PDF(Pubmed)
Abstract：
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.
摘要：
索马里是世界上零剂量儿童最多的20个国家之一。这项研究旨在确定零剂量和疫苗接种不足的儿童是谁和在哪里，以及索马里零剂量儿童的现有疫苗接种策略是什么。这项定性研究是在索马里三个地理上不同的地区进行的(农村/偏远，游牧/牧民，国内流离失所者，和城市贫困人口)，与政府官员和非政府组织工作人员(n=17)，以及疫苗接种者和社区成员（n=52）。使用GAVI疫苗联盟IRMMA框架分析数据。游牧人口,国内流离失所者，生活在偏远和青年党控制地区的人口是三个脆弱和被忽视的人口，零剂量儿童比例很高。尽管这些群体的背景异质性，缺乏针对性,针对特定人群的战略和当地社区有意义地参与免疫服务的规划和实施在有效覆盖零剂量儿童方面存在问题。这是,根据我们的知识，这是第一项研究，在索马里脆弱的背景下，研究零剂量和疫苗接种不足人群的疫苗接种策略。关于面临疫苗可预防疾病风险的人群和重要疫苗接种服务障碍的证据仍然至关重要和紧迫，特别是在像索马里这样面临复杂卫生系统挑战的国家。
