Project report
Root Causes of Low Vaccination Coverage and Under-Immunisation in Sub-Saharan Africa Report
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Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This report looks at why vaccination coverage is low and many children are under-immunised in Sub-Saharan Africa. It notes that the African region had about 43% of the world's unimmunised and incompletely immunised infants in 2019, and the lowest regional coverage. Coverage differs between countries and within countries over time, which suggests shared underlying causes. The report sets out to group these 'root causes' under four linked themes using a theory of change. It also aims to recommend actions based on documented successes.
Key points
- WHO estimated that in 2019 the African region had about 43% of the world's unimmunised and incompletely immunised infants (8.5 million of 19.4 million).
- Regional immunisation coverage was 76%, compared with 86% globally.
- Earlier studies found that performance varies between countries and within countries over time.
- The report groups root causes under four broad, interlinked themes using a theory of change.
- Recommendations are to be based on documented successes, to help reach every child with all recommended vaccines.
Limitations
Only the introduction is available, so the four themes, the root causes, the methods of the consensus study and the recommendations are not shown. The opening statement that the region accounts for '40% of all global deaths' is unclear as worded and cannot be checked from the text.
Abstract
Sub–Saharan Africa (SSA) alone accounts for 40% of all global deaths, a phenomenon attributed to lack of access to available lifesaving vaccines (Wiysonge, Uthman, Ndumbe, & Hussey, 2012). WHO estimates that in 2019 the African region accounted for approximately 43% of unimmunised and incomplete immunised infants in the world (i.e.: 8.5 million of the global 19.4 million). Relatedly, the region scores the lowest immunisation coverage, at 76% versus the global coverage of 86% (WHO, 2020a). This is despite several documented efforts by different stakeholders to improve coverage in the region (Mihigo, Okeibunor, Anya, Mkanda, & Zawaira, 2017). Many studies have been conducted on coverage and drivers for and bottlenecks against immunisation in SSA. (Wiysonge, Uthman, Ndumbe, & Hussey, 2012), (Wiysonge, Young, Kredo, McCaul, & Volmik, 2015), (Mihigo, Okeibunor, Anya, Mkanda, & Zawaira, 2017), (Madhi & Rees, 2018),(Bangura, et al., 2020), all of which have observed that there is varied performance among the constituent countries, and also within countries over time, denoting some implicitly common underlying correlates threading through areas of higher performance; and the same is seen with the poorer performing areas. This consensus study therefore seeks to categorise and make explicit these “root causes” and based on documented successes, to make recommendations to address the bottlenecks and harness the opportunities for reaching every child with all the recommended vaccines. The theory of change presentation style used in this report, categorising the root causes under four broad interlinked themes, can provide a common basis to rally like-minded partners around a thematic cause and thus develop multi-component, comprehensive strategies to bring about impactful change. This is in line with the call made by the World Health Organisation Strategic Advisory Group of Experts on Immunisation, which recommended that countries, regions and global immunisation partners commit to a comprehensive review of progress, impact, and implementation of the WHO Global Vaccine Action Plan to inform a post-2020 strategy taking into account lessons learned. This strategy will assist with attaining the relevant United Nations Sustainable Development Goals by 2030.