Near universal childhood vaccination rates in Rwanda: how was this achieved and can it be duplicated?

作者：James Bao, Heather McAlister, Julia Robson, Alissa Wang, Kirstyn Koswin, Félix Sayinzoga, Hassan Sibomana, JeanPaul Uwizihiwe, Jean de Dieu Hakizimana, José Nyamusore, Adeline Kabeja, Joseph Wong, Stanley Zlotkin · 发表于：The Lancet Global Health · 年份：2018 · DOI：10.1016/s2214-109x(18)30176-1 · 被引用次数：39 · 研究领域：Vaccine Coverage and Hesitancy、Viral Infections and Outbreaks Research、Hepatitis B Virus Studies

Background According to data from the WHO Vaccine-Preventable Disease Monitoring System, Rwanda has achieved near universal childhood vaccination rates, with an overall national coverage rate for childhood immunisation of 98% in 2015. These rates are striking given the country's status as a post-conflict, post-genocide, and low-income country. In this study, we aimed to determine factors that contributed to the success of Rwanda's childhood immunisation programme. Methods We used primary and secondary sources to identify such factors. Primary research was conducted in August, 2017, in Eastern Province, Northern Province, and the city of Kigali, Rwanda. We used snow-ball sampling to recruit interviewees. Semi-structured interviews were conducted with government, multilateral organisations, and non-governmental staff members involved in the planning and delivery of Rwanda's immunisation programme. Secondary sources included review of primary databases, grey literature, and peer-reviewed literature that was identified through searches in Google Scholar and PubMed for articles written in English and published since Jan 1, 2000, using combinations of the search terms "Rwanda", "vaccination", "immunisation", and "programme". Findings 24 interviews were conducted and secondary data were analysed. Several factors have contributed to Rwanda's vaccination success. First, at the local level, an engaged cadre of community health workers sensitises communities on the importance of vaccina...