterranean regions had measles vaccine coverage below 50%, and although all increased coverage by 2019, at a median of 60%, it remained far below levels needed for elimination. Geospatial estimates show many low coverage districts across Africa and much of the Eastern Mediterranean and southeast Asian regions. A large proportion of children unvaccinated for MCV live in conflict-affected areas with remote rural areas and some urban areas also at risk. Countries with low RI coverage use SIAs frequently, yet the ideal timing and target age range for SIAs vary within countries, and the impact of SIAs has often been mitigated by delays or disruptions. SIAs have not been sufficient to achieve or sustain measles elimination in the countries with weakest routine systems. Demographic changes also affect measles transmission, and their variation between and within countries should be incorporated into strategic planning. Conclusions Rebuilding services after the COVID-19 pandemic provides a need and an opportunity to increase community engagement in planning and monitoring services. A broader suite of interventions is needed beyond SIAs. Improved methods for tracking coverage at the individual and community level are needed together with enhanced surveillance. Decision-making needs to be decentralized to develop locally-driven, sustainable strategies for measles control and elimination.

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Section: Discussionmentioning

confidence: 99%

Vaccination strategies for measles control and elimination: time to strengthen local initiatives

Cutts

Ferrari

Krause

et al. 2021

BMC Med

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“…21 Other scholars have also lamented that cases of inequity in access to health services continue to exist in the African region. 22,23 The United Nations International Children's Emergency Fund has also lamented that despite the remarkable progress in maternal and child health care provisioning high disparities in health outcomes among mothers and their children remain high due to socioeconomic differences. 12 In this study, equal number of variables correlated with the quality of services received from ANC clinics during the last pregnancy than with the access to health services the last time health care was needed.…”

Section: Discussionmentioning

confidence: 99%

Inequities in Access to Maternal Health Care in Enugu State: Implications for Universal Health Coverage to Meet Vision 2030 in Nigeria

Ozumba

Onyeneho

Chalupowski

et al. 2018

Int Q Community Health Educ

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We explored the equity issues in access to maternal health services in Enugu State, Nigeria. We conducted a cross-sectional survey of 1,600 women who had babies within 6 months prior to the survey, drawn from four urban and rural local government areas in Enugu State of Nigeria, using structured questionnaire. Focus group discussions were held with grandmothers and fathers of the new babies. In-depth interviews were held with health workers. Results showed that inequities exist in access to quality health service when the mothers needed health care. The inequities in access to quality antenatal care (ANC) services were driven mainly by the type of localities of the mothers. Mothers who lived in the urban areas had better access ( p = .013). Other factors that facilitated access to better ANC services included being educated ( p = .049), being older ( p = .009), and belonging to the richer wealth quintile ( p < .001). With respect to access to health service when in need of health, differentials were seen with respect to living in urban residence ( p < .001), distance to the health facilities ( p < .001), and being rich ( p < .001). Access to health services was associated with odds ratio of 3.6 (95% CI [2.9, 4.4]) and 1.54 (95% CI [1.3, 2.0]) for living in urban residence and existence of good ANC service points, respectively. Similarly, living in urban areas was associated with an odds ratio of 1.3 (95% CI [1.1, 1.6]) of having access to good ANC services. These inequities in access to health service were also captured in the qualitative data. Suboptimal access to quality health care by segments of the populations poses challenge to universal health coverage in Enugu State. Action is needed to promote coordinated delivery of health services to ensure no one is left behind, irrespective of where they live or the socioeconomic strata they are born into.

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“…The Expanded Programme on Immunisation (EPI) in African countries has attained significant progress since its establishment in 1974. However, EPI in Africa still faces many challenges including suboptimal funding, poor immunisation data quality, insufficient resources, and vaccines stock outs [8] among others.…”

Section: Introductionmentioning

confidence: 99%

An update on trends in the types and quality of childhood immunization research outputs from Africa 2011–2017: Mapping the evidence base

Haddison

Machingaidze²,

Wiysonge

et al. 2019

Vaccine: X

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Highlights Update of an analysis used to synthesise data on childhood immunisation in Africa. PubMed and Africa Wide databases were searched from January 2011 to September 2017 for articles on childhood immunisation. There was a remarkable increase in immunisation output from 2011 to 2017 compared to the previous decades. Most studies focused on the EPI and a majority of the studies were generated by Nigeria and South Africa. There is need for collaboration between high and low research generating countries to foster research on the continent.

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Challenges of immunization in the African region

Cited by 52 publications

References 9 publications

Vaccination strategies for measles control and elimination: time to strengthen local initiatives

Vaccination strategies for measles control and elimination: time to strengthen local initiatives

Inequities in Access to Maternal Health Care in Enugu State: Implications for Universal Health Coverage to Meet Vision 2030 in Nigeria

An update on trends in the types and quality of childhood immunization research outputs from Africa 2011–2017: Mapping the evidence base

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