Interventions to improve vaccination delivery during protracted humanitarian crises
Citation: Ismail SA, Lam ST, Bell S, et al. Strengthening vaccination delivery system resilience in the context of protracted humanitarian crisis: a realist-informed systematic review. BMC Health Services Research. 2022;22:1277.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: Wellcome Trust Clinical Research Training Fellowship.
What is this? In this systematic review, the authors searched the peer-reviewed and grey literature for the effectiveness of system-level vaccine delivery interventions to maintain and improve vaccination coverage across populations in low- and middle-income countries during protracted crises. They searched in September 2021 for articles published in Arabic, English, or French between January 2001 and November 2021. The authors included 50 studies, most from in-conflict or immediate post-conflict settings in sub-Saharan Africa. This systematic review was registered with PROSPERO, number CRD42021273124.
What was found: The authors identified eight areas of interventions that may improve vaccination coverage, of which vaccination campaigns were the most common. Most successful campaigns were multi-dimensional and used a variety of approaches. Strong community engagement was critical to improve vaccination outcomes in crisis-affected populations. One study found a statistically significant increase in vaccination coverage when the private sector was involved.
Implications: The authors of the review stated that the findings emphasise the need for improved outcome reporting, clearer definitions of protracted crises, and the identification of best practices from a wider range of sources to inform future interventions. When there is distrust towards the government, the authors suggested that the recruitment of non-traditional workers from within affected communities, such as community mobilisers, could help to increase vaccination uptake.
Other considerations: The authors of the review discussed their findings in the context of socioeconomic status.
This summary was prepared by Riwa Deghaim, checked by Grace Meng, and finalized by William Summerskill.