Prevalence of Measles and Associated Healthcare System Factors in Chasefu District, Eastern Province, Zambia
Résumé
Abstract Measles remains a major public health concern despite the availability of an effective vaccine. In Zambia, outbreaks continue to occur due to gaps in immunisation coverage, surveillance systems, and healthcare service delivery. Chasefu District has experienced recurrent measles cases despite ongoing routine immunisation programmes. This study assessed the prevalence of measles and healthcare system factors associated with its outbreak in Chasefu District, Eastern Province, Zambia. A convergent parallel mixed methods study design was employed in this study. Quantitative data were collected using structured questionnaires administered to 73 healthcare workers and through review of health facility records from 2024 to 2025. Qualitative data were purposively collected through key informant interviews. Quantitative data were analysed using descriptive statistics and multiple linear regression in SPSS version 28, while qualitative data were analysed thematically. Forty-nine percent (49%) of respondents reported measles outbreaks in their facilities, while 51% reported no outbreaks. Lusuntha Rural Health Centre recorded the highest number of cases. Multiple linear regression analysis showed that vaccine availability and the presence of a functional vaccine refrigerator were significant predictors of measles occurrence. Qualitative findings revealed challenges related to vaccine stock-outs, inadequate staffing, long distances to health facilities, poor community uptake of immunisation services, and gaps in surveillance activities. Measles outbreaks in Chasefu District are influenced by healthcare system factors including vaccine availability, cold chain functionality, accessibility of services, and surveillance capacity. Strengthening routine immunisation services, improving cold chain management, and enhancing community outreach programmes are essential for reducing measles transmission.
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