Exemplars in vaccine delivery protocol: a case-study-based identification and evaluation of critical factors in achieving high and sustained childhood immunisation coverage in selected low-income and lower-middle-income countries

• Type of Material: Article
• Authors: Robert Bednarczyk, Emory University; Kyra A Hester, Emory University; Sameer M Dixit, Center for Molecular Dynamics; Anna S Ellis, Emory University; Ngoc-Cam Escoffery, Emory University; William Kilembe, Zambia Emory HIV Research Project; Katie Micek, Emory University; Zoë M Sakas, Emory University; Moussa Sarr, Institut de Recherche et Santé de Épidémiologique et de Formations; Matthew Freeman, Emory University
• Language: English
• Date: 2022-04-01
• Publisher: BMJ PUBLISHING GROUP
• Publication Version: Final Published Version
• Copyright Statement: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1136/bmjopen-2021-058321
• Title of Journal or Parent Work: BMJ OPEN
• Volume: 12
• Issue: 4
• Start Page: e058321
• End Page: e058321
• Grant/Funding Information: This work was supported by the Bill & Melinda Gates Foundation, grant number OPP1195041. Pilot and proposal development funds were provided by Gates Ventures.
• Keywords: IMPLEMENTATION; International health services; IMPACT; Science & Technology; Life Sciences & Biomedicine; Paediatric infectious disease & immunisation; PUBLIC HEALTH; General & Internal Medicine; Medicine, General & Internal
• Research Categories: Environmental Sciences; Health Sciences, Public Health

Abstract

Introduction Increases in global childhood vaccine delivery have led to decreases in morbidity from vaccine-preventable diseases. However, these improvements in vaccination have been heterogeneous, with some countries demonstrating greater levels of change and sustainability. Understanding what these high-performing countries have done differently and how their decision-making processes will support targeted improvements in childhood vaccine delivery. Methods and analysis We studied three countries - Nepal, Senegal, Zambia - with exemplary improvements in coverage between 2000 and 2018 as part of the Exemplars in Global Health Programme. We apply established implementation science frameworks to understand the € how' and € why' underlying improvements in vaccine delivery and coverage. Through mixed-methods research, we will identify drivers of catalytic change in vaccine coverage and the decision-making process supporting these interventions and activities. Methods include quantitative analysis of available datasets and in-depth interviews and focus groups with key stakeholders in the global, national and subnational government and non-governmental organisation space, as well as community members and local health delivery system personnel. Ethics and dissemination Working as a multinational and multidisciplinary team, and under oversight from all partner and national-level (where applicable) institutional review boards, we collect data from participants who provided informed consent. Findings are disseminated through a variety of forms, including peer-reviewed manuscripts related to country-specific case studies and vaccine system domain-specific analyses, presentations to key stakeholders in the global vaccine delivery space and narrative dissemination on the Exemplars.Health website.