After rising for more than two decades, routine immunization coverage rates began to stagnate in 2010, with an estimated 19.4 million children under the age of one not receiving basic vaccines in 2018. While immunization services have historically focused on supply and delivery functions, inequities have highlighted the significance of demand generation – and the need for a people-centered model that incorporates health worker and client perspectives and needs – for a more positive immunization service experience.
Partners in the Demand Hub Service Experience Workstream are collaborating to inform a new direction in people-centered quality immunization service delivery and reorient immunization services to include caregiver, client, and health worker perspectives and needs. In support of this effort, John Snow Research & Training Institute, Inc. (JSI), in collaboration with Gavi, the Vaccine Alliance, consolidated existing knowledge and conducted rapid learning around immunization service experience at global and regional levels through desk reviews and key informant interviews (KIIs). Results from these KIIs were organized into nine main themes.
These themes formed the basis for additional insight gathering in four countries, including Kenya. To understand if and how the global and regional findings resonate in the country (and efforts underway in Kenya to address the immunization service experience), in April and May 2020, JSI conducted a review of the grey and peer-reviewed literature to gather the following information:
• The experience of clients and caregivers in the healthcare system
• Health system and facility factors that affect the immunization service
experience
• Health worker and client factors and perceptions that impact service
delivery and experience
• Community contributions to service design and delivery
The published and grey literature were identified through a web-based search and gathering suggestions from key stakeholders. The search, which yielded over 80 documents, focused on immunization issues as well as maternal, newborn, and child health, HIV/AIDS, family planning, and antenatal care.