National Immunization programme in rural area of Mozambique; evaluation of immunization coverage rates in child population accessed to a health service

Vaccine preventable diseases still weigh on mortality in the world and especially in children population. Vaccine protection is not uniformly guaranteed being rural areas and low- income population the most disadvantaged. Aim of the study was to verify the children coverage in a rural district in Mozambique where government fixed and mobile health facilities are supported by an Italian ONG (Medicus Mundi Italia). On a sample of 787 accessing children born from 2015 to 2017, the proportion of fully vaccinated (for BCG, Polio 1-3, DTP/HepB/Hib 1-3, PCV 1-3, measles first dose) by one year of age was 80.4% (95% CI 76.6-83.7), by 23 months it was 91% (95% CI 88-93%). However, in a contest where health care can be not easily accessible, the rate of missed opportunities of vaccination (children accessing to the health service at an age proper for administration of a certain vaccine dose but not vaccinated by the evaluating health operator) (MOV) was high for the intramuscular measles second dose (54%). Such a risk was higher in fixed health centre, lower during activity of mobile equipe (79% vs 46%; p value 0.01). Therefore, despite good immunization coverage, there are still margins to intensify strategies for not missing children vaccine opportunities.