Resilience of Vaccination Services in Crisis Situations in Sub-Saharan Africa: A Scoping Review

Abstract

Introduction: Vaccination remains one of the most effective public health interventions. Despite progress made in vaccination worldwide, challenges remain, particularly among populations in crisis areas. The resilience of vaccination services in disaster situations appears to be poorly documented in the scientific literature. The objective of this review is to document the current state of resilience of vaccination services in crisis situations in sub-Saharan Africa. Methodology: We conducted this research following the guidelines provided by the Joanna Briggs Institute (JBI) and the PRISMA approach. We conducted the literature search in electronic databases such as PubMed/Medline, Embase, Scopus, and Research4Life. In addition to the databases, identification was based on the reference lists of all included sources of evidence. We included studies published between January 1, 2016, and December 31, 2024. A narrative synthesis based on the Braun and Clarke model allowed us to map and organize the results thematically. Results: In total, we included thirty-six (36) studies. The main crises were the COVID-19 pandemic, the Ebola epidemic, armed conflicts, and terrorist attacks. These crises impacted vaccination coverage, surveillance systems, vaccination service delivery, vaccine supply, and vaccination personnel. The barriers to immunization services identified were redeployment, shortage of health personnel, travel restrictions, fear of contracting the disease, stigma, vaccine hesitancy, community engagement, and communication. The study identified key strategies such as vaccination campaigns, investment in health personnel, community engagement, communication campaigns, coordination of interventions, and lessons to be learned. Conclusion: This study highlighted the impact of health and humanitarian crises on vaccination in sub-Saharan Africa. However, the resilience strategies identified underscore the need to sustainably integrate crisis preparedness, community strengthening, and continuity of vaccination services into health policies.