Ad. Dulou et G. Pison, BARRIERS TO UNIVERSAL CHILD IMMUNIZATION IN RURAL SENEGAL 5 YEARS AFTER THE ACCELERATED EXPANDED PROGRAM ON IMMUNIZATION, Bulletin of the World Health Organization, 72(5), 1994, pp. 751-759
Although the Expanded Programme on Immunization (EPI) has been a world
wide success, weak points remain, particularly in Africa. In Senegal,
for example, immunization coverage was low in 1990 (60%), in part beca
use of poor results in rural areas. In order to identify obstacles to
EPI in such areas, we carried out an immunization survey in Bandafassi
, a rural area of Senegal, where 6078 inhabitants lived in 23 small vi
llages. Only 41% of children aged 1-10 years were completely vaccinate
d in February 1992, with considerable variations in coverage from one
village to another, according to their geographical location: 71% of c
hildren were completely vaccinated in villages less than 10 km from th
e health centre, whereas in remote villages only 10% of children had b
een completely vaccinated. There was no variation according to ethnic
group. From 1987 to 1992, the gap in immunization coverage between the
remote villages and those located close to the health centre has stea
dily increased. There is a need to improve the performance of the mobi
le teams in the remote villages and to increase awareness about the im
portance of immunization.