*2.2. Key Operational Definitions*

In this study, childhood routine immunization access was measured using diphtheria, pertussis, tetanus first dose (DTP-1) vaccination coverage as an indicator, while routine immunization utilization was based on DTP-3 vaccination coverage, DTP-1 and DTP-3 were used as indicators to align with the Cameroon ministry of public health's definitions for vaccination access and utilization; thus allowing for result dissemination and use by policy makers. Moreover, we defined COVID-19 hotspot regions as those with the highest number of cumulative COVID-19 cases as of July 2022.
