Challenges and strategies in implementing immunization schedules in rural communities: A systematic review
DOI:
https://doi.org/10.5281/zenodo.17074027Keywords:
rural health accessibility, vaccination coverage, immunization strategiesAbstract
The purpose of this systematic review was to identify the main barriers to the implementation of immunization programs in rural areas, evaluate the strategies used, and propose evidence-based recommendations to improve vaccination coverage and reduce inequalities in access to health care. Following the PRISMA protocol, an exhaustive search was conducted in databases such as PubMed, Scopus, and Latindex, using specific inclusion and exclusion criteria. After a rigorous selection and critical appraisal process, 18 studies were selected that provided valuable information on obstacles and effective strategies in rural contexts. The most common barriers included limited geographic accessibility, insufficient health infrastructure, socioeconomic inequalities, and cultural mistrust of health services, factors that affect both coverage and the continuity of vaccination schedules. In contrast, successful strategies were identified, such as the decentralization of services through mobile brigades and community vaccination centers, the strengthening of health education, and the integration of immunization with other primary care services. Finally, recommendations are proposed focused on strengthening trust between communities and health personnel, improving health infrastructure, and adopting comprehensive approaches that consider sociocultural and territorial specificities. These actions are essential to ensuring equitable, sustainable, and effective access to vaccination in rural areas.
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