The vision for the Decade of Vaccines is a world in which all individuals and communities enjoy lives free from vaccine-preventable diseases. Inhomogeneous vaccination coverage between urban and rural areas is one of the realities that hamper the efforts to meet the Decade of Vaccines goals. Sub-Saharan Africa is among the regions most affected by the phenomenon. The determinants that affect the awareness of the caregiver, the mother, about vaccination, the decision and motivation to bring the child to the health center to receive vaccines form the focus of our work. We found that the aforementioned determinants are unequally distributed between urban and rural areas in Sub-Saharan Africa, disadvantaging the rural setting. We identified 5 steps needed for a mother or any other caregiver to take a child to the vaccination center, and we made recommendations accordingly. The work is a contribution to the improvement of vaccination coverage in all settings and should be especially useful to community workers, managers from immunization programs, national governments, international organizations and donors, or anyone else interested in child survival.