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Finally since the PC strategy has a lower population coverage than the first two, we formulated a fourth strategy that combines it with a more general vaccine distribution to attain a final 47% coverage.
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This is generally much lower than population coverage.
With these parameters, effective coverage is generally considerably lower than population coverage, and exceeds 50% only when population coverage is close to 100% (Fig. 3).
The fact that the proportion of vaccinated infants reached a maximum of around 75%, which is still 20% lower than the general population coverage, is not unexpected.
Studies elsewhere suggest that CHW performance is higher when the CHW to population coverage ratio is lower [ 14].
The low effective coverage is corroborated by population genetic studies, showing that even in areas with high population coverage, the selection coefficient is usually lower than 0.5, that is, resistant mosquitoes have less than 50% higher fitness than sensitive ones (e.g., Curtis et al. 1978; Wood and Cook 1983; Lynd et al. 2010).
National population coverage with ACS is likely to be much lower than facility coverage estimates, as a large proportion of births take place outside of high-volume facilities or outside any facility.
In western countries, the radius of hospital service area may be set larger due to a lower population density, smaller number of hospitals, and differences in health insurance systems and coverage [34], [35].
These results reflect those of Grimshaw and colleagues [ 6] but coverage is far lower than those of Cosens et al. [ 29] who achieved a 58% population coverage rate.
It promised to reach 99% population coverage within two years.
(A) Population coverage distribution.
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