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Learning study to reduce drop-out from the infant primary immunization
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Discussion
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Expected Project Scope
The Immunization Program Strategy Team at the Bill & Melinda Gates Foundation is requesting proposals for a rapid learning project to understand drivers of drop out from the primary infant series to the 9-month touchpoint to and identify approaches to increase retention. This project will complement the zero-dose work that is a focus of the Foundation, Gavi and Alliance partners – while the zero-dose work focuses on access (identifying and reaching children never touched by the immunization system) this project will focus on retention (how do we keep families in the immunization program and reduce the number of MCV0 children?).
While immunizations are scheduled to be delivered at 9 months, timeliness challenges are well-documented globally.[4] The research should be able to understand the age at which MCV (and all other 9-month touchpoint antigens relevant to the country) are actually administered, as well as document relevant timepoints at which caregivers are bringing their children to health facilities for other services.
Project goals include:
- Develop and execute learning agenda to answer key questions (examples below) about improving coverage at the 9-month touchpoint. This may include (but need not be limited to) data on age of vaccination and timeliness, reasons for dropout, barriers to access, and health system engagement at this touchpoint.
- What are the underlying characteristics of the missed kids and their families?
- At what age are children arriving for MCV1? Is this age the same for all vaccines delivered at 9 months per the immunization schedule? What vaccines and services are available when families arrive?
- Are HCWs administering MCV1 with DTP3 if it has been delayed or are they asking families to return?
- What barriers keep caregivers from returning / visiting health facilities at this touchpoint?
- Are there gender related advantages/barriers that could be used to help design interventions to increase coverage?
