Gestion Opérationnelle et Couverture Vaccinale Contre la Rougeole de Décembre 2023 à Tshamilemba, Lubumbashi (RDC) : Une Étude de Cas Évaluative Mixte.
DOI:
https://doi.org/10.47941/ijhmnp.4079Keywords:
Vaccination, Rougeole, Gestion de campagne, Étude mixte, République démocratique du Congo.Abstract
Objectif de l’étude : évaluer la gestion opérationnelle de la campagne de vaccination contre la rougeole menée en décembre 2023 dans la Zone de santé de Tshamilemba et identifier les leviers susceptibles d’améliorer l’équité et la qualité de la couverture vaccinale.
Méthodes : Une étude de cas évaluative à devis mixte a été menée de janvier à mai 2025. Les données quantitatives issues des registres, rapports et fiches techniques de la campagne ont été l’objet d’analyses descriptives et inférentielles sous SPSS 27.0 (tests du χ² et de Kruskal-Wallis, corrélation de Spearman et régression logistique binaire). La composante qualitative reposait sur des entretiens semi-structurés avec trois acteurs clés du BCZS, analysés thématiquement avec NVivo 14. L’interprétation s’appuyait sur les cadres ACEZ, de Tanahashi et des six composantes du système de santé de l'OMS.
Résultats : La couverture globale déclarée était de 94,9%, avec des écarts importants entre aires de santé (52,6% à 112,5%). Des déficits ont été relevés pour le personnel (41,3% du besoin planifié), les fiches de pointage (22,7%) et les mégaphones (50%), ainsi qu’une absence de piles, de véhicules et de guides d'âge. Dans le modèle multivarié rapporté, l’insuffisance de personnel (OR ajusté = 3,82 ; IC95% : 1,45-10,07), l'absence de fiches de pointage (OR ajusté = 4,21 ; IC95% : 1,68-10,54) et une distance supérieure à 2 km (OR ajusté = 2,96 ; IC95% : 1,12-7,82) étaient associés à une couverture inférieure à 90%. Les entretiens ont fait ressortir une planification descendante, des difficultés de communication communautaire et des retards de financement.
Contribution unique à la théorie, aux politiques et à la pratique : L’étude décrit des contraintes opérationnelles susceptibles d’expliquer les disparités de couverture lors d’une campagne en milieu urbain congolais. Elle souligne l’intérêt d’une microplanification fondée sur des données démographiques actualisées, d’une allocation adéquate des ressources et d’un engagement communautaire renforcé.
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Copyright (c) 2026 Ngoyi Mukonkole Jean, Chuy Kalombola Didier, Kayembe Kitenge Tony, Bwalya Peti Richard, Katumbayi Katanda Tresor, Kikangala Ebondo Didi, Nkonde Kasanda Jean Marie, Luboya Numbi Oscar
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