Critical success factors for implementing cholera vaccination campaigns in humanitarian emergencies: a DEMATEL-based approach

Cholera outbreaks are quite common in the aftermath of natural or man-made disasters. Population displacement and overcrowding in conjunction with increased prevalence of malnutrition and degradation of sanitary conditions present the main drivers favoring cholera outbreaks in these settings. Although cholera is a vaccine-preventable disease, the implementation of mass vaccination campaigns remains still a difficult task in humanitarian emergencies. In this paper an attempt is made for identifying critical success factors as well as the possible interrelationships among them for successfully implementing cholera vaccination campaigns in humanitarian emergencies. Such factors are identified through systematically surveying the literature. Based on this survey and following experts’ responses relevant priorities are identified and the description and analysis of the interrelationships among these factors are given through the usage of the Decision-Making Trial and Evaluation Laboratory (DEMATEL) method. According to the results of the analysis, sound coordination among the key-players involved, establishment of surveillance systems and mobilization of the target communities present the three most important factors while security issues and the general political context in which an immunization campaign is implemented are considered the most influential factors. The findings could be of significant value to those drafting contingency plans or implementing immunization campaigns in humanitarian emergencies.