Conference Abstract | Volume 9 (ConfProc7): Abstract 095 | Published: 06 Oct 2026
Pat-Thomas Antwi Okyere1,2,&, George Akowuah2, Magdalene A. Odikro2, Zakaria Adam1,2, Gideon Kye-Doudu 2,3, Samuel Sackey2
1Ghana Health Service, Pusiga District Health Directorate, Upper East Region, 2Ghana Field Epidemiology and Laboratory Training Programme, School of Public Health, Legon, Accra, 3Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Ho, Volta Region
&Corresponding author: Pat-Thomas Antwi Okyere, 1Ghana Health Service, Pusiga District Health Directorate, Upper East Region, Email: antwiokp@gmail.com
Received: 29 Aug 2025, Accepted: 28 Oct 2025, Published: 06 Oct 2026
Domain: Infectious Disease Epidemiology
This is part of the Proceedings of the 8th Ghana FELTP Scientific Conference and FELTP Competency Graduation, Accra, Ghana, 10 – 11 December, 2025
Keywords: measles, MR2, vaccination, coverage, health education, Pusiga, Ghana
©Pat-Thomas Antwi Okyere et al. Journal of Interventional Epidemiology and Public Health (ISSN: 2664-2824). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Cite this article: Pat-Thomas Antwi Okyere et al. Problem analysis of declining measles-rubella second-dose vaccination coverage in Pusiga District, Ghana, 2025. Journal of Interventional Epidemiology and Public Health. 2026;9(ConfProc7):095. https://doi.org/10.37432/JIEPH-CONFPRO7-0095
Since its introduction, measles vaccine has been very effective in reducing measles incidence and mortality globally. In Ghana, the national target for measles vaccination coverage is 90%. Pusiga District has seen a consistent decline in the measles-rubella second-dose (MR2) coverage over the last three years; from 89.9% in 2022 to 80.8% in 2024. To identify the possible drivers of this decline, a problem analysis was conducted to determine the root and critical causes affecting MR2 coverage in the district.
A problem analysis was conducted at Pusiga Health Center involving a multidisciplinary team of caregivers, Community Health Nurses, Health Information Officers, Public Health Officers and laboratorians. Participants brainstormed to identify contributory factors to the problem. Four categories of causes were identified and classified based on their level of control as either Total (T), Partial (P) or Not (N) under control. The cause with the highest influence was identified as the critical cause. Results were presented using a fishbone diagram.
Seventeen people were involved in the brainstorming. A total of 17 factors were identified and grouped under four categories: Supply chain & logistics, health staff & service delivery, socioeconomic & environmental, and community demand & caregiver factors. Of these 35.3% (6/17) were totally under control, 23.5% (4/17) were partially under control and 41.2% (7/17) was not under control. The critical cause was limited information on MR2 vaccination among caregivers which was totally under our control to address.
Root causes for the decline of MR2 vaccination included supply chain & logistics, health staff & service delivery, socioeconomic & environmental and community demand & caregiver factors. Limited caregiver awareness on MR2 vaccination was identified as the critical cause. Improving coverage will require a coordinated approach that strengthens health system readiness, builds staff capacity, and enhances community awareness and demand for MR2.
Menu