Administratively, South Africa is divided into nine provinces and 52 Districts. The metropolitan municipalities like Cape Town have the largest urban communities and perform the function of both district and local municipalities.25 In the Western Cape Province, the Cape Town Metro Health district has 8 legislated sub-districts serving a population of 4.1 million persons.26 There are 152 PHC facilities, 102 of which are managed by the City of Cape Town (local government) to augment PHC services provided by provincial facilities.26 Like elsewhere in South Africa, routine immunization services in Cape Town are funded through the Expanded Programme on Immunization of South Africa (EPI-SA) and provided free of charge primarily through the PHC facilities.1 (link) While the Western Cape is often regarded as having a better resourced health system and health outcomes compared with other provinces, immunization coverage remains lower than optimal levels. For instance, a recent study has shown that more than a third (36.11%) of children in the province are incompletely immunized.27 (link) The current routine immunization schedule for children in South Africa is outlined in Table 2 .
Current routine childhood vaccination schedule in South Africa.
| Age eligibility | Vaccine offered |
|---|---|
| Birth | BCG, OPV (0) |
| 6 Weeks | OPV (1), RV (1), DTaP-IPV-Hib-HepB (1), PCV (1) |
| 10 Weeks | DTaP-IPV-HIB-HepB (2) |
| 14 Weeks | RV (2), DTaP-IPV-Hib-HepB (3), PCV (2) |
| 6 months | Measles (1) |
| 9 Months | PCV (3) |
| 12 months | Measles (2) |
| 18 Months | DTaP-IPV-Hib-HepB (4) |
| 6 years | Td (1) |
| 9 years | HPV (1), HPV (2) (2 doses, 6 months apart)* |
| 12 years | Td (2) |
BCG = Bacille Calmette Guerin, DTaP-IPV-Hib-HepB = hexavalent vaccine (containing diphtheria, tetanus, pertussis, inactivated polio, Haemophilus influenzae type b and hepatitis B vaccines), HPV = human papillomavirus vaccine, OPV = oral polio vaccine, PCV = pneumococcal conjugate vaccine, RV = rotavirus vaccine, Td = tetanus and reduced dose diphtheria vaccine.
*HPV vaccine is given as part of the school health programme rather than the EPI-SA.
