VoICE Immunization Evidence: Synergies Between Health System Programs
Synergies between health system programs
Families who access the health system for non-vaccine services are more likely to have fully immunized children. Non-vaccine related healthcare encounters serve as opportunities to vaccinate children.
A study of 14 geographically diverse countries with a DPT vaccination rate below 70%, evaluated missed vaccination opportunities. Researchers found that children – and their mothers – who were fully immunized were more likely to have received other health interventions. In Cote d’Ivoire, children of mothers who had four or more antenatal care (ANC) visits were 54% more likely to be fully immunized than children of mothers who had no ANC visits. Large differences in full immunization coverage were also found in children who received Vitamin A vs. children who didn’t (greatest difference of 41% was noted in the DRC) and in mothers who had access to a skilled birth attendance (36 % difference in Nigeria) and postnatal care (31% difference in Ethiopia), as compared to mothers without access to these services.
The integration of maternal and child health interventions into immunization campaigns can lead to improved rates of immunizations and related healthcare interventions.
In an effort to reach children with vitamin A deficiency in the African countries of Angola, Chad, Cote d’Ivoire and Togo, vitamin A supplementation was administered during Polio vaccine campaigns. This led to a minimum coverage of 80% for vitamin A and 84% for polio vaccine in all of the immunization campaigns. During the second year of vitamin A integration into the polio vaccination campaign, coverage exceeded 90% for both vitamin A and polio vaccination in all four countries.
An analysis of rotavirus vaccine introduction in two Latin American countries (Honduras and Peru) suggest that the introduction of the vaccine might have had a favorable impact on coverage and timing of other similarly scheduled vaccinations.
Prenatal care-seeking can be combined with maternal immunization to compound the health benefits to mother and child while leveraging the cost-savings of integrating programs.
Increased uptake of immunization for vaccine-preventable diseases, particularly in low- and middle-income countries, could save the lives of thousands of mothers and children each year. The disease burden of tetanus, influenza, and pertussis has been minimized in many countries through maternal immunization, but wider applications of this strategy are now needed.
Where routine immunization programs are well-established, introduction of new vaccines rarely causes major disruptions and may offer collateral benefits.
Despite delivery of HPV vaccine through a mechanism new to the country (school-based campaigns), the HPV vaccine integrated well into the Rwandan health system and caused no major disruptions. In fact, its introduction resulted in strengthened collaboration between the Ministries of Health and Education and provision of additional health services to school-children including health promotion sessions and de-worming.