Evaluation of the Quality of Services Provided by the Expanded Program on Immunization at the Banconi University Community Health Center in Bamako in 2025

Background: Vaccination is an essential public health intervention for reducing infant morbidity and mortality. The quality of service is crucial for the effectiveness of vaccination programs. This study evaluated the quality of services provided by the Expanded Program on Immunization (EPI) at the Banconi University Community Health Center (CSCOM-U) in Bamako in 2025.
Methodology: This was a cross-sectional study conducted from January 2024 to March 2025 at the Banconi Community Health Center (CSCOM-U). The study population included 586 parents/guardians of children under one year old and 6 healthcare workers. Data were collected through questionnaires, individual interviews, document reviews, and observation grids, and then analyzed using SPSS version 25.0. The quality of the Expanded Program on Immunization (EPI) services was assessed using service ratings of good, average, and poor, with scores > 80%, 60-80%, and < 60%, respectively.
Results: The majority of vaccinated children were one day old (32.4%), with a predominance of males (56%). Parental satisfaction was high in several aspects: ease of appointment scheduling (87.03%), reception (92.83%), clarity of information (99.5%), staff availability (99.3%), cleanliness of the unit (99%), comfort of the facilities (99.8%), and staff competence (99.8%). However, stockouts (BCG and polio) were noted (25%), indicating average quality in this respect. All functional requirements were met.
Conclusion: This study highlights an overall satisfactory quality of PEV at CSCOM-U Banconi, stock shortage represents a major challenge requiring special attention.

Quality, Vaccination, PEV, CSCOM-U of Banconi, Bamako.

1. Ehreth J. The global value of vaccination. Vaccinated. 30 Jan 2003;Vaccines and Immunization 2003. Based on the Third World Congress on Vaccines and Immunization21(7):596-600. doi:10.1016/S0264-410X(02)00623-0 [Google Scholar] [Crossref]

2. Ateudjieu J, Kenfack B, Nkontchou BW, Demanou M. Program on immunization and cold chain monitoring: the status in eight health districts in Cameroon. BMC Res Notes. March 16, 2013;6(1):101. doi:10.1186/1756-0500-6-101 [Google Scholar] [Crossref]

3. CDC. MMWR [Internet]. 2006 [cited 27 Feb 2026]. Vaccine-Preventable Deaths and Global Immunization Vision and Strategy, 2006-2015. Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5518a4.htm [Google Scholar] [Crossref]

4. Montgomery JP, Ganguly P, Carlson BF, Shrivastwa N, Boulton ML. An evaluation of immunization services, using the reaching every district criteria, in two districts of Gujarat, India. Global Health Res Policy. 2018;3:5. doi:10.1186/s41256-018-0060-4 PubMed PMID: 29445774; PubMed Central PMCID: PMC5803910. [Google Scholar] [Crossref]

5. Luthi JC, Kessler W, Boelaert M. A vaccine efficacy survey in the city of Bongor (Chad) and its operational implications for the vaccination program. Bull World Health Organ [Internet]. 1997 [cited 27 Feb 2026];75(5):427-33. Available from: https://www.lissa.fr/rep/articles/9480198 [Google Scholar] [Crossref]

6. World Health Organization. Declaration of Alma-Ata: International Conference on Primary Health Care, [Internet]. Alma-Ata; 1978 [cited 20 June 2025]. Available from: https://www.who.int/teams/social-determinants-of-health/declaration-of-alma-ata [Google Scholar] [Crossref]

7. Gazmararian JA, Oster NV, Green DC, Schuessler L, Howell K, Davis J, et al. Vaccine storage practices in primary care physician offices: assessment and intervention. Am J Prev Med. Nov 2002;23(4):246‑53. doi:10.1016/s0749-3797(02)00512-3 PubMed PMID: 12406478. [Google Scholar] [Crossref]

8. Streefland PH, Chowdhury AM, Ramos-Jimenez P. Quality of vaccination services and social demand for vaccinations in Africa and Asia. Bull World Health Organ. 1999;77(9):722-30. PubMed PMID: 10534895; PubMed Central PMCID: PMC2557734. [Google Scholar] [Crossref]

9. Salah AA, Baraki N, Egata G, Godana W. Evaluation of the Quality of Expanded Program on Immunization Service Delivery in Primary Health Care Institutions of Jigjiga Zone Somali Region, Eastern Ethiopia. Eur J Prev Med. Jul 2015;3(4):117‑23. doi:10.11648/j.ejpm.20150304.14 [Google Scholar] [Crossref]

10. Tesfaye E, Debie A, Sisay F, Tafere TZ. Maternal satisfaction on quality of childhood vaccination services and its associated factors at public health centers in Addis Ababa, Ethiopia. BMC Health Serv Res. 29 Nov 2023;23(1):1315. doi:10.1186/s12913-023-10174-7 PubMed PMID: 38031017; PubMed Central PMCID: PMC10685558. [Google Scholar] [Crossref]

11. Doumbia D. Surveillance of target diseases of the Expanded Program on Immunization in Mali: retrospective analysis of surveillance data from 2004 to 2014 [Internet]. 2018 [cited 27 Feb 2026]. Available from: https://www.bibliosante.ml/handle/123456789/2056 [Google Scholar] [Crossref]

12. Sanogo FB. Factors Contributing to the Persistence of Measles Outbreaks in Mali [Thesis] [Internet]. University of Sciences, Techniques and Technologies of Bamako; 2016 [cited 27 Feb 2026]. Available from: https://www.bibliosante.ml/handle/123456789/5262 [Google Scholar] [Crossref]

13. ZDLH_Mali_Landscape_2023_FR.pdf [Internet]. [cited 27 Feb 2026]. Available from: https://zdlh.gavi.org/sites/default/files/2024-03/ZDLH_Mali_Landscape_2023_FR.pdf [Google Scholar] [Crossref]

14. Mali becomes the first country to use a new hybrid vaccination approach to fight malaria | WHO | Regional Office for Africa [Internet]. [cited 27 Feb 2026]. Available from: https://www.afro.who.int/fr/news/le-mali-devient-le-premier-pays-utiliser-une-nouvelle-approche-hybride-de-vaccination-pour [Google Scholar] [Crossref]

15. National Directorate of Health. National Strategic Plan for the Expanded Program on Immunization (EPI) 2021-2025. Bamako; 2021. [Google Scholar] [Crossref]

16. Burstein R, Dansereau E, Conner R, DeCenso B, Delwiche K, Gasasira A, et al. Assessing vaccine cold chain storage quality: a cross-sectional study of health facilities in three African countries. The Lancet. June 1, 2013;381:S25. doi:10.1016/S0140-6736(13)61279-9 [Google Scholar] [Crossref]

17. Shawon MSR, Adhikary G, Ali MW, Shamsuzzaman M, Ahmed S, Alam N, et al. General service and child immunization-specific readiness assessment of healthcare facilities in two selected divisions in Bangladesh. BMC Health Serv Res. 25 Jan 2018;18(1):39. doi:10.1186/s12913-018-2858-7 PubMed PMID: 29370842; PubMed Central PMCID: PMC5784675. [Google Scholar] [Crossref]

18. Ministry of Health of Mali. National guide for the implementation of Results-Based Financing (RBF). Bamako; 2020. [Google Scholar] [Crossref]

19. Donabedian A. The quality of care. How can it be assessed? JAMA. 1988;260(12):1743‑8. [Google Scholar] [Crossref]

20. Diallo M. Evaluation of EPI vaccination coverage among children aged 12 to 24 months in Commune II of the District of Bamako [Internet]. 2015 [cited 27 Feb 2026]. Available from: https://www.bibliosante.ml/handle/123456789/846 [Google Scholar] [Crossref]

21. Tiembré I, Vroh J, Attoh-Touré H, Douba A, N'Zi E, Dagnan N, et al. Quality of vaccination services at public social centers in Abidjan, Côte d'Ivoire. Public Health. 1 Jan 2012;24:429. doi:10.3917/spub.125.0429 [Google Scholar] [Crossref]

22. Fikadu T, Gebru Z, Abebe G, Tesfaye S, Zeleke EA. Assessment of mothers' satisfaction towards child vaccination service in South Omo zone, South Ethiopia region: a survey on clients' perspective. BMC Womens Health. May 9, 2024;24(1):272. doi:10.1186/s12905-024-03120-0 PubMed PMID: 38724930; PubMed Central PMCID: PMC11080138. [Google Scholar] [Crossref]

23. Espinosa A, Marti J, Calderón-Prada A, Ticliahuanca M, Lobrano J, Carreón N. Satisfaction with vaccination services and its relationship to emotional responses of service users in Lima. LEGADO's quality management model as a public solution to promote citizen emotional well-being during pandemic. Front Public Health. 2023;11:1136312. doi:10.3389/fpubh.2023.1136312 PubMed PMID: 37608977; PubMed Central PMCID: PMC10441115. [Google Scholar] [Crossref]

24. Terefe Lafore, Bekafe Kibamo, Kebebush Ergicho, Elias Ezo. Client Satisfaction towards Expanded Program on Immunization Service and Associated Factors in Doyogena Woreda, Southern Ethiopia. Middle East Res J Nurs. 2021;01(01):21‑30. doi:10.36348/merjn.2021.v01i01.004 [Google Scholar] [Crossref]

25. Dana E, Asefa Y, Hirigo AT, Yitbarek K. Satisfaction and its associated factors of infants' vaccination service among infant coupled mothers/caregivers at Hawassa city public health centers. Hum Vaccines Immunother. 17(3):797-804. doi:10.1080/21645515.2020.1790278 PubMed PMID: 32898441; PubMed Central PMCID: PMC7993134. [Google Scholar] [Crossref]

26. Hatchett R. The medicines refrigerator and the importance of the cold chain in the safe storage of medicines. Nurs Stand R Coll Nurs GB 1987. 4 Oct 2017;32(6):53‑63. doi:10.7748/ns.2017.e10960 PubMed PMID: 29094526. [Google Scholar] [Crossref]

27. Purssell E. Reviewing the importance of the cold chain in the distribution of vaccines. Br J Community Nurses. Oct 2015;20(10):481‑6. doi:10.12968/bjcn.2015.20.10.481 PubMed PMID: 26418400. [Google Scholar] [Crossref]

28. Ateudjieu J, Kenfack B, Nkontchou BW, Demanou M. Program on immunization and cold chain monitoring: the status in eight health districts in Cameroon. BMC Res Notes. Mar 16, 2013;6:101. doi:10.1186/1756-0500-6-101 PubMed PMID: 23497720; PubMed Central PMCID: PMC3630054. [Google Scholar] [Crossref]

29. Adu FD, Adedeji AA, Esan JS, Odusanya OG. Live viral vaccine potency: an index for assessing the cold chain system. Public Health. Nov 1996;110(6):325-30. doi:10.1016/s0033-3506(96)80003-5 PubMed PMID: 8979747. [Google Scholar] [Crossref]

30. Hussien A. Assessment of Maternal Satisfaction Towards Childhood Immunization and Its Associated Factors in MCH Clinic, at Kombolcha, in Amhara Regional State, Northern Ethiopia. In. 2015 [cited Feb 27, 2026]. Available at: https://www.semanticscholar.org/paper/Assessment-of-Maternal-Satisfaction-Towards-and-Its-Hussien/1f6a18157ec5ab38380d226947eb4c3090897058 [Google Scholar] [Crossref]

31. Montgomery JP, Ganguly P, Carlson BF, Shrivastwa N, Boulton ML. An evaluation of immunization services, using the reaching every district criteria, in two districts of Gujarat, India. Global Health Res Policy. 2018;3:5. doi:10.1186/s41256-018-0060-4 PubMed PMID: 29445774; PubMed Central PMCID: PMC5803910. [Google Scholar] [Crossref]

32. Labama MB, Longembe EB, Likwela JL. Vaccine management effectiveness and vaccination quality at the EPI Kisangani office in the Democratic Republic of Congo. Pan Afr Med J. 2 May 2017;27(4). doi:10.11604/pamj.2017.27.4.11513 [Google Scholar] [Crossref]

33. Siddiqi DA, Abdullah S, Dharma VK, Khamisani T, Shah MT, Setayesh H, et al. Assessment of vaccination service delivery and quality: a cross-sectional survey of over 1300 health facilities from 29 districts in Sindh, Pakistan conducted between 2017-18. BMC Health Serv Res. June 1, 2022;22(1):727. doi:10.1186/s12913-022-08098-9 PubMed PMID: 35650570; PubMed Central PMCID: PMC9157477. [Google Scholar] [Crossref]

34. Rainey JJ, Watkins M, Ryman TK, Sandhu A, Bootman A, Dzidoti K. Reasons for under-vaccination and missed opportunities: A review. Vaccinated. 2011;29(38):6469‑78. doi:10.1016/j.vaccine.2011.07.010 [Google Scholar] [Crossref]

35. WHO. Essential Programme on Immunization [Internet]. [cited 10 March 2026]. Reducing Missed Opportunities for Vaccination (MOV). Available from: https://www.who.int/fr/teams/immunization-vaccines-and-biologicals/essential-programme-on-immunization/implementation/reducing-missed-opportunities-for-vaccination [Google Scholar] [Crossref]

36. Progress made and challenges encountered in achieving universal immunization coverage [Internet]. [cited 10 March 2026]. Available from: https://www.who.int/fr/publications/m/item/progress-and-challenges [Google Scholar] [Crossref]

37. Rainey JJ, Watkins M, Ryman TK, Sandhu P, Bo A, Banerjee K. Reasons associated with non-vaccination and under-vaccination of children in low and middle income countries: findings from a systematic review of the published literature, 1999-2009. Vaccinated. 26 Oct 2011;29(46):8215‑21. doi:10.1016/j.vaccine.2011.08.096 PubMed PMID: 21893149. [Google Scholar] [Crossref]

38. Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Global Health. 1 Nov 2018;6(11):e1196‑252. doi:10.1016/S2214-109X(18)30386-3 PubMed PMID: 30196093. [Google Scholar] [Crossref]

39. Lafond AK, Kanagat N, Steinglass R, others. A theory of change for capacity building in data use in public health. Health Policy Plan. 2015;30(5):644‑55. doi:10.1093/heapol/czu030 [Google Scholar] [Crossref]

40. Hogan D, Gupta A. Why Reaching Zero-Dose Children Holds the Key to Achieving the Sustainable Development Goals. Vaccines. Mar 31, 2023;11(4):781. doi:10.3390/vaccines11040781 PubMed PMID: 37112693; PubMed Central PMCID: PMC10142906. [Google Scholar] [Crossref]

41. Brown D, Burton A, Gacic-Dobo M. An analysis of reported vaccination coverage. Lancet Infect Dis. 2010;10(12):822‑4. doi:10.1016/S1473-3099(10)70269-0 [Google Scholar] [Crossref]

42. National Institute of Statistics (INSTAT), ICF. Demographic and Health Survey in Mali 2018 (EDSM-VI) [Technical Report]. Bamako, Mali and Rockville, Maryland, USA: INSTAT and ICF; 2019. Report No. [Google Scholar] [Crossref]

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