Journal of Vaccines & Vaccination

Abstract

In-Depth Reasons for the High Proportion of Zero-Dose Children in a Remote Rural District in Cameroon: A Qualitative Study

Yauba Saidu*, Sangwe Clovis Nchinjoh, Pietro Di Mattei, Nkwain Jude Muteh, Nadege Edwige Nnang, Andreas Ateke Njoh, Amani Adidja, Shalom Tchofke Ndoula, Owens Wiwa, Ancel Emmanuel Songo, Calvin Tonga, Emanuele Montomoli, Sue Ann Costa Clemens, Chen Stein-Zamir and Sveta Roberman

Background: Manoka Health District (MHD), an enclaved archipelago district in Cameroon, is home to about 1,732 under-2 children. Over 90% of these children have not received a single dose of any vaccine. In this paper, we explored the reasons for the high proportion of zero-dose children in this district so as to generate information that policymakers can use to develop context-specific interventions to boast coverage for Routine Immunization (RI) in this remote fishing island.

Methodology: We collected qualitative data via Key Informant Interviews (KII) and Focused Group Discussions (FGD) and analyzed them using thematic analysis. Participants for KII were selected using purposive sampling, and a snowballing approach helped to recruit an intermixed population of locals and immigrants for FGDs.

Results: MHD is a hard-to-reach zone with a lone health facility that lacks a functional cold chain equipment to cover the 47 islets of the district. Diurnal floods, long distance, sea turbulence, infrastructural and resource constraints, and immigrant population without residence permits hinders optimal childhood vaccination. Insufficient community health workers and lack of proper community engagement with feedback loops hamper effective communication and vaccine uptake during campaigns and outreaches. The reasons for vaccination hesitancy included hospital-based vaccination preference over home-based vaccination, fear of post-vaccination fever, rumors, repeated postponement of the vaccination schedules, and refusal by some ethnic group leaders.

Conclusion: This study revealed context-specific reasons for zero-dose childhood vaccination status in MHD. These findings should be leveraged to design tailored interventions to raise RI in MHD and similar under-vaccinated communities.

Published Date: 2023-09-07; Received Date: 2023-08-05