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Globally, diarrhea and pneumonia are leading etiology of morbidity and mortality among children under the age of five 12. Diarrheal disease is responsible for killing around 525 000 children annually 3. Most diarrheal disease in children are attributed to rotaviruses which cause gastroenteritis, an inflammation of the stomach and intestines that can lead to severe dehydration, hospitalization, and even death in young children 45.

On the other hand, diseases caused by Streptococcus pneumoniae (pneumococcus) constitute also a major global public health problem in young children 67. In 2010, it was estimated that there were 1.73 billion episodes of diarrhea and 120 million episodes of pneumonia in children younger than 5 years. Furthermore, it was also estimated that 700 000 episodes of diarrhea and 1.3 million of pneumonia progressed to death 2.In addition to the basic vaccinations, it is recommended that all children 12-23 months should receive one dose of polio vaccine at birth, three doses of the pneumococcal vaccine, and two doses of the rotavirus vaccine before their first birthday 58.

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The pneumococcal vaccine protects against Streptococcus pneumoniae bacteria, which cause severe pneumonia, meningitis, otitis media, sinusitis, bronchitis and other illnesses 59. On the other hand, the WHO ingeminates that rotavirus vaccines are an important measure that can be used to reduce severe rotavirus-associated diarrhea and child mortality 10. Thus, the use of rotavirus and pneumococcal vaccines should be part of a comprehensive strategy to control diarrhea and pneumonia diseases.The Government of Malawi introduced the pneumococcal conjugate vaccine (PCV13) and monovalent human rotavirus vaccine (RV1) into the nation’s infant immunization programme in November 2011 and October 2012 11. Studies in Malawi show that rotavirus vaccines are safe and effective against severe rotavirus disease and are a cost-effective intervention 1213. However, no study has ever been conducted national wide to determine the factors related to the uptake of rotavirus vaccination in Malawi.

Thus the aim of this study was to investigate the uptake and the factors related to rotavirus and pneumococcal vaccines in Malawi.  

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