ArticleThe Lancet. Global health2024
Integration of the RTS,S/AS01 malaria vaccine into the Essential Programme on Immunisation in western Kenya: a qualitative longitudinal study from the health system perspective.
Article in The Lancet. Global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Genetic diversity, population structure, and drug resistance of Plasmodium falciparum in Kenya: a systematic review and meta-analysis.Malaria journal · 2025Pooled it
- Determinants of Malaria Vaccine Acceptance: A Systematic Review and Meta-Analysis of Awareness, Acceptance, Hesitancy, and Willingness to Pay.Immunity, inflammation and disease · 2025Pooled it
- Validation of Health Belief Model and Theory of Planned Behaviour Constructs for Predicting Malaria Vaccine Acceptance in Ghana: A Partial Least Squares Structural Equation Modelling Approach.Tropical medicine & international health : TM & IH · 2026Article
- Determinants of caregivers' acceptance of the malaria vaccine: The case of Bamenda and Bamenda III Health Districts in Cameroon.Public health in practice (Oxford, England) · 2026Article
- The Malaria Vaccine Programme Evaluation in Kenya: results of a baseline household survey prior to the introduction of the RTS,S/AS01 vaccine.Malaria journal · 2026Observational
- Unmasking non-malarial mosquito-borne infections among febrile children in malaria-endemic regions of western Kenya.Scientific reports · 2026Article
- Timing of the fourth dose of RTS,S/AS01 malaria vaccine in perennial settings: a modelling study.Malaria journal · 2026Article
- Preliminary insights into knowledge and attitudes toward malaria vaccination among Sudanese healthcare workers: an exploratory cross-sectional study.Malaria journal · 2025Article
- Recommendations to mitigate barriers to uptake and delivery of a four-dose malaria vaccine schedule: insights from the MVIP's qualitative evidence.Malaria journal · 2025Article
- General knowledge and attitude of healthcare professionals and infrastructural readiness prior to implementation of malaria vaccine in selected hospitals in Tororo district, Uganda: a cross-sectional study.BMC public health · 2025Article
- Costs, delivery strategies and implementation challenges for malaria vaccines: a rapid review of literature.Tropical diseases, travel medicine and vaccines · 2025Review
- Subnational introduction of the RTS,S/AS01Malaria journal · 2025Article
- Emerging Molecular Mechanisms in Malaria Pathogenesis and Novel Therapeutic Approaches: A Focus onBiomolecules · 2025Review
- Where is the hard-to-reach population? Spatial analysis from a cross-sectional study on the access to bed net and malaria vaccine in the Lake Victoria Region, Kenya.Malaria journal · 2025Article
- Current Developments in Malaria Vaccination: A Concise Review on Implementation, Challenges, and Future Directions.Clinical pharmacology : advances and applications · 2025Review
- Policy uptake and implementation of the RTS,S/AS01 malaria vaccine in sub-Saharan African countries: status 2 years following the WHO recommendation.BMJ global health · 2024Review
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Authors and funding
7 authors at 2 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMalaria accounts for over half a million child deaths annually. WHO recommends RTS,S/AS01 to prevent malaria in children living in moderate-to-high malaria transmission regions. We conducted a qualitative longitudinal study to investigate the contextual and dynamic factors shaping vaccine delivery and uptake during a pilot introduction in western Kenya.
methodsThe study was conducted between Oct 3, 2019, and Mar 24, 2022. We conducted participant and non-participant observations and in-depth interviews with health-care providers, health managers, and national policymakers at three timepoints using an iterative approach and observations of practices and processes of malaria vaccine delivery. Transcripts were coded by content analysis using the consolidated framework for implementation research, to which emerging themes were added deductively and categorised into challenges and opportunities.
findingsWe conducted 112 in-depth interviews with 60 participants (25 health-care providers, 27 managers, and eight policy makers). Health-care providers highlighted limitations in RTS,S/AS01 integration into routine immunisation services due to the concurrent pilot evaluation and temporary adaptations for health reporting. Initial challenges related to the complexity of the four-dose schedule (up to 24-months); however, self-efficacy increased over time as the health-care providers gained experience in vaccine delivery. Low uptake of the fourth dose remained a challenge. Health managers cited insufficient trained immunisation staff and inadequate funding for supervision. Confidence in the vaccine increased among all participant groups owing to reductions in malaria frequency and severity.
interpretationIntegration of RTS,S/AS01 into immunisation services in western Kenya presented substantial operational challenges most of which were overcome in the first 2 years, providing important lessons for other countries. Programme expansion is feasible with intensive staff training and retention, enhanced supervision, and defaulter-tracing to ensure uptake of all doses.
fundingPATH via World Health Organization; Gavi, the Vaccine Alliance; The Global Fund; and Unitaid.
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