Program Description (Background) / Description du programme (contexte)
Despite progress made through the Expanded Program on Immunization (EPI) in Cameroon, vaccination coverage remains insufficient and unevenly distributed across the country. In 2023, national coverage for the third dose of the diphtheria-tetanus-pertussis vaccine (DTP3) was estimated at approximately 75%, but important disparities persist in regions such as the Far North, North-West, and South-West, where coverage remains below 60%. These gaps are largely linked to structural challenges, including recurrent vaccine stock-outs, weak logistics and supply chain systems, limited human resources, irregular planning, low use of data for decision-making, and insufficient community engagement. Cultural barriers and reliance on external funding further compound these challenges. Zero-dose children, those who have never received any routine vaccine, represent around 16% of children nationally. In the Far North region, due to the complex humanitarian context, the proportion is estimated to be between 20% and 30%, while under-vaccinated children may represent 30% to 40% of the target population. As a result, more than half of children may be either unvaccinated or insufficiently vaccinated. This situation highlights the urgent need for targeted interventions to strengthen immunization systems and improve equitable access to vaccination services.
Ensuring strong primary health care systems capable of delivering reliable immunization services is essential to improving health outcomes and preventing outbreaks of vaccine-preventable diseases such as measles and poliomyelitis. In communities with large numbers of unvaccinated children, herd immunity is weakened, increasing the risk of epidemic outbreaks. Strengthening vaccine supply systems and improving immunization service delivery are therefore critical to protecting vulnerable populations. In this context, with funding from the Pfizer Foundation, VillageReach is implementing the Next Generation of Supply Chain (NGCA) initiative to build resilient, responsive, and sustainable vaccine supply systems. In Cameroon, the initiative will target five health districts in the Far North region—Mada, Petté, Roua, Goulfey, and Makary, located in the departments of Logone-et-Chari, Mayo-sava, Diamarré and Mayo-Tsanaga. These districts cover approximately 8,485 km² and serve an estimated population of 859,143 people, including about 34,366 live births and 29,984 surviving infants. The project will run from January 2026 to June 2027.
These districts were selected based on vaccination coverage data from January to September 2025 provided by the Regional Delegation for Public Health and the national EPI program. The districts face overlapping humanitarian, security, and environmental challenges, including the effects of the Boko Haram insurgency, recurrent flooding, and population displacement. These conditions have disrupted health services and vaccine delivery, damaged infrastructure, and limited access to remote communities. Frequent vaccine stock-outs, difficulties in maintaining the cold chain during floods, limited transportation capacity, and insufficient staffing further restrict the ability of health facilities to conduct effective vaccination outreach. At the community level, awareness of vaccination remains low due to displacement, limited health promotion activities caused by insecurity, and misinformation in isolated communities. Weak data collection and reporting systems also delay early detection and response to potential outbreaks.
To address these challenges, International Medical Corps (IMC), with financial support from VillageReach, will implement a program to strengthen routine immunization services and optimize vaccine supply chains in the targeted districts. The program will focus on improving access to vaccination services, ensuring continuous vaccine availability at health facilities, strengthening the use of data for decision-making, and building sustainable capacity within provincial and district health systems. Key interventions will include strengthening micro-planning, expanding fixed, outreach, and mobile vaccination services, implementing targeted strategies to reach zero-dose children, improving vaccine forecasting and stock management, and introducing direct vaccine distribution systems adapted to local contexts. The program will also deploy digital monitoring tools, including an interactive dashboard integrated with DHIS2 and Power BI, to improve real-time analysis of immunization and supply chain performance. In addition, training, mentoring, and supportive supervision will be provided to strengthen the leadership and technical capacities of provincial and district health managers.
Through these interventions, the program will contribute to increasing vaccination coverage, reducing the number of zero-dose children, and strengthening the resilience and performance of the routine immunization system in the Far North region of Cameroon.