BARRIERS TO UNIVERSAL CHILD IMMUNIZATION IN RURAL SENEGAL 5 YEARS AFTER THE ACCELERATED EXPANDED PROGRAM ON IMMUNIZATION

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.