Authors :
Ousmane SY; Adama Sanogo; Aissata Toure; Oumar Dembele; Abdoul Razakou Abacar Dicko; Youssouf Diam Sidibe; Moussa Djire
Volume/Issue :
Volume 11 - 2026, Issue 1 - January
Google Scholar :
https://tinyurl.com/uf8xy9w
Scribd :
https://tinyurl.com/3sxnd27j
DOI :
https://doi.org/10.38124/ijisrt/26jan1367
Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.
Abstract :
Introduction:
"Zero-dose" children are those who have not received any dose of routine vaccines. These children represent a major
challenge to achieving vaccination coverage goals, especially in rural areas where geographic inaccessibility, mistrust of
health services, poverty, and parental ignorance contribute to their lack of vaccination. In Konséguéla, an active search
strategy for zero-dose children was implemented in 2024 with the support of community health workers and local leaders.
This study was conducted to assess the effect of implementing the "zero dose" child search strategy on vaccination coverage
in Konséguéla, comparing the results with those of a control site (Kôkô) where the strategy was not applied.
Methodology:
This was a before-and-after study with a control site, retrospective and analytical, using a mixed-methods approach. A
non-probability sampling method was used. Data collected were analyzed using IBM SPSS Statistics 25 and Excel 2016. The
tools included a questionnaire and an interview guide to identify challenges related to the vaccination of zero-dose children.
Results:
The study revealed a clear increase in vaccination coverage rates in Konséguéla after the implementation of the
strategy: (BCG: 61.21% → 95.06%) ;(Penta1: 84.67% → 90.12%) ; (Penta3: 86.32% → 90.43%) et (VAR1-RR1: 88.27% →
90.33%). In Kôkô, the control site, the coverage rates remained generally stable. The comparison of these averages using the
Wilcoxon test showed that there was no statistically significant difference between the two periods. The main barriers
identified were: low educational level of parents, difficult geographic accessibility, socio-cultural barriers, forgetfulness or
refusal from fathers, lack of information, family displacement, logistical constraints, limited resources, and lack of parental
motivation.
Conclusion:
Overall, the study shows that the zero-dose child tracing strategy implemented in Konséguéla in 2024 did not lead to a
significant improvement in vaccination coverage, despite an observed increase in coverage rates after the strategy was
introduced. These findings support international recommendations to integrate the identification and tracing of
unvaccinated children into routine immunization programs, particularly in areas with low coverage or high dropout rates.
Keywords :
Evaluation, Effect, Implementation, Search Strategy, Zero-Dose Children, Vaccination Coverage, Konséguéla.
References :
- Gavi, the Vaccine Alliance. Definition and Mapping - Zero Dose [Internet]. Geneva, Switzerland: Vaccine Alliance; 2021 [cited 3 Jan 2025]. Available at: https://fr.scribd.com/presentation/690308366/4-Definition-Et-Cartographie-Zero-Dose.
- Gavi, 2. GAVI. Understanding the issue of zero-dose children. Geneva, Switzerland: Vaccine Alliance; 2022. pp. 7–9. Available at: https://www.gavi.org/fr/vaccineswork/comprendre-problematique-enfants-zero-dose
- © UNICEF. The State of the World's Children 2023: Vaccines for Every Child [Internet]. New York, United States: UNICEF; 2023 [cited 3 May 2025]. Available from: https://www.gavi.org/fr/vaccineswork/comprendre-problematique-enfants-zero-dose.
- World Health Organisation. Global vaccination coverage in 2023 (WUENIC Estimates) [Internet]. Geneva, Switzerland: WHO; 2024 [cited 7 October 2024]. Available from: https://www.who.int/fr/news-room/fact-sheets/detail/immunization-coverage.
- UNICEF, World Health Organization. Global childhood immunisation levels stalled in 2023 leaving many without life-saving protection [Internet]. Geneva, Switzerland and New York, United States; 2024 [cited 10 Jan 2025]. Available from: https://www.unicef.org/fr/communiques-de-presse/les-niveaux-de-vaccination-infantile-dans-le-monde-ont-stagne-en-2023.
- Gavi, the Vaccine Alliance. Understanding the issue of zero-dose children [Internet]. Geneva, Switzerland: Vaccine Alliance; 2022 [cited 11 Nov 2024]. Available from: https://www.gavi.org/fr/vaccineswork/comprendre-problematique-enfants-zero-dose
- CAPEV. Rapid assessment: situation of zero-dose and under-vaccinated children in Mali. Mali Country Learning Hub, coordinated by GaneshAID. Bamako, Mali: CAPEV; 2024.
- Ministry of Health and Social Development of Mali. Analysis of the situation of children in Mali in the Comprehensive Multi-Year Plan for the Expanded Programme on Immunisation (2022–2026). Bamako, Mali; 2022. pp. 20–21.
- UNICEF & WHO. The State of the World's Children 2023 | UNICEF [Internet]. 2023 [cited 3 May 2025]. Available from: https://www.unicef.org/fr/rapports/situation-enfants-dans-le-monde-2023.
- Gavi. Annual Report 2022. Geneva, Switzerland: Vaccine Alliance; 2022.
- Médecins Sans Frontières (MSF). Strengthening routine immunization in fragile settings: Chad case study. Chad: MSF Operational Center Geneva; 2021. p. 8–10 1..
- GAVI. Reaching zero-dose children: Nigeria’s outreach strategy [Internet]. Geneva, Switzerland: Vaccine Alliance; 2022. Available at: www.gavi.org.
- UNICEF. Reaching urban poor children with immunization: Experience from Bangladesh. New York: UNICEF; 2021
- Médecins Sans Frontières (MSF). Strengthening routine immunization in fragile settings: Chad case study. Chad: MSF Operational Center Geneva; 2021. p. 8–10 1..
- PATH. Immunization in the Democratic Republic of the Congo: Landscape Analysis and Policy Recommendations. Seattle, WA, USA: PATH; 2016. p. 23–24.
- Serme M. Community determinants of high rates of non-compliance with BCG and VAR vaccinations among children aged 0 to 11 months in the town of Pouytenga (Burkina Faso) [Internet]. Burkina Faso: National School of Public Health; 2011 [cited 3 May 2025]. Available from: https://www.memoireonline.com/02/12/5276/
Introduction:
"Zero-dose" children are those who have not received any dose of routine vaccines. These children represent a major
challenge to achieving vaccination coverage goals, especially in rural areas where geographic inaccessibility, mistrust of
health services, poverty, and parental ignorance contribute to their lack of vaccination. In Konséguéla, an active search
strategy for zero-dose children was implemented in 2024 with the support of community health workers and local leaders.
This study was conducted to assess the effect of implementing the "zero dose" child search strategy on vaccination coverage
in Konséguéla, comparing the results with those of a control site (Kôkô) where the strategy was not applied.
Methodology:
This was a before-and-after study with a control site, retrospective and analytical, using a mixed-methods approach. A
non-probability sampling method was used. Data collected were analyzed using IBM SPSS Statistics 25 and Excel 2016. The
tools included a questionnaire and an interview guide to identify challenges related to the vaccination of zero-dose children.
Results:
The study revealed a clear increase in vaccination coverage rates in Konséguéla after the implementation of the
strategy: (BCG: 61.21% → 95.06%) ;(Penta1: 84.67% → 90.12%) ; (Penta3: 86.32% → 90.43%) et (VAR1-RR1: 88.27% →
90.33%). In Kôkô, the control site, the coverage rates remained generally stable. The comparison of these averages using the
Wilcoxon test showed that there was no statistically significant difference between the two periods. The main barriers
identified were: low educational level of parents, difficult geographic accessibility, socio-cultural barriers, forgetfulness or
refusal from fathers, lack of information, family displacement, logistical constraints, limited resources, and lack of parental
motivation.
Conclusion:
Overall, the study shows that the zero-dose child tracing strategy implemented in Konséguéla in 2024 did not lead to a
significant improvement in vaccination coverage, despite an observed increase in coverage rates after the strategy was
introduced. These findings support international recommendations to integrate the identification and tracing of
unvaccinated children into routine immunization programs, particularly in areas with low coverage or high dropout rates.
Keywords :
Evaluation, Effect, Implementation, Search Strategy, Zero-Dose Children, Vaccination Coverage, Konséguéla.