Publication Date
Fall 2025
Abstract
Vaccinations and child immunizations are widely recognized as a safe and effective public health tool to stop preventable deaths of children and eliminate disease. Refugees and asylum-seeking children are often more vulnerable and have a greater risk of having incomplete immunization. This is due to a wide variety of barriers that refugees can face, which can be unique to different health system designs or country policies. Chad and Uganda are two lower-middle-income countries that have different refugee health system designs. Chad has a health system design where a parallel system is run for refugees, which heavily involves humanitarian aid from groups like NGOs, while Uganda has a health system design where refugees are very integrated into national policies and receive the same vaccination care as locals. This paper aims to understand the strengths and weaknesses of each system and report on barriers that exist for refugee and asylum-seeking children to access vaccines. The methodology includes a comparative analysis of both systems through expert interviews and secondary data. Findings show that each model has varying strengths and weaknesses. Chad’s humanitarian aid model has barriers primarily related to systemic structural weaknesses or humanitarian fragmentation, while Uganda’s integrated model has barriers primarily related to organizational implementation challenges, and both also experience barriers due to resource strain. Overall, both systems can provide useful insights for policymakers, workers, and even refugees themselves.
Disciplines
Medicine and Health Sciences | Social and Behavioral Sciences
Recommended Citation
Lunt, Maya, "Access in Context: A Comparative Study of Refugee and Asylum-Seeking Child Immunization in Uganda’s National System and Chad’s Humanitarian System" (2025). Switzerland: Global Health and Development Policy. 12.
https://digitalcollections.sit.edu/szh2/12