Submission ID 131594
| Issue/Objective | Immunisation is among the most cost-effective public health interventions and a cornerstone of reproductive, maternal, newborn, child, and adolescent health (RMNCAH). Yet in 2024, 14.3 million children received no routine vaccines - an increase of 1.4 million since 2019 - with most concentrated in fragile settings and facing overlapping deprivations. Amid shrinking aid budgets and fragmented global health governance, vertical immunisation strategies alone cannot close these equity gaps. Integrating immunisation within primary health care (PHC) and across health-enhancing sectors offers a pathway to reduce fragmentation, improve efficiency, and advance universal health coverage (UHC). This scoping review, conducted under the Anchoring evidence-informed integration of immunisation within health services and across sectors (ARRIVE) Consortium, maps and synthesises evidence on integration of immunisation within health systems and across sectors in low- and middle-income countries (LMICs). |
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| Methodology/Approach | Guided by Joanna Briggs Institute methodology and prospectively registered on OSF, we searched MEDLINE, CINAHL, EBM Reviews, EMBASE, LILACS, and Google Scholar for peer-reviewed quantitative, qualitative, and mixed-methods studies published between January 2015 and October 2025. Five reviewers independently screened citations in Covidence through two stages (title/abstract, full text), with discrepancies resolved by consensus. Data charting is ongoing using a standardised form, applying a PROGRESS-Plus equity lens. An advisory group including WHO, UNICEF, Gavi, and the Sabin Vaccine Institute provides technical guidance and knowledge translation support. |
| Results | Of 2,828 records identified, 2,557 were excluded at title/abstract and 83 at full-text screening, yielding 188 articles included for data extraction. Preliminary gap analysis reveals limited evidence on integrated approaches spanning the full life course, multisectoral models addressing upstream determinants, and equity-focused strategies targeting zero-dose children. Full results are expected in fall 2026. |
| Discussion/Conclusion | Findings will inform forthcoming WHO guidance on PHC-immunisation integration, Gavi 6.0 implementation, and country-level decision-making, while identifying scalable models adaptable across diverse contexts. Beyond its efficiency gains amid constrained financing, integration offers a more holistic response to population needs, strengthens health systems more effectively, better aligns with country priorities, and is more likely to be sustainable over time. In a fragmented and uncertain global health landscape, it is a foundational approach for advancing equity and building resilient health systems. |
| 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) Étienne 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) |
