Jerome ATEUDJIEU1,2,3 Martin YAKUM 3, André PascalGOURA3, Frank Forex KIAJEU3, Amada LAPIA3, Manualla CHEUGEU3, Pelagie FIDA4 Anne Cecile BISSEK.2
1Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Dschang; 2 Division of Health Operations Research, Cameroon Ministry of Public Health; 3 Department of Research and Access to Care, M.A. SANTE (Meilleur Acces aux Soins de Santé); 4 METABIOTA, Yaounde Cameroon
CaHReF 2018, Yaoundé Congres hall, 08 – 11 January 2019 , OAUU0117
Background: The Expanded Program on Immunization (EPI) routinely offers to children and pregnant women a number of vaccines to prevent vaccine-preventable diseases. The persistence in Cameroon of outbreaks of these diseases questions the targeted population’s access to EPI vaccines.
Objective: The objective of this study was to assess access to EPI vaccines among children under five.Methods: This part of a baseline survey conducted prior to the implementation the project: Tracking Demographic Movements and Immunization Status to Improve Children's Access to Immunization that is funded by the Bill Gates Foundation Grant Challenge Exploration and implemented by M.A. Sante ( Meilleur Access aux soins de Santé )In Foumban Health District. Data were collected in July 2018 by trained and supervised surveyors using a pretested questionnaires administered in face to face to community volunteers living in targeted villages and children guardian living in households (HH) randomly selected. Data were analyzed to describe villages’ geographic accessibility to vaccinating health facilities or outreach vaccination points, knowledge and perceptions of guardians on why and when to bring children to vaccination as well barrier limiting children access to communication and immunization sessions. The study was approved by national and local health authorities and by the Cameroon National Ethics Review Committee. Results. Of the 2576 visited households in 80 villages from 14 health areas, 1585 (61,5 %) had guardians present during the 3 days of village visit among who 36 (2.3%) refused to participate. Of respondent, 1014 (65.5%) new that the first EPI vaccine dose has to be administered at birth and 391 (25.2) declared not to know when. The mean distance between villages and vaccinating health facilities or outreach EPI vaccination was 0.85 [± 1.07] hours with 0.00 hour as median, 0.00 first quartile and 2.00 hours as third quartile. The mean distance between HH and vaccinating health facilities or outreach EPI vaccination was 0.88 [± 1.15] hours with 0.00 hour as median, 0.00 first quartile and 2.00 hours as third quartile. The maximum distance was 6 hours. Seventy three 73 (97.3%) villages had road access to health facility during the whole year. Of 1435 children under five living in visited HH 1347 (93.9%) were declared to have been vaccinated at least once but only 429 (29.9%) children had a documented vaccination and 418 (29.1%) had evidence to have enrolled in the EPI program with a documented dose of BCG administered.
Conclusion : There is a need to improve guardian knowledge on EPI calendar and on a necessity to secure evidence of children immunization. In addition the planning of immunization session has to be revised to improve geographic access of children to vaccinating health facilities.
Keyword: Immunization, vaccine, access, EPI