Advancing Immunization Coverage and Equity: A Structured Synthesis of Pro-Equity Strategies in 61 Gavi-Supported Countries

Background: Global immunization inequities persist, reflected in the 25 million underimmunized and 18 million zero-dose children in 2021. To identify country approaches to reach underimmunized and zero-dose children, we undertook a structured synthesis of pro-equity strategies across 61 countries re...

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Vydáno v:Vaccines (Basel) Ročník 11; číslo 1; s. 191
Hlavní autoři: Ivanova, Vesela, Shahabuddin, A. S. M., Sharkey, Alyssa, Johri, Mira
Médium: Journal Article
Jazyk:angličtina
Vydáno: Switzerland MDPI AG 16.01.2023
MDPI
Témata:
children
Decision making
equity
Gender
Immunization
Keywords
remote
rural
Synthesis
Vaccines
Nigeria
Syria
gender
urban
children
immunization
poor
rural
remote
equity
conflict
ISSN:2076-393X, 2076-393X
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Shrnutí:Background: Global immunization inequities persist, reflected in the 25 million underimmunized and 18 million zero-dose children in 2021. To identify country approaches to reach underimmunized and zero-dose children, we undertook a structured synthesis of pro-equity strategies across 61 countries receiving programmatic support from Gavi, the Vaccine Alliance. Methods: We extracted data from 174 Country Joint Appraisals and Multi-Stakeholder Dialogue reports (2016–2020). We identified strategies via a targeted keyword search, informed by a determinants of immunization coverage framework. Strategies were synthesized into themes consolidated from UNICEF’s Journey to Health and Immunization (JTHI) and the Global Routine Immunization Strategies and Practices (GRISP) frameworks. Results: We found 607 unique strategies across 61 countries and 24 themes. Strategies to improve care at the point of service (44%); to improve knowledge, awareness and beliefs (25%); and to address preparation, cost and effort barriers (13%) were common. Fewer strategies targeted experience of care (8%), intent, (7%) and after-service (3%). We also identified strategies addressing gender-related barriers to immunization and targeting specific types of communities. Conclusions: We summarize the range of pro-equity immunization strategies employed in Gavi-supported countries and interpret them thematically. Findings are incorporated into a searchable database which can be used to inform equity-driven immunization programs, policies and decision-making which target underimmunized and zero-dose communities.
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ISSN:2076-393X
2076-393X
DOI:10.3390/vaccines11010191