Assessment of Vaccine managers' Knowledge and Observance of Vaccination Norms and Standards in an Urban Health District of Yaounde (Cameroon) during the COVID-19 Pandemic

BackgroundRoutine childhood immunization remains a highly cost-effective public health intervention. Global immunization efforts have increased the coverage of proxy antigens in recent decades. However, annual reports indicated a progressive decline in immunization coverage in Yaounde. This study aimed to identify knowledge gaps and organizational deficiencies in the implementation of routine immunization in health facilities (HFs) in the Efoulan Health District (HD) of Yaounde. MethodsA descriptive cross-sectional study was conducted in Efoulan, an urban HD of Yaounde, the capital of Cameroon, in May 2022. A self-administered questionnaire was used to collect knowledge data from consenting HCWs. An observation grid was used to assess the implementation of some relevant national EPI guidelines and recommendations. ResultsA total of 46 HCWs providing vaccinations in the nine health areas of HDs were enrolled in the study. Almost all participants (93.5%) were unable to name all the diseases that the pentavalent vaccine protects against. More than half of the respondents (59%) were aware of the 15-month booster dose of the measles-rubella (MR) vaccine included in the EPI. Half of the respondents were aware of the type of antigen contained in the BCG vaccine (52%). More than two-thirds of the respondents (72%) had not identified the 6-month MR vaccine as recommended without risk for HIV+ children. Most of the respondents were not aware of the management of opened nonlyophilized vials (50%), calculation of the wastage factor (89%) or vaccine requirements (98%). Almost all the respondents (87%) had poor knowledge of vaccination norms and standards. Most of the visited HFs did not follow the monthly EPI monitoring curve (87%), did not store vaccines according to standards (80%), or had an EPI case reporting form (93%). Most of the consultants in visited HFs were not familiar with the case definitions of common vaccine- preventable diseases. ConclusionsThe implementation of routine immunization remained poor in most of the HFs in Efoulan HDs because of the lack of knowledge of the EPI norms and standards of the staff. There is a need to strengthen the capacities of HCWs through ongoing training and supervision.