In resource-poor settings the prevention of child mortality through immunization is one of the most cost-effective public interventions in use. The Expanded Program on Immunization (EPI) aims at delivering the primary immunization series to at least 90 percent of infants(14). However, inadequate levels of immunization against childhood diseases remain a significant public health problem in resource-poor areas of the globe(15).
The percentage of fully immunized children in Afghanistan is around 27% and the dropout rate is between DTP-Hep B 1 and DTP-Hep B 3 is around 14%. The Ministry of Public Health (MoPH) aim is to achieve at least 90% coverage of DTP-Hep B-3 in 80% districts of the country by the end of the year 2013. The country is facing tremendous challenges to achieve the goal. Significant challenges include: poor managerial capacity at various levels, access problems, poor utilization of available services, lack of knowledge, skills and motivation among staff and problems with vaccine and supply management(16).