Burundian Rural Schools Hepatitis B Vaccination Programmes: A Three-Year Coverage and Impact Assessment Through Community Health Workers

Burundi faces challenges in implementing comprehensive vaccination programmes, particularly in rural areas where healthcare infrastructure is limited. A mixed-methods approach was employed, including surveys and qualitative interviews with CHWs and school administrators to evaluate coverage and impact. Coverage increased from 70% at baseline to 85% by the end of the study period, with a significant reduction in missed vaccinations identified through CHW monitoring data (95% CI: -12.3%, +1.6%). The collaborative model between schools and CHWs was effective in improving Hepatitis B vaccination coverage. Sustained support for CHWs is recommended to ensure continued high vaccine uptake. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.