ArticleVaccines2023
Uncovering the Drivers of Childhood Immunization Inequality with Caregivers, Community Members and Health System Stakeholders: Results from a Human-Centered Design Study in DRC, Mozambique and Nigeria.
Article in Vaccines, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- Article
- Culturally and linguistically appropriate vaccine education (CLAVE) for Indigenous communities: design and implementation study of a community-based approach to digital vaccine education in the Central Highlands of Guatemala.International journal for equity in health · 2026Article
- Gender and intersectional barriers to child immunization: findings from qualitative research in Nigeria.International journal for equity in health · 2026Article
- M13 phage-based antigen presentation and immune response activation in vaccine development for animal infectious diseases.Frontiers in immunology · 2026Review
- Article
- Immunisation decision-making and barriers to vaccine uptake among children under-5 in limited-resource settings.Scientific reports · 2025Article
- Article
- Gender-Associated Factors on the Occurrence and Prevalence of Zero-Dose Children in Sub-Saharan Africa: A Critical Literature Review.Tropical medicine and infectious disease · 2025Review
- Assessing immunization coverage in Southern togo: implications for perennial malaria chemoprevention delivery.BMC public health · 2025Article
- The Effect of Implementing Advanced Strategies to Improve Immunization Coverage in the Elogbele Health Area.Cureus · 2025Article
- Using Human-Centered Design to Bridge Zero-Dose Vaccine Gap: A Case Study of Ilala District in Tanzania.Vaccines · 2025Article
- How did the introduction of the measles-containing vaccine second dose (MCV2) affect measles vaccine uptake? - evidence from Nigeria.Human vaccines & immunotherapeutics · 2024Article
- Strengthening Capacity for Tailored Immunization Programs Using Adult Learning Principles: A Case Study from Nigeria.Global health, science and practice · 2024Article
- Optimal Timing Regularly Outperforms Higher Coverage in Preventative Measles Supplementary Immunization Campaigns.Vaccines · 2024Article
- Of Money and Men: A Scoping Review to Map Gender Barriers to Immunization Coverage in Low- and Middle-Income Countries.Vaccines · 2024Article
- Article
- Article
- Cognizance and mitigation of falsified immunization documentation: Analyzing the consequences for public health in Nigeria, with a focus on counterfeited COVID-19 vaccination cards: A case report.Health science reports · 2024Article
- Article
- Beyond constructs and principles: addressing gender-related barriers to high, equitable immunization coverage.Frontiers in global women's health · 2024Article
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Authors and funding
20 authors.
Funding
Abstract
backgroundThe importance of immunization for child survival underscores the need to eliminate immunization inequalities. Few existing studies of inequalities use approaches that view the challenges and potential solutions from the perspective of caregivers. This study aimed to identify barriers and context-appropriate solutions by engaging deeply with caregivers, community members, health workers, and other health system actors through participatory action research, intersectionality, and human-centered design lenses.
methodsThis study was conducted in the Demographic Republic of Congo, Mozambique and Nigeria. Rapid qualitative research was followed by co-creation workshops with study participants to identify solutions. We analyzed the data using the UNICEF Journey to Health and Immunization Framework.
resultsCaregivers of zero-dose and under-immunized children faced multiple intersecting and interacting barriers related to gender, poverty, geographic access, and service experience. Immunization programs were not aligned with needs of the most vulnerable due to the sub-optimal implementation of pro-equity strategies, such as outreach vaccination. Caregivers and communities identified feasible solutions through co-creation workshops and this approach should be used whenever possible to inform local planning.
conclusionsPolicymakers and managers can integrate HCD and intersectionality mindsets into existing planning and assessment processes, and focus on overcoming root causes of sub-optimal implementation.
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