Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries: Systematic Review Update 2011–2020
<b>Background</b>: The integration of maternal and child health services (MCH) with routine immunization is an important global health strategy, particularly in low- and middle-income countries (LMICs). However, evidence is lacking regarding the best practices for service integration and...
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MDPI AG
2024-11-01
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| author | Monica P. Shah Christopher J. Morgan James G. Beeson Elizabeth Peach Jessica Davis Barbara McPake Aaron S. Wallace |
| author_facet | Monica P. Shah Christopher J. Morgan James G. Beeson Elizabeth Peach Jessica Davis Barbara McPake Aaron S. Wallace |
| author_sort | Monica P. Shah |
| collection | DOAJ |
| description | <b>Background</b>: The integration of maternal and child health services (MCH) with routine immunization is an important global health strategy, particularly in low- and middle-income countries (LMICs). However, evidence is lacking regarding the best practices for service integration and the effect of integration on immunization and linked health service outcomes. <b>Methods</b>: We searched publication databases and gray literature for articles published between 2011 and 2020 that include approaches to integrating MCH services with immunizations during the first two years of life in LMICs. Abstracts and full-text articles were screened for eligibility. For the included articles, data extraction and analysis examined the descriptive characteristics of studies, outcomes, and implementation considerations. <b>Results</b>: Among the 16,578 articles screened, 44 met the criteria for inclusion, representing 34 studies, of which 29 were from Africa. The commonly linked MCH services were family planning (24%), human immunodeficiency virus (HIV) diagnosis or care (21%), and malaria prevention or control (21%). Multiple integration strategies were typically used; the co-location of linked services (65%), the provision of extra services by immunization staff (41%), and/or the provision of extra information by immunization staff (41%) were the most common. In general, integration improved MCH service outcomes (76%) and was either beneficial (55%) or neutral for immunization (35%), with some examples in family planning, malaria, and HIV where integrated services were not beneficial. Important implementation considerations included the careful matching of target populations in service re-design, ensuring support from policy, logistics, and information systems, the provision of adequate training and support of staff to avoid overload, clear client communication regarding service integration, and the need to address community concerns. <b>Conclusions</b>: Integrating MCH services with routine immunization can expand linked services and improve immunization coverage. This study has identified key implementation considerations relevant to both childhood and adult vaccination programs. More research is needed regarding costs and client preferences. |
| format | Article |
| id | doaj-art-76fe900ae9504fe08efdfdccb6877fc5 |
| institution | DOAJ |
| issn | 2076-393X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj-art-76fe900ae9504fe08efdfdccb6877fc52025-08-20T02:43:49ZengMDPI AGVaccines2076-393X2024-11-011212131310.3390/vaccines12121313Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries: Systematic Review Update 2011–2020Monica P. Shah0Christopher J. Morgan1James G. Beeson2Elizabeth Peach3Jessica Davis4Barbara McPake5Aaron S. Wallace6Global Immunization Division, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA 30333, USAJhpiego, a Johns Hopkins University Affiliate, Baltimore, MD 21231, USABurnet Institute, Melbourne, VIC 3004, AustraliaBurnet Institute, Melbourne, VIC 3004, AustraliaBurnet Institute, Melbourne, VIC 3004, AustraliaMelbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC 3053, AustraliaGlobal Immunization Division, Global Health Center, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA<b>Background</b>: The integration of maternal and child health services (MCH) with routine immunization is an important global health strategy, particularly in low- and middle-income countries (LMICs). However, evidence is lacking regarding the best practices for service integration and the effect of integration on immunization and linked health service outcomes. <b>Methods</b>: We searched publication databases and gray literature for articles published between 2011 and 2020 that include approaches to integrating MCH services with immunizations during the first two years of life in LMICs. Abstracts and full-text articles were screened for eligibility. For the included articles, data extraction and analysis examined the descriptive characteristics of studies, outcomes, and implementation considerations. <b>Results</b>: Among the 16,578 articles screened, 44 met the criteria for inclusion, representing 34 studies, of which 29 were from Africa. The commonly linked MCH services were family planning (24%), human immunodeficiency virus (HIV) diagnosis or care (21%), and malaria prevention or control (21%). Multiple integration strategies were typically used; the co-location of linked services (65%), the provision of extra services by immunization staff (41%), and/or the provision of extra information by immunization staff (41%) were the most common. In general, integration improved MCH service outcomes (76%) and was either beneficial (55%) or neutral for immunization (35%), with some examples in family planning, malaria, and HIV where integrated services were not beneficial. Important implementation considerations included the careful matching of target populations in service re-design, ensuring support from policy, logistics, and information systems, the provision of adequate training and support of staff to avoid overload, clear client communication regarding service integration, and the need to address community concerns. <b>Conclusions</b>: Integrating MCH services with routine immunization can expand linked services and improve immunization coverage. This study has identified key implementation considerations relevant to both childhood and adult vaccination programs. More research is needed regarding costs and client preferences.https://www.mdpi.com/2076-393X/12/12/1313integrationvaccinationimmunizationservice deliverysystematic reviewmaternal and child health |
| spellingShingle | Monica P. Shah Christopher J. Morgan James G. Beeson Elizabeth Peach Jessica Davis Barbara McPake Aaron S. Wallace Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries: Systematic Review Update 2011–2020 Vaccines integration vaccination immunization service delivery systematic review maternal and child health |
| title | Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries: Systematic Review Update 2011–2020 |
| title_full | Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries: Systematic Review Update 2011–2020 |
| title_fullStr | Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries: Systematic Review Update 2011–2020 |
| title_full_unstemmed | Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries: Systematic Review Update 2011–2020 |
| title_short | Integrated Approaches for the Delivery of Maternal and Child Health Services with Childhood Immunization Programs in Low- and Middle-Income Countries: Systematic Review Update 2011–2020 |
| title_sort | integrated approaches for the delivery of maternal and child health services with childhood immunization programs in low and middle income countries systematic review update 2011 2020 |
| topic | integration vaccination immunization service delivery systematic review maternal and child health |
| url | https://www.mdpi.com/2076-393X/12/12/1313 |
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