From 9-18 May 2012, the local Regional Health Agency and PAHO jointly evaluated the immunization programme of the French Department of Guyane. French Guiana is located in the North-east of South America and shares borders with Brazil and Suriname. With 236,250 inhabitants in 2011 and a surface of 83,500 km2, it is sparsely populated (2.8 persons per km2).

This evaluation sought to assess the coordination among private and public partners, investigate options for vaccination data collection in a territory where private practitioners perform a significant proportion of all vaccinations, and review the integration of the local programme with those of the Americas. Teams visited 16 of the 27 public and non-governmental clinics providing vaccination and interviewed private practitioners, administrative and health authorities, and departmental cold chain facilities.

Vaccination generally follows the national French immunization schedule, which currently includes 15 main antigens. Specific adjustments for French Guiana include yellow fever vaccination from nine months of age and Bacillus Calmette-Guérin (BCG) vaccination at birth. Based on the national structure for delivery of curative and preventive health services, vaccination occurs in four different settings—namely, private medical practices (40–45% of all vaccinations), a public child and maternal health programme, and public and Red Cross health care centers. Improvements are needed in the coordination of activities by age and/or geography and in the harmonization of data collection among partners.

Administrative coverage data is not available and surveys are periodically carried out (most recently, a school-based survey showed in 2009 85% coverage for the second Measles, Mumps and Rubella (MMR) dose). Although recommended, uptake of PCV and HPV vaccines remains very low. Whilst showing a well-performing immunization programme, the evaluation in French Guiana demonstrates the challenges of maintaining coordinated immunization activities and vaccination coverage evaluation in an administrative territory where advanced health care services and dispersed rural population coexist.

Published in Global Immunization Newsletter, May 2012.