[Effects of Monitoring "Out-of-Area" Vaccinated Children on Data Quality, San Pedro Health District, Côte D'ivoire in 2019]. / Effets du Suivi des Enfants « Hors Zone ¼ Vaccinés sur la Qualité des Données, District Sanitaire de San Pedro, Côte D'ivoire, 2019.

In order to improve the quality of vaccination data from the health centers, we carried out the follow-up of "out-of-area" children, vaccinated in the district of San Pedro. The objective of this work was to measure the effects of taking into account the "out-of-area" vaccinated children on the quality of the data and the immunization performance of the health centers. This monitoring, which was carried out between March and August 2019, consisted of four steps: the vaccination of "out-of-area" children by the health center, the monthly update in the register of the status of vaccinated "out-of-area" children, the accounting of these children, and the re-evaluation of the health center's vaccine performance. A total of 37 of the 40 district centers had 980 "out-of-area" vaccinated children, representing 5.7% of the immunization target. The quarter of these children resided outside the district. The vaccination of "out-of-area" children included all EPI vaccines, but especially BCG, DTP-HepB-Hib and Pneumococcus_13. The number of "outside the extra-district area" vaccinated children had not changed the district's immunization coverage. On the other hand, in the health centers concerned, the accuracy of the data had been improved in 65% of the centers for DTP-HepB-Hib_1, in 70% of the centers for RR and in 65% of the centers for the overall immunization dropout rate. The approach used had made it possible to improve the quality of immunization data from health centers at no additional cost.

[Performance of the Strategy to Catch Up with Drop Out and Unvaccinated Children in Côte d'Ivoire in 2018]. / Performance de la stratégie de rattrapage des enfants perdus de vue et non vaccinés en Côte d'Ivoire en 2018.

To improve the performance of Côte-d'Ivoire's immunization program, we have implemented a strategy to catch up with drop out children (DOC) and unvaccinated children (UVC) in 14 Health Districts (HDs) with the lowest measles vaccination coverage. This article presents the effectiveness and cost of this strategy. We selected the areas with the highest numbers of DOC: 5 health areas (HAs) per HD and 5 villages/neighborhoods per HA. The strategy, which was implemented by civil society organizations, health centre managers (HCMs) and community health workers (CHWs), combined sensitization of community leaders and groups, home visits (HV) and referral of children to the HCs for immunization. Out of the 17,912 reported DOC, 9,425 found (52.6%) and 8,245 were vaccinated (46% of declared, 87.5% of found). The HCMs reported 484 UVC while the home visits identified 1,315 of which 1,087 were vaccinated (82.7%). Out of a total declared number of 18,396 children to be caught up, 10,740 found (58.4%) and 9,332 vaccinated, i.e. 50.8% (9,332/18,396) of children to be caught up and 86.9% (9,332/10,740) of children found. The total specific recurrent cost of the strategy was XOF 22,375,008, with XOF 2,083 (22,375,008/10,740) per child found and XOF 2,398 (22,375,009/9,332) per child found and vaccinated. In view of these results, this strategy should be implemented in all of the country's low-performing HDs.

Pour améliorer la performance du programme élargi de vaccination de Côte d'Ivoire, nous avons mis en place une stratégie de rattrapage des enfants perdus de vue (EPDV) et des enfants non vaccinés (ENV) dans les 14 districts sanitaires (DS) ayant les plus faibles couvertures vaccinales antirougeoleuses. Cet article présente l'efficacité et le coût de cette stratégie. Nous avons retenu les localités ayant les plus grands nombres d'EPDV : cinq aires de santé (AS) par DS et cinq villages/quartiers par AS. La stratégie qui a été mise en oeuvre par les organisations de la société civile, les responsables des centres de santé (RCS) et les agents de santé communautaire a combiné la sensibilisation des leaders et groupes communautaires, les visites à domicile (VAD) et la référence des enfants aux CS pour la vaccination. Sur les 17 912 EPDV déclarés, 9 425 ont été retrouvés (52,6 %) et 8 245 vaccinés (46 % des déclarés et 87,5 % des retrouvés). Les RCS ont déclaré 484 ENValors que les VAD ont permis d'en identifier 1 315 dont 1 087 ont été vaccinés (82,7 %). Sur un nombre total déclaré de 18 396 enfants à rattraper, 10 740 ont été retrouvés (58,4 %) et 9 332 vaccinés, soit 50,8 % (9 332/18 396) d'enfants à rattraper et 86,9 % (9 332/10 740) d'enfants retrouvés. Le coût récurrent spécifique total de la stratégie était de 22 375 008 FCFA, soit 2 083 FCFA (22 375 008/10 740) par enfant retrouvé et 2 398 FCFA (22 375 008/9 332) par enfant retrouvé et vacciné. Au vu de ces résultats, cette stratégie devrait être mise en oeuvre dans tous les DS à faible performance du pays.