The performance of the expanded programme on immunization in a rural area of Mozambique.

Vaccines are an effective public health measure. Vaccination coverage has improved in Africa in the last decades but has still not reached WHO/UNICEF target of at least 90% first-dose coverage for vaccines in the Expanded Programme on Immunization (EPI) implemented in Mozambique in 1979. There are concerns about reliability of vaccination coverage official data from low-income countries, and inequities in vaccine administration. We randomly sampled 266 under-five years children from Taninga, a poor rural area in Southern Mozambique under a Demographic surveillance system and collected data directly from the individual national health cards when available (BCG, DTP/HepB/Hib, Polio, Measles). We also collected data on socio-economic variables through an interview. Overall, only 5% of the participants did not receive all the doses of the vaccines included in the EPI in a timely manner (overall vaccination coverage 95%, 95% CI: 93.5-95.5%). The socio-economic status was homogenously low and no differences were found between vaccinated and unvaccinated children. Vaccination coverage in Taninga was very high, despite the low socio-economic status of the population. The high performance of the EPI in Taninga is an encouraging experience for achieving high vaccination coverage in low-income rural settings.