Interventions to improve childhood immunisation coverage in low‐ and middle‐income countries
Citation: Oyo-Ita A, Oduwole O, Arikpo D, et al. Interventions for improving coverage of childhood immunisation in low‐ and middle‐income countries. Cochrane Database of Systematic Reviews. 2023;(12):CD008145. Podcast available in EN.
Language: Abstract available in EN / ES / FA / HO / PT / TH. Full text available in EN.
Free to view: Yes.
Funding sources: Cochrane Nigeria, University of Calabar Teaching Hospital, Nigeria.
What is this? In this Cochrane review, the authors searched for articles that evaluated the effectiveness of interventions to increase childhood vaccination coverage in low- and middle-income countries. They searched without language restrictions in July 2022 and found 41 studies.
What works: The authors found that immunisation outreach, either alone or in conjunction with non-monetary incentives or health education, was likely to have increased full vaccination uptake among children under the age of five years. Health education may result in more children receiving three doses of the diphtheria-tetanus-pertussis (DTP3) vaccine. The use of specially designed immunisation cards may increase DTP3 uptake. However, reminder interventions such as phone calls and text messages had little or no effect on DTP3 uptake. The involvement of community leaders, in conjunction with health providers, was likely to have improved DTP3 uptake.
What doesn’t work: Wearable reminders probably had little or no effect on DTP3 uptake.
What is uncertain: It is unclear whether or not training for healthcare providers in interpersonal communication skills improved DTP3 uptake.
Implications: The authors of the review stated that these findings can inform policymakers and healthcare providers in low- and middle-income countries about the most effective strategies to improve immunisation coverage. There is a need for targeted interventions in specific regions and communities with low rates of immunisation. Interventions of uncertain effectiveness or sustainability should be implemented with caution.
Other considerations: The authors of the review did not discuss their findings in the context of issues relating to health equity.
This summary was prepared by Riwa Deghaim, checked by Grace Meng, and finalized by William Summerskill.