eastern and southern africa - unicef
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Coverage and numberof infants not vaccinatedfor DTP3 by country, 2019
Immunization Regional Snapshot 2019Eastern and Southern Africa
Coverage levels (%) and numbers of infants un-vaccinated and under-vaccinated for DTP, 2019
>=90%80~89%60~79%<60%
Global and regional coverage of DTP3, 2000–2019
In 2019, the regional coverage of DTP3 was 80%, compared to global average of 85%.
In 2019, the regional coverage of MCV1 was 75% compared to global coverage of 85%
In 2019, 3.4 out of 16.5 million surviving infants in the region did not receive the three recommended doses of DTP vaccine
9 out of 23 countries in the region have reached and sustained the target coverage of 90% or above for DTP3 for the past three years
Vaccination Coverage by country, 2019
*Achieved greater than 90% coverage for at least the past 3 consecutive years
Note: Please find the acronym definitionson page 3
Ethiopia and Angola, with an estimated 1.6 million infants not vaccinated for DTP3, accounted for 46 per cent of the total ESAR un- and under-vaccinated surviving infants.
Countries with dark blue color, Angola, Ethiopia, Madagascar, Somalia, South Africa, and South Sudan have the lowest coverage levels with highest number of not vaccinated infants for DTP3. Botswana, Comoros, Eritrea, Eswatini, Mauritius, and Seychelles have the highest coverage levels with lowest numbers of not vaccinated infants for DTP3.
No. of Unvaccinated Children
Cove
rage
(%)
LOWER
HIGHER
MOREFEWER
Angola
Botswana
Burundi
Comoros
Eritrea
Ethiopia
Kenya
Lesotho
Madagascar
Malawi
Mauritius
Mozambique
Namibia
RwandaSeychelles
Somalia
South Sudan
Eswatini
United Republicof Tanzania
Uganda
Zambia
Zimbabwe
SouthAfrica
Note: Numbers in this graph are the rounded numbers of infants not vaccinated for DTP3.
More than 3 million still not fully vaccinated
Forty per cent of countries to reach and maintain 90% coverage
Measles regional coverage below global levels
Note: This map is not to scale. It does not reflect a position by UNICEF on the legal status of any country or area or the delimitation of any frontiers. Please find more information on how to interpret the map on page 3.
BCG DTP1 DTP3 Polio3 MCV1 MCV2 HepB3 Hib3 Rota PCV3 YFV HPV Angola 69 67 57 51 51 45 53 53 58 53 45 –
Botswana 98 98 95* 96 97 76 95 95 86 92 – 47Burundi 93 97 93* 93 92 80 93 93 95 93* – –
Comoros 94 96 91* 94 90 – 91 91 – – – –Eritrea 97 97 95* 95 99 88 95 95 96 95* – –
Eswatini 98 96 90* 89 81 75 90 90 87 87 – –Ethiopia 69 80 69 72 58 41 68 68 68 63 – 84
Kenya 95 97 92 87 89 45 92 92 92 92 2 –Lesotho 96 92 87 87 90 82 87 87 87 87 – –
Madagascar 70 85 79 80 69 – 79 79 79 79 – –Malawi 91 97 95 94 92 75 95 95 92 95 – –
Mauritius 99 97 96* 97 99 99 97 97 96 97 – 80Mozambique 94 93 88 88 87 85 88 88 88 80 – –
Namibia 94 92 87 84 80 56 87 87 90 57 – –Rwanda 98 99 98* 98 96 92 98 98 98 98* – 94
Seychelles 98 99 99* 99 99 99 99 99 99 92 – 68Somalia 37 52 42 47 46 – 42 42 – – – –
South Africa 84 84 77 77 72 54 77 77 73 76 – 56South Sudan 52 51 49 50 49 – 49 49 – – – –
Uganda 88 99 93* 92 87 – 93 93 87 92* – 64United Republic of Tanzania 91 91 89 89 88 72 89 89 85 83 – 49
Zambia 95 94 88 89 93 66 88 88 90 89 – –Zimbabwe 95 94 90 90 85 75 90 90 92 90 – 67
88 ROSA85 Global
80 ESAR
95 CEECIS
91 MENA
81 LACR
66 WCAR
92 EAPR
7275
7983
85 85
91
84
93 93 94
83
8893
59
65
70
75 7779
93
87 86 91 89
6773
80
4346
58
7063
61
20
40
60
80
100
2000 2005 2010 2015 2019
Cove
rage
(%)
89
Angola
Burundi
Ethiopia
KenyaMadagascar
Malawi
Mozambique
Somalia South Africa
South SudanUnited Republic of Tanzania
Uganda
ZambiaZimbabwe
519,600
1,071,200
115,100 178,900
128,800
348,600 263,900
185,500 223,200
110,400
Sources: WHO-UNICEF Estimates of National Immunization Coverage (WUENIC), revision 2019 / The World Population Prospects – 2020 revision, UN Population Division, New York, USA.
Top 5 countries with the most infants not vaccinated for DTP1 (un-vaccinated) and DTP3 (under-vaccinated), 2017–2019
DTP3 coverage change from 2018 to 2019, by country
Under−vaccinatedUn−vaccinated
Under−vaccinatedUn−vaccinated
Immunization Regional Snapshot 2019 I Eastern and Southern Africa UNICEF
2019
2019
2019
2019
2019
2018
2018
2018
2018
2018
2017
2017
2017
2017
2017
United Republicof Tanzania
South Africa
Somalia
Angola
Ethiopia
Number of infants (in thousands)
Note: Countries with high coverage (>=95%) in 2019 and a change in coverage within 2% from 2018: Botswana, Eritrea, Mauritius, Rwanda, and Seychelles.
Decrease more than -5% Decrease 2% to 5% Change within 2% Increase more than 5%Increase 2% to 5%
Regional Vaccination Trends, 2000–2019
0
10
20
30
40
50
60
70
80
90
100
2000 2005 2010 2015 2019
Cove
rage
(%)
0
10
20
30
40
50
60
70
80
90
100
2000 2005 2010 2015 2019
Cove
rage
(%)
0
10
20
30
40
50
60
70
80
90
100
2000 2005 2010 2015 2019
Cove
rage
(%)
0
10
20
30
40
50
60
70
80
90
100
20102005 2015 2019
Cove
rage
(%)
74
59
9
6
79
65
45
23
82
70
56
33
84
75
85
77
8679
868079
DTP1
DTP3
HEPB3
HIB3
60
6
64
5
67
5
74
6
78
5
76
22
75
47
MCV1
MCV2
6367 69
7578
9
807680
IPV1
POL3
1
29
7
69
58
7476PCV3
ROTAC
0
1
2
3
4
5
2010 20152000 2005 2019
1.61.6 1.7 1.7 1.7
1.4 1.6 1.7 1.41.3 1.3 1.3 1.2 1.1
1.2 1.1 1.2 1 1 1.1
3.1 2.9 2.7 2.6 2.5 2.5 2.4 2.2 2.3 2.2 2.1 2 2.3 2.52.2 2.2 2.2 2.4 2.3 2.3
0 300 600 900
520
1071
349
264
223
437
1091
340
300
219
508
1042
331
278
195
40
50
60
70
80
90
100
40 50 60 70 80 90 100
Year of 2018
Year
of 2
019
Num
ber o
f inf
ants
(mill
ions
)
Angola
Burundi
Eswatini
Ethiopia
Kenya
Lesotho
Madagascar
Malawi
Mozambique
Namibia
Somalia
South Africa
South Sudan
United Republic of Tanzania
Uganda
Zambia
Number of infants in the region not vaccinated for DTP1 (un-vaccinated)* and DTP3 (under-vaccinated), 2000–2019
Note: Zero-dose is defined as un-vaccinated children for DTP1
Immunization Regional Snapshot 2019 I Eastern and Southern Africa UNICEF
Source: Global Routine Immunization Strategies and Practices (GRISP): a companion document to the GLobal Vaccine Action Plan (GVAP). ISBN 978 92 4 151010 3 (NLM classification: WA 115).https://www.who.int/immunization/programmes_systems/policies_strategies/GRISP_infographic_EN.pdf?ua=1
Vaccine coverage: Percentage of infants (children under one year of age) who received certain vaccine-doses. For example, coverage of DTP3 is the percentage of infants that received all three doses of diphtheria, tetanus, and pertussis (DTP) vaccine.
Un-vaccinated: An infant that did not receive any vaccine. In this regional profile, un-vaccinated is defined as an infant that did not receive any DTP vaccine (not vaccinated for DTP1). It is also used as a proxy for "zero-dose".
Under-vaccinated: An infant that received some but not all the recommended vaccine-doses on the national schedule. In this regional profile, under-vaccinated is defined in relation to the DTP vaccination series not the entire national immunization schedule.
Vaccine-Doses:
• Bacillus Calmette-Guerin (BCG): vaccine against tuberculosis• Diphtheria, tetanus, and pertussis vaccine, first dose (DTP1) andthird dose (DTP3)• Hepatitis B vaccine, third dose (HepB3)• Haemophilus influenzae type B vaccine, third dose (Hib3)• Poliomyelitis vaccine, third dose (Polio3)• Measles containing vaccine, first dose (MCV1) and second dose(MCV2)• Rotavirus vaccine, last dose (Rota)• Pneumococcal vaccine, third dose (PCV3)• Human Papillomavirus vaccine, last dose (HPV): vaccine to protectagainst certain types of human papillomavirus that can lead to canceror genital warts• Yellow Fever vaccine (YFV)
The bi-scale map shows both the level of coverage and the total number of infants not vaccinated for DTP3.
Definitions of immunization terms Interpretation of graphs
GRISP: Global Routine Immunization Strategies and PracticesCoordinating Actions to Achieve Disease Prevention for All
Tailored strategies that identify undervaccinated and unvaccinated persons and regularly provide them with the vaccines they need
Strategies to reach
Strategic multiyear plans and operational annual plans outlining and coordinating strategies and activities, monitored quarterly
Strategic and operational plans
Assurance that sufficient and adequately appropriated funds reach the operational level of the programme regularly
Operational level funding
Regular and systematic capacity building, skills development and supportive supervision for
vaccinators and district managers
Vaccinator and manager skills
The most important factor for all other eight investments to succeed: A capable national team—supplied with sufficient resources and authority—to excellently manage each country's national immunization program
National team
Expanded routine immunization schedules that
cover people's entire lives
Life course vaccination
An information system that identifies and tracks each person's vaccination status
Accurate information system
Modernized vaccine supply chains and management to ensure the correct amounts of the right potent vaccines are available at each vaccination session
Modern vaccine supply chain
Community support
Shared responsibility for immunization delivery between communities and the immunization programme to reach uniformly high
coverage through high demand and quality services
Less than 80% coverage and ranked in the group of countries with the most number of under-vaccinated infants within the region.
80% to 89% coverage and ranked in the group of countries with the most number of under-vaccinated infants within the region.
Greater than or equal to 90% coverage and ranked in the group of countries with the most number of under-vaccinated infants within the region.
Less than 80% coverage and ranked in the middle group of countries in terms of number of under-vaccinated infants within the region.
80% to 89% coverage and ranked in the middle group of countries in terms of number of under-vaccinated infants within the region.
Greater than or equal to 90% coverage and ranked in the middle group of countries in terms of number of under-vaccinated infants within the region.
Less than 80% coverage and ranked in the group of countries with the least number of under-vaccinated infants within the region.
80% to 89% coverage and ranked in the group of countries with the least number of under-vaccinated infants within the region.
Greater than or equal to 90% coverage and ranked in the group of countries with the least number of under-vaccinated infants within the region.
The DTP3 coverage change from 2018 to 2019 scatter plot shows the change in DTP3 coverage between 2018 and 2019. Countries that experienced more than 5 percentage point drop in coverage since the previous year are labelled in dark red. Similarly, countries that experienced more than 5 percentage point increase in coverage since the previous year are labelled in dark blue. Countries with no significant changes (less than 2 percentage points) are labelled in yellow.
The GRISP framework outlines the specific strategies and activities required to ensure the lifesaving power of routine immunization is accessible to all—regardless of who they are or where they live. It breaks down into the following nine areas: