Exploring the Barriers and Facilitators of Vaccine Procurement in Health Districts of the South West Region of Cameroon

Background Immunization is the most cost-effective way of preventing vaccine-preventable diseases and reducing morbidity and mortality in children 0 to 5 years old. The vaccine procurement capacity of health districts significantly influences the vaccine coverage rates. The advent of the socio-political crisis in the North West and South West Regions of Cameroon could have had a negative bearing on vaccine procurement and thus coverage rates. Thus, this study was carried out to explore the barriers and facilitators of vaccine procurement in health districts of a South West Region of Cameroon. This will help reduce vaccine stock-out at the health district level and increase vaccine coverage. Methodology A qualitative study was conducted using in-depth interviews (IDIs) to collect data from healthcare providers in all the 21 health districts in the South West Region working with the Expanded Program on Immunization (EPI), and who met the inclusion criteria. A Delphi consensus approach was employed to formulate feasible facilitators to the optimization of vaccine procurement. Data was analysed using Nvivo 11. Thematic analysis was used to explore the barriers to vaccine procurement at the level of health districts. A Delphi consensus of ≥ 70.0% was considered acceptable. Results From the thematic analysis, nine broad themes: financial constraints, limited workforce, inadequate transportation logistics, poor equipment, inadequate managerial skills, inadequate in-service training, vaccine stock-out and weak primary health care (PHC) system facilities emerged as barriers to vaccine procurement . Of the 12 strategies retained for the optimization of vaccine procurement, 5 (41.7%) were priority strategies: provision of extra solar refrigerators (100.0%), WHO certification training for EPI staff (100.0%), financial allocation for transport (100.0%), equipment and training, in-service training for both district and health facility staff (100.0%), resolving the socio-political crisis (100.0%) and provision of specialized transport logistics for maritime Health Districts (100.0%). Conclusion Financing of vaccine procurement, recruitment/certification of staff, provision of transportation logistics, provision of solar refrigerators, regular supervision, organization of in-service training, with focus on requisition/stock and bulk-requisition were the main strategies suggested to overcome the barriers to vaccine procurement. Recommendations These findings highlight the need for all stakeholders to co-finance and manage vaccine procurement at the health district level in the South West Region of Cameroon.