Assessing Vaccination Delivery Strategies for Zero-Dose and Under-Immunized Children in the Fragile Context of Somalia

• Published in: Vaccines (Basel) Vol. 12; no. 2; p. 154
• Main Authors: Bile, Ahmed Said, Ali-Salad, Mohamed A, Mahmoud, Amina J, Singh, Neha S, Abdelmagid, Nada, Sabahelzain, Majdi M, Checchi, Francesco, Mounier-Jack, Sandra, Nor, Barni
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.02.2024; MDPI
• Subjects: Access control; At risk populations; Caregivers; Children; Coasts; Community; Community planning; conflict; Context; crisis; Data analysis; Data collection; Displaced persons; Focus groups; fragility; Health aspects; Health facilities; Heterogeneity; Humanitarianism; Immunization; International Health; Internationell hälsa; Local communities; Methods; Militancy; Population; Populations; populations at risk; Qualitative research; Researchers; Tetanus; Urban poverty; Vaccination; Vaccines; Whooping cough; zero-dose children; Somalia; Indian Ocean; Ethiopia; crisis; fragility; populations at risk; conflict; vaccination; zero-dose children
• DOI: 10.3390/vaccines12020154
• ISSN: 2076-393X

Somalia is one of 20 countries in the world with the highest numbers of zero-dose children. This study aims to identify who and where zero-dose and under-vaccinated children are and what the existing vaccine delivery strategies to reach zero-dose children in Somalia are. This qualitative study was conducted in three geographically diverse regions of Somalia (rural/remote, nomadic/pastoralists, IDPs, and urban poor population), with government officials and NGO staff ( = 17), and with vaccinators and community members ( = 52). The data were analyzed using the GAVI Vaccine Alliance IRMMA framework. Nomadic populations, internally displaced persons, and populations living in remote and Al-shabaab-controlled areas are three vulnerable and neglected populations with a high proportion of zero-dose children. Despite the contextual heterogeneity of these population groups, the lack of targeted, population-specific strategies and meaningful engagement of local communities in the planning and implementation of immunization services is problematic in effectively reaching zero-dose children. This is, to our knowledge, the first study that examines vaccination strategies for zero-dose and under-vaccinated populations in the fragile context of Somalia. Evidence on populations at risk of vaccine-preventable diseases and barriers to vital vaccination services remain critical and urgent, especially in a country like Somalia with complex health system challenges.