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Related Experiment Videos

Equity and immunization supply chain in Madagascar.

Maya M V X van den Ent1, Andre Yameogo2, Eric Ribaira3

  • 1United Nations Children's Fund (UNICEF), NY, NY, USA.

Vaccine
|April 3, 2017
PubMed
Summary

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Madagascar

Area of Science:

  • Global Health
  • Public Health
  • Immunization Programs

Background:

  • Persistent immunization inequities disproportionately affect the poorest communities globally.
  • Madagascar exhibits significant immunization equity gaps, particularly impacting impoverished rural populations.
  • Barriers in immunization supply chain, human resources, and service delivery exacerbate these disparities.

Purpose of the Study:

  • To describe Madagascar's immunization inequities and their programmatic causes.
  • To outline the country's strategies for addressing immunization barriers in impoverished regions.
  • To quantify immunization system barriers in four Malagasy regions.

Main Methods:

  • Two cross-sectional health facility surveys conducted in 2013 and 2015.
Keywords:
Cold chainCoverageEquityImmunizationReaching Every DistrictSupply chainVaccination

Related Experiment Videos

  • Assessment of geographic access to health centers, cold chain functionality, health worker availability, and vaccination session completion rates.

    • Main Results:

    • Significant geographic barriers exist, with 26-33% of the population living >5km from a health center.
    • Acceptable cold chain functionality ranged from 52-80%, and qualified health workers were scarce (10-57% of centers).
    • Vaccination session completion rates varied (65-95% fixed, 50-88% outreach), with an increase in outreach sessions over time.

    Conclusions:

    • Madagascar's immunization program faces substantial challenges, with the poorest populations bearing the brunt.
    • Subnational immunization inequities are primarily geographic, necessitating equitable system improvements.
    • Future strategies should focus on sustainable supply chain solutions, functional cold chains, and universal vaccination service access.