FACTORS INFLUENCING COVERAGE AND KEY CHALLENGES TO ACHIEVING TARGETS OF ROUTINE IMMUNIZATION IN AFRICA: A SYSTEMATIC REVIEW
Keywords:
Child survival , EPI , routine immunization , coverage/accessAbstract
Background: Immunization is one of the most important cost effective public health interventions available for prevention of childhood illnesses and death. Complete vaccination status rates according to the World Health Organization (WHO) vaccination schedule is low. Coverage (average) for the 3rd dose of DPT (Diphtheria, Pertussis, and Tetanus) in Africa in 2013 was 75%.
Objective: To identify the factors contributing to low coverage and the challenges to routine immunization in Africa.
Methods: review of published journal articles from Pub med and Google search
Results: Current literature has identified several barriers to immunization, including lower parental education, younger maternal age, lower income, being a female child, and larger family size. Low access to services and inadequate awareness about vaccination were also barriers to complete vaccination series. Children were more likely to be vaccinated if their mother received antenatal care during pregnancy and delivered in health facility. Health facility factors, such as long waiting times, missed opportunities and high dropout rates were associated with lower rates of vaccination. Availability of vaccines was not a major problem, but there was problem of distribution according to the need of health facilities.
Conclusion: There is a need to give health education on immunization to raise awareness of parents. Improving litracy of women, participation in household decision making also improved immunization coverage. Development and use of micro-plans, maps, and monitoring charts in health facilities improved the use of data for action. EPI training of health workers helped to provide good quality immunization service. Parent reminder and recall systems and mass media interventions have the potential to increase immunization coverage. Verbal, video, or provider delivered communication tools may also increase parents’ understanding
