Introduction:

Childhood vaccination is a fundamental public health strategy. In Bolivia, it is implemented both inside health services (in health facilities) and outside health services (through mobile brigades and outreach campaigns). Analyzing the distribution of these approaches helps guide more efficient planning and intervention efforts. This study aimed to analyze the distribution of vaccinations administered inside and outside health services to children under five years of age during 2024 in the municipalities of the Cochabamba department, Bolivia. Methodology: An observational, descriptive, and cross-sectional study was conducted using data from the National Health Information System (SNIS), which included all children under five who received at least one vaccine in 2024, regardless of vaccine type. Absolute frequencies and percentages were calculated by municipality according to the place of vaccination. A Wilcoxon signed-rank test was applied to statistically compare both strategies. Results: A total of 1,271,810 vaccinations were recorded. Of these, 50.6% were administered inside health services and 49.4% outside. The statistical test revealed a significant difference between the two strategies (p = 0.017). Variability was observed across municipalities. Discussion: Despite the overall balance at the departmental level, municipal-level differences highlight the need to adapt vaccination strategies to local conditions. Strengthening both facility-based care and outreach interventions is recommended to ensure equitable coverage.