Adidja Amani*, Yauba Saidu, Collins Tatang Asaah, Fabrice Zobel Lekeumo Cheuyem, Andreas Ateke Njoh, Haamit Abba Kabir, Serge Eyebe, Tatiana Mossus, Hélène Kamo Selenguai, Jeannette Épée Ngoué, Georges-Nguefack Tsagué, Joseph Kamgno, Pierre Ongolo-Zogo
Background: Childhood mortality remains a significant public health issue in Cameroon, despite efforts to reduce mortality rates. Vaccination is recognized as an effective measure to prevent mortality, morbidity, and complications from infectious diseases. The Cameroon Expanded Program on Immunization (EPI) has made remarkable progress in introducing and scaling up several vaccines to reduce infant morbidity and mortality rates, but the program's performance needs to be evaluated to achieve the Sustainable Development Goals (SDGs) by 2030.
Objective: This study aimed to evaluate the performance of the EPI and identify its strengths, weaknesses, opportunities for improvement, and factors contributing to its successes and challenges.
Methods: A mixed-method approach was employed, comprising a web-based qualitative analysis and a quantitative analysis of EPI performance from 2006 to 2019 in Cameroon. Qualitative data was collected through open-ended interviews and focus group discussions with various stakeholders, while quantitative data was obtained from EPI routine reports. The study included all key immunization stakeholders and actors in Cameroon, as well as children aged 0-11 months between 2006 and 2019.
While Cameroon has made significant progress in introducing new vaccines and eliminating some target diseases, it has lagged behind in vaccination coverage, program management, and financing. The COVID-19 pandemic and other factors have further burdened the immunization system. The weaknesses identified included failure to meet the targeted vaccination coverage of all antigens, low coverage in some health districts, and insufficient quality of vaccination data. The country also lagged in geographical equity, program management, and financing.
Conclusion: We recommend intensifying efforts to fill gaps and weaknesses in the immunization system, prioritizing immunization programs for primary health care and universal health coverage, and amplifying efforts to achieve the ambitious targets of the immunization agenda 2030. Cameroon needs to address the challenges posed by the COVID-19 pandemic, conflicts, social unrest, and widespread misinformation that negatively impact the output of vaccination services. By doing so, Cameroon can ensure a strong immunization system and improve the health and well-being of its population, not be left behind in attaining the targets for this decade embedded in the SDGs.