February 2025 — Gender Analysis on Vaccination and Vitamin A Supplementation in Mozambique is a comprehensive study that sheds light on the pressing challenges and opportunities within Mozambique's immunization landscape, particularly in the wake of the COVID-19 pandemic.

Background 

Before the pandemic, Mozambique's vaccination coverage was already facing hurdles due to natural disasters and other health emergencies. The situation worsened dramatically with the onset of COVID-19, leading to a significant rise in the number of zero-dose children—from 7% in 2019 to 32% in early 2022. In response, the Mozambique Expanded Programme on Immunization (EPI) developed a Recovery Plan, with UNICEF's support, to address these urgent needs and build a more resilient immunization system.

Key Findings

The report, based on data collected by IPSOS in 2023, identifies three primary barriers to routine immunization (RI) uptake:

1. Poor knowledge and/or low risk perception.

2. Lack of family support.

3. Service provision problems.

These barriers are deeply interconnected, especially when access to health services is limited, placing additional burdens on families. The behavior of families can either hinder or facilitate vaccination, depending on the level of practical support provided.

Focus on Vulnerable Populations

The report highlights that children of poor, single, uneducated women from both rural and urban areas are the most at risk. These children face multiple barriers simultaneously, with lack of awareness and low risk perception being the most common reasons for zero-dose children. For partially vaccinated children, weak service provision is a significant factor. The dropout rate from vaccination increases as children grow older, influenced by everyday life challenges, lack of family support, and distance to health facilities.

The Role of Male Caregivers

An important aspect of the findings is the role of male caregivers. While their physical presence in health units was perceived to be less critical than their practical and economic support, their involvement positively influences vaccination rates. Contact with healthcare workers is a positive predictor for male caregivers, who report being treated with more respect than women. This underscores the need for further research on the impact of male caregivers' presence in health units.

Looking Ahead

The EPI's Recovery Plan aims to create a resilient immunization program that ensures high coverage for all children. By addressing gender barriers and enhancing family support, Mozambique can improve vaccination rates and protect the health of its children.