| Autor: |
Bile AS; Somali Institute for Development Research and Analysis (SIDRA), Garowe, Puntland State, Somalia., Ali-Salad MA; Somali Institute for Development Research and Analysis (SIDRA), Garowe, Puntland State, Somalia., Mahmoud AJ; Somali Institute for Development Research and Analysis (SIDRA), Garowe, Puntland State, Somalia.; Department of Women's and Children's Health, Uppsala University, 753 10 Uppsala, Sweden., Singh NS; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.; Health in Humanitarian Crises Centre, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK., Abdelmagid N; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.; Health in Humanitarian Crises Centre, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK., Sabahelzain MM; School of Health Sciences, Ahfad University for Women (AUW), Omdurman P.O. Box 167, Sudan.; School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia., Checchi F; Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.; Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK., Mounier-Jack S; Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK., Nor B; Department of Women's and Children's Health, Uppsala University, 753 10 Uppsala, Sweden. |
| Abstrakt: |
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 ( n = 17), and with vaccinators and community members ( n = 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. |
