Interventions for improving coverage of childhood immunisation in low- and middle-income countries
Angela Oyo-Ita 1, Charles S Wiysonge 2 3 , Chioma Oringanje 4, Chukwuemeka E Nwachukwu 5, Olabisi Oduwole 6,
Martin M Meremikwu 7
1 University of Calabar Teaching Hospital, Department of Community Health, Calabar, Nigeria
2 Stellenbosch University, Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences, Cape Town, South Africa
3 South African Medical Research Council, Cochrane South Africa, Cape Town, South Africa
4 University of Tucson, GIDP Entomology and Insect Science, Tucson, Arizona, USA
5 Excellence & Friends Management Consult (EFMC), Abuja, FCT, Nigeria
6 University of Calabar Teaching Hospital (ITDR/P), Institute of Tropical Diseases Research and Prevention, Calabar, Cross River State, Nigeria
7 University of Calabar Teaching Hospital, Department of Paediatrics, Calabar, Cross River State, Nigeria.
Oyo-Ita A, Wiysonge CS, Oringanje C, Nwachukwu CE, Oduwole O, Meremikwu MM. Interventions for improving coverage of childhood immunisation in low- and middle-income countries. Cochrane Database of Systematic Reviews 2016, Issue 7. Art. No.: CD008145. DOI: 10.1002/14651858.CD008145.pub3.
To read the full review please follow this link: DOI: 10.1002/14651858.CD008145.pub3/full
Interventions that will increase and sustain the uptake of vaccines in low- and middle-income countries
What is the aim of this review?
The aim of this Cochrane review was to evaluate the effect of different strategies to increase the number of children in low-and-middle-income countries who are vaccinated to prevent infection by a disease. Researchers in Cochrane collected and analysed all relevant studies to answer this question and found 14 relevant studies.
Do strategies to improve childhood vaccination work?
Giving information about vaccination to parents and community members, handing out specially designed vaccination reminder cards, offering vaccines through regular immunisation outreach with and without household incentives (rewards), identifying unvaccinated children through home visits and referring them to health clinics, and integrating vaccination services with other services may lead to more children getting vaccinated. However, offering parents money to vaccinate their children may not improve vaccination uptake. Most of these findings were of low-certainty, and we need more well-conducted research in this area.
What was studied in the review?
Millions of children in low-and-middle-income countries still die from diseases that could have been prevented with vaccines. There are a number of reasons for this. Governments and others have tried different strategies to increase the number of children vaccinated.
What are the main results of the review?
The review authors found 14 relevant studies from Georgia, Ghana, Honduras, India, Mali, Mexico, Nicaragua, Nepal, Pakistan, and Zimbabwe. The studies compared people receiving these strategies to people who only received the usual healthcare services. The studies showed the following:
Giving information and discussing vaccination with parents and other community members at village meetings or at home probably leads to more children receiving three doses of diphtheria-tetanus-pertussis vaccine (moderate-certainty evidence).
Giving information to parents about the importance of vaccinations during visits to health clinics combined with a specially designed participant reminder card and integration of vaccination services with other health services may improve the uptake of three doses of diphtheria-tetanus-pertussis vaccine (low-certainty evidence).
Offering money to parents on the condition that they vaccinate their children may make little or no difference to the number of children that are fully vaccinated (low-certainty evidence).
Using vaccination outreach teams to offer vaccination to villages on fixed times monthly may improve coverage for full vaccination (low-certainty evidence).
How up-to-date is this review?
The review authors searched for studies that were published up to May 2016.