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Table 3 Summary of 25 papers reviewed

From: Too little but not too late: Results of a literature review to improve routine immunization programs in developing countries

Country [Ref] Year(s)

Brief Description

Study Type

Change in FVC*

Bringing immunizations closer to the community

Kenya [11] Unknown

Providing outreach immunization services in schools along with dissemination of information about immunizations by students

Trial with evaluation before and after

28% and 32% §

India [6] 1975–1988

Supporting immunization activities in the community by using local women to provide health information and track immunizations

Trial with comparison groups

n/a**

Papua New Guinea [12] 1983–1987

Improving access to immunizations by providing vaccinations at lower level health facilities (health posts) by trained Aid Post Orderlies

Trial with comparison group

n/a

Nigeria [13] 1984–1986

Providing immunizations at more locations and more convenient times in combination with parent education ‡

Trial with evaluation before and after

38%

Mozambique [15,16] 1985–1987

Visiting homes to mobilize the community and refer unvaccinated children to services while providing regular pulse outreach

Trial with evaluation before and after

-4%, 32%, 33% and 14% §

South Africa [8] 1987–1988

Conducting home visits using village health workers who retain visit records ‡

Trial with evaluation before and after

n/a

Bangladesh [7] 1987–1988

Following-up defaulters using low-literacy urban volunteers

Observational

n/a

Ghana [9] 1991–1992

Visiting homes to refer families to services using non-health workers ‡

Trial with comparison groups

19%

Mozambique [14] 1994

Providing outreach services to areas affected by conflict

Observational

n/a

Mexico [10] 1994

Identifying children needing vaccines through home visits by community members

Trial with comparison groups

42%

Using information dissemination to increase demand for vaccination

The West Bank [19] 1985–1996

Developing staffed village-resource rooms

Observational

n/a

Philippines [17] 1989–1990

Communicating measles information through a mass media campaign ‡

Trial with evaluation before and after

11%

Bangladesh [18] 1995

Advocating, by an NGO credit program, for women to utilize immunization services ‡

Observational

n/a

Changing practices in fixed sites

Sudan [21] Unknown

Moving vaccination locations closer to the consulting room or having physicians give an immunization "prescription" after curative care

Observational

n/a

Nigeria [22] 1982

Reorganizing health centers to include a quick immunization line

Trial with evaluation before and after

18%

Mexico [23] 1991

Screening hospitalized children for vaccination status and immunizing those not up-to-date

Observational

n/a

Ethiopia [20] 1991–1992

Using reminder stickers to reduce dropout in fixed facilities along with health education ‡

Trial with comparison groups

n/a

Using innovative management practices

Papua New Guinea [26] 1982–1984

Creating a reporting system based on updated catchment area and target population data, including regular feedback

Trial with evaluation before and after

n/a

Nicaragua [29,30] 1985

Providing food incentives to improve attendance at well child clinics (mobile and fixed) ‡

Trial with evaluation before and after

n/a

Bolivia [25] 1992–1994

Using data and community information to develop appropriate programs

Trial with comparison groups

70%

Indonesia [27] 1993–1994

Training nurses in under-performing health centers using low-cost on-the-job peer training ‡

Trial with comparison groups

n/a

Cambodia [24] 1997–2000

Using contractors to increase immunization coverage and equity ‡

Trial with comparison groups

13% and 1%¶

Madagascar [28] 2000

Using auto-disable syringes for increasing safety and reducing missed opportunities

Trial with comparison groups

n/a

  1. * The change in fully vaccinated children (FVC) may not be comparable across papers as duration of intervention, baseline coverage, and populations vary. For trials with comparison groups, the term "change" represents the difference between groups, whereas for trials with before-and-after evaluations this term represents the change over time.
  2. ** n/a indicates that the change in FVC is not reported in the paper.
  3. ‡ Paper reported a statistically significant change for vaccination results (α < 0.05).
  4. § Results for areas reported separately.
  5. Change in FVC before and after intervention in multiple areas.
  6. ¶Two different contracting methods were evaluated.