The Alliance recently organized two workshops to facilitate cross-country learning for two ongoing immunization strengthening initiatives. These two programmes of work leverage health policy and systems research (HPSR) approaches to improve immunization coverage and uptake in low- and middle-income countries (LMICs).
In August, the Alliance co-organized an Annual Learning Forum as part of its work on improving vaccine uptake in LMICs. The workshop, hosted at the Aga Khan University in Karachi, Pakistan, brought together the six research teams from Ethiopia, India, Indonesia, Nigeria, Pakistan and the Philippines. The workshop also convened participants from WHO (the Immunization, Vaccines and Biologicals Department, or IVB, and the country office in Pakistan) as well as external experts in complex evaluation and communication. The final day offered an opportunity to engage with local immunization stakeholders from Sindh and Balochistan provinces to better understand the diverse challenges of improving vaccine uptake in Pakistan.
In September, the Alliance organized a cross-country research synthesis workshop in support of the Case Studies of Big Catch-up immunization activities in LMICs initiative. Research teams from Cameroon, Nigeria, Pakistan, the United Republic of Tanzania and Yemen came together in Cairo, Egypt, to share preliminary findings, synthesize cross-country learnings, and prepare communication products. By focusing on institutionalizing catch-up efforts, these case studies contribute to the monitoring, evaluation and learning of The Big Catch-Up (BCU), a strategy developed in response to COVID-19 to address setbacks in reaching un- and under-immunized children, with a focus on institutionalizing catch-up efforts. The workshop and the overall programme of work have been conducted in coordination with IVB and also included participation from the WHO Eastern Mediterranean Regional Office.
These two programmes have different accents – the vaccine uptake initiative uses diverse HPSR methods to examine how individual-level and system-level factors interact to hinder immunization, while the BCU studies are using HPSR to understand how a major global initiative was implemented and what it means for strengthening immunization systems. However, there are common themes that emerge across both.
- Ongoing learning: in both initiatives, research teams are grappling with the realities of how to measure systems change. For the vaccine uptake initiative, this meant teams needed to think beyond typical indicators focused on their intervention towards measuring less tangible shifts in their settings that are occurring as a result of their engagements. For BCU, this workshop came at a crucial time. Country teams are analysing and triangulating multiple data sources, and feedback from other research teams can help deepen their interpretation of findings, creating an opportunity for South-to-South learning. As one participant noted, “The workshop was very productive, especially in the analytics part, in showing how other countries have implemented well their analysis.”
- Communicating effectively: Especially at a time when the value of immunization is being questioned globally, the shaping of key messages is a vital part of ensuring the success of the research efforts. With HPSR to improve vaccine uptake, teams are prioritizing communication early, making it a core part of the research, and being deliberate about who delivers the message, when and how. The BCU experience illustrates this, as teams shaped and refined key messages from their research to better engage key stakeholders in their local contexts.
- Building partnerships: The successful progress of the research teams is linked with the consistency with which they engage with their local stakeholders to interpret, explain and validate. The value that the Alliance brings is to further provide convening spaces for research teams, working in partnership with WHO Immunization, Vaccines and Biologicals Department (IVB) and WHO regional and country offices.
Health policy and systems research brings critical approaches to engaging with complex, dynamic issues such as immunization services. Together, these efforts underscore that improving vaccine uptake requires leveraging policy windows, building trusted partnerships, and tailoring solutions to local barriers.