How can embedded implementation research strengthen immunization coverage and equity?

The MAINSTREAM initiative worked with local mentor institutes in Cameroon, Ghana, Madagascar, Malawi, Mozambique and Pakistan to support 25 small embedded implementation research (IR) projects to strengtheng immunization coverage and equity, especially for zero dose children. This report summarize the different projects and their results.

 

At the start of the project, mentor institutes worked with key stakeholders to develop a list of priority themes to be researched in each country; this list formed the basis for selecting the IR projects.

 

Geospatial mapping projects in Malawi were able to pinpoint with more accuracy pockets of zero dose children. In Pakistan, community health workers (CHWs) improved their skills and agency to engage caregivers through arts-based methods and training. CHWs in Cameroon improved their vaccination awareness and screening to improve identification and referral of zero dose children. Modifying vaccination time slots in Madagascar to be more convenient was highly preferable to families, with providers supporting the change as well. In Ghana, the national malaria elimination efforts were adapted to integrate malaria vaccination to increase coverage. Work in Mozambique found that immunization services were less resilient after crises so preparedness and contigency planning are being revised. This is only some of the work highlighted in the report!

 

Mentor institutes, local IR teams and EPI partners are contiuously working to pursue appropriate programmatic changes that reflect the findings from this work. Importantly, there are still pending priority themes that need to be addressed so the learning agenda is there just waiting for more resources!