Zaire, a large central African country with a population of more than 30 million, has had much experience with nongovernmental agencies in its health sector. Of special importance have been missionary groups that established health facilities and conduct "mobile" health activities in rural areas. They established efficient communications and supply networks, and because they could refrigerate vaccines, they were among the first groups to deliver vaccines in rural areas. Expansion of Expanded Programme on Immunization services to rural areas was only made possible through the efforts of nongovernmental agencies.
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Mambu ma-Disu (1989) studied this question.