Reducing the number of zero-dose children by 25 percent in Cameroon by 2025

Using geospatial-based composite score to identify and map missed communities.

Vaccines have reduced disease burden and death in children; still, inequality in coverage continues to persist globally. Although Cameroon has made significant progress in vaccination since the start of the millennium, it remains one of the countries with the largest zero-dose population in Africa due to missed pockets of communities living in hard-to-reach areas. Zero-dose children are those that have not received diphtheria, pertussis, and tetanus vaccine (DPT 1). They are also likely to miss out on other healthcare services, further widening the health inequality gaps for under-five health services.

The traditional head counting approach typically employed in identifying unvaccinated children is expensive and unsustainable – especially on a national scale. Cameroon’s Expanded Program for Immunization (EPI), supported by Clinton Health Access Initiative (CHAI), implemented a project to identify and characterize missed communities by triangulating data from different sources, including —Geographic Information System (GIS), District Health Information Software 2 (DHIS2), Demographic and Health Survey (DHS), Geo-Referenced Infrastructure and Demographic Data for Development (GRID3) and World Health Organization (WHO) data on health facility location. These communities were then ranked based on the probability of finding zero-dose children. This intervention will provide the platform for the EPI to prioritize communities for action based on available limited health resources. Findings from the project are described in the case study below.

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