Background: Routine childhood immunization remains a highly cost-effective public health intervention. Global immunization efforts have increased the coverage of proxy antigens in recent decades. However, annual reports indicated a progressive decline in immunization coverage in Yaounde. In addition, data management issues related to Expanded Programme of Immunization (EPI) inputs have been identified. This study aimed to identify knowledge gaps and organizational deficiencies in the implementation of routine immunization in health facilities (HFs) in the Efoulan Health District (HD) of Yaounde. Methods: A descriptive cross-sectional study was conducted in Efoulan, an urban HD of Yaounde, the capital of Cameroon, in May 2022. A self-administered questionnaire was used to collect knowledge data from consenting HCWs. An observation grid was used to assess the implementation of some relevant national EPI guidelines and recommendations. Results: A total of 46 HCWs providing vaccinations in the nine health areas of the HD were enrolled in the study. Almost all participants (93.5%) were unable to name all the diseases that the pentavalent vaccine protects against. More than half of the respondents (59%) were aware of the 15-month booster dose of measles-rubella (MR) vaccine included in the EPI schedule. Half of the respondents knew of the type of antigen contained in the BCG vaccine (52%). More than two-thirds of respondents (72%) had not identified the 6-month MR vaccine as recommended without risk for HIV+ children. Most of respondents were not aware of the management of opened non-lyophilized vials (50%), calculation of wastage factor (89%) and vaccine requirements (98%). Almost all respondents (87%) have poor knowledge on vaccination norms and standards. Most of the visited HFs did not follow the monthly EPI monitoring curve (87%), did not store vaccines according to standards (80%) neither have an EPI case reporting form (93%). Most of the consultants in visited HFs were not familiar with the case definitions of common vaccine preventable diseases. Conclusions: The implementation of routine immunization in HFs remained poor in most of the HFs visited in Efoulan HD, due to the lack of knowledge in the EPI norms and standards of the staff. There is a need to strengthen the capacities of HCWs through ongoing training and supervision.

The authors have declared no competing interest.

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics committee/IRB of the Faculty of Medicine of Yaounde waived ethical approval for this work

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data produced in the present work are contained in the manuscript