EXPANDING IMMUNIZATION COVERAGE IN PUNTLAND, SOMALIA: A QUALITATIVE ANALYSIS

The objectives of this study are to (1) to identify strategies to improve the immunization program in order to achieve a higher and more sustainable coverage, (2) to study demand-related and supply-related factors affecting childhood immunization, (3) to explore (perceived) barriers to high, and sustainable immunization coverage, and (4) to identify how communities can contribute to increasing the coverage rate, especially in remote areas. Qualitative data were collected using focus group discussions and in-depth interviews. The main findings are that: (1) the Puntland government currently does not have strategies to financially contribute to the EPI Program and is totally dependent on international donors (e.g. UNICEF and WHO) to finance the EPI program, while the donors are facing financial shortages due to ongoing crises in other countries such as Nigeria, Syria, and Yemen, for which they also provide financial support; (2) the understanding of mothers with regard to the benefits of the EPI program is relatively low, due to a low engagement level and poor awareness; (3) community involvement in the planning and consultation process of the EPI program has been limited and the Ministry of Health has not adequately involved the community in the planning process. There is a greater need for the government to generate its own funds to support the EPI program to be financially sustainable. The Government should allocate specific (earmarked) funds to the EPI program, and come up strategies to improve the EPI performance, increase coverage, as well as to restructure the program such that mothers and community members at large are encouraged to participate in the planning process in order for them to have a stronger ownership in the EPI program.