**2.5 Measles vaccination coverage in Africa**

Strategies based on vaccination program have been implemented in order to reduce measles mortality. In 2008, countries in the WHO African Region adopted measles pre-elimination goal to be achieved by the end of 2012. Target was to achieve >98% reduction in estimated regional measles mortality. The goal was to have national measles incidence of <5 cases per 1,000,000 population per year, achieve >90% national coverage with MCV1 with >80% MCV1 coverage target. For SIAs, MCV coverage >95% was targeted in all districts [16]. In the WHO regions, highest percentage of reduction was in Eastern Mediterranean (90%) and African (89%) regions, accounting for 16 and 63% of global reduction [34, 35]. Relatively high measles vaccination in southern Nigeria in West Africa can be attributed to high level of literacy and awareness created by free use of mass media to disseminate information on vaccination activities, without fear of intimidation [33]. The Global Vaccine Action Plan (GVAP) set out a target of reaching 80% coverage with all vaccines including measles vaccine in all districts by 2020 [36]. Health policy decision-making based on spatially heterogeneous vaccination has resulted in shift from pursuing coverage targets at national-level to ensuring high coverage levels evenly distributed across provinces or districts [37]. While this likely represents a more effective strategy over targeting country-level goals, administrative area summaries may still mask important geographical inequities in coverage [38].
