Burundi continues to face persistent challenges in achieving high and equitable routine immunization coverage. Although national vaccination efforts have expanded over the past decade, progress has been constrained by system-level gaps such as limited
managerial capacity, weak coordination structures, irregular data review practices, and inadequate use of
routine health information for decision-making. These challenges mirror those observed across many low-income countries, where system performance is shaped not only by commodity delivery and service provision but also by the strength of leadership,
management, and accountability mechanisms within national and subnational health systems.
