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Strategies to increase the demand for childhood vaccination in low- and middle-income countries: a systematic review and meta-analysis

Overview of attention for article published in Bulletin of the World Health Organization, March 2015
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Title
Strategies to increase the demand for childhood vaccination in low- and middle-income countries: a systematic review and meta-analysis
Published in
Bulletin of the World Health Organization, March 2015
DOI 10.2471/blt.14.146951
Pubmed ID
Authors

Mira Johri, Myriam Cielo Pérez, Catherine Arsenault, Jitendar K Sharma, Nitika Pant Pai, Smriti Pahwa, Marie-Pierre Sylvestre

Abstract

To investigate which strategies to increase demand for vaccination are effective in increasing child vaccine coverage in low- and middle-income countries. We searched MEDLINE, EMBASE, Cochrane library, POPLINE, ECONLIT, CINAHL, LILACS, BDSP, Web of Science and Scopus databases for relevant studies, published in English, French, German, Hindi, Portuguese and Spanish up to 25 March 2014. We included studies of interventions intended to increase demand for routine childhood vaccination. Studies were eligible if conducted in low- and middle-income countries and employing a randomized controlled trial, non-randomized controlled trial, controlled before-and-after or interrupted time series design. We estimated risk of bias using Cochrane collaboration guidelines and performed random-effects meta-analysis. We identified 11 studies comprising four randomized controlled trials, six cluster randomized controlled trials and one controlled before-and-after study published in English between 1996 and 2013. Participants were generally parents of young children exposed to an eligible intervention. Six studies demonstrated low risk of bias and five studies had moderate to high risk of bias. We conducted a pooled analysis considering all 11 studies, with data from 11 512 participants. Demand-side interventions were associated with significantly higher receipt of vaccines, relative risk (RR): 1.30, (95% confidence interval, CI: 1.17-1.44). Subgroup analyses also demonstrated significant effects of seven education and knowledge translation studies, RR: 1.40 (95% CI: 1.20-1.63) and of four studies which used incentives, RR: 1.28 (95% CI: 1.12-1.45). Demand-side interventions lead to significant gains in child vaccination coverage in low- and middle-income countries. Educational approaches and use of incentives were both effective strategies.

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The data shown below were compiled from readership statistics for 183 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Unknown 182 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 29 16%
Student > Ph. D. Student 27 15%
Researcher 26 14%
Student > Bachelor 11 6%
Student > Postgraduate 10 5%
Other 30 16%
Unknown 50 27%
Readers by discipline Count As %
Medicine and Dentistry 41 22%
Social Sciences 27 15%
Nursing and Health Professions 17 9%
Psychology 11 6%
Agricultural and Biological Sciences 6 3%
Other 28 15%
Unknown 53 29%