Immunization and Child Survival in Jonglei State: Assessing the Impact of Immunization Programs in D

Duk County has struggled with vaccine-preventable childhood diseases for many years, largely due to a combination of harmful cultural practices, population mobility, and documentation challenges. Deep-rooted cultural norms have historically discouraged caregivers from bringing children for routine immunization, resulting in persistent pockets of unvaccinated and under-vaccinated children. Frequent population movements-especially seasonal migration and displacement further contribute to missed doses. Children are often vaccinated when they temporarily reach health facilities or outreach points, but later return to remote areas where follow-up is difficult. In addition, many parents misplace immunization cards, making it difficult for vaccinators to verify previous doses and determine the correct schedule. This has contributed to dropout rates exceeding 20%, particularly between early and later doses of the EPI schedule. Despite these challenges, significant efforts have been made. Community awareness campaigns, stakeholder engagement, and targeted social mobilization have been implemented to address cultural barriers, improve caregiver knowledge, and strengthen the overall performance of the EPI programme. These interventions continue to play a critical role in reducing dropout rates and improving immunization coverage across Duk County Jonglei State.