Immunisation coverage rates in Malawi: the official view

Universally, the goal of immunisation programmes is the sustainable control of vaccine-preventable infectious diseases. It has been reported that the Demographic and Health Survey (DHS) of 1992 indicated that 82 per cent of all children (aged 12-23 months) had had all the recommended vaccinations, 67 per cent of them before their first birthday – as recommended by World Healthy Organisation (WHO). On the other hand, the 1995 Malawi Social Indicators Survey (MSIS) shows that 75 per cent of the children rated above had had all the recommended vaccines at the time of the survey, and 61 per cent before their first birthday – implying a slight drop from the 1992 figures. The 1996 Malawi Knowledge and Practices Healthy Survey (MKAPHS) reported that complete vaccination at any time before the survey among the same age range of children was 81per cent, while 55 per cent of children were reported to have been fully vaccinated before their first birthday. These results confirm that there has been a discernible downward trend in Expanded Programme on Immunisation (EPI) performance.

This paper, therefore, analyses the social and cultural factors which determine immunisation coverage in Malawi from the perspective of both quality of vaccination services and compliance with the social demand for the services amongst the people in the community.

The study also points out that most of the official immunisation figures in Malawi are mainly based on the amount of antigen given out, whereas the recommended WHO reports cover the rate of specific age groups (children of 12 to 23 months old that have been fully vaccinated by their first birthday) which are lower than the current official rates.

By reporting recommended figures, the study assists Government Policy makers to appreciate where things are going wrong and act and plan accordingly. The author argues that the official rates are quite misleading; hence they fail to explain the high infant mortality rates in Malawi.

The authors advise policy makers that there is a need to report the WHO recommended coverage rates which will assist them in the planning, designing and implementation of correct and relevant immunisation programmes.