Submission ID 118228
| Issue/Objective | Immunization is a cornerstone intervention within the broader framework of reproductive, maternal, newborn, child, and adolescent health (RMNCAH). Despite its proven effectiveness, the integration of immunization within health systems and across sectors remains inconsistent, leading to missed opportunities for enhancing service delivery and promoting equity. A more comprehensive, evidence-based approach to integration is required to maximize efficiency, reduce fragmentation, and strengthen primary health care (PHC) and universal health coverage. We are conducting a mixed methods systematic review to assess the effectiveness and implementation of the integration of immunization within health services and intersectoral approaches in low- and middle-income countries (LMICs). |
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| Methodology/Approach | Our protocol, drafted as per PRISMA-E guidelines, will be prospectively registered on PROSPERO. Our search strategies, designed in collaboration with a research librarian, will allow to identify qualitative, quantitative and mixed methods primary studies with a focus on RMNCAH services. Study selection, critical appraisal and data extraction will be conducted by two independent reviewers, with disagreements resolved by consensus or consultation with a senior reviewer. Qualitative and quantitative evidence will be synthesized separately before integration, following a mixed convergent segregated approach. An advisory committee of experts from the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), Gavi the Vaccine Alliance, and the Sabin Vaccine Institute will provide guidance throughout the review and leverage their global- and country-level networks to amplify evidence uptake. |
| Results | A preliminary evidence gap analysis highlighted gaps in evidence on integrated immunization approaches within RMNCAH services, PHC, and multi-sectoral models, including a lack of mixed-methods reviews and comprehensive equity-focused analyses. While some evidence exists on individual sectoral integration (e.g., immunization within maternal care or school health programs), a fully multi-sectoral approach remains underexplored. Preliminary results from the systematic review are expected ahead of the conference in October. |
| Discussion/Conclusion | Our findings are expected to inform revisions of WHO guidance on primary health care and service integration for immunization. These findings and associated recommendations will support country-level decision-makers in designing evidence-based, equity-focused strategies to improve health outcomes and advance UHC. Given the current constraints on global health financing, integrating and optimizing essential health services is more critical than ever. |
| Presenters and affiliations | Joelle Ducharme École de santé publique de l'Université de Montréal (ESPUM) Audrey Beaulieu École de santé publique de l'Université de Montréal (ESPUM) Amy Reid Partnership for Maternal, Newborn & Child Health (PMNCH), World Health Organization (WHO) Etienne Langlois Partnership for Maternal, Newborn & Child Health (PMNCH), World Health Organization (WHO) Andrea Tricco University of Toronto Dalla Lana School of Public Health Mira Johri École de santé publique de l'Université de Montréal (ESPUM) |
