Interventions for Improving Childhood Immunization Coverage in Middle and Low Income Countries

Running head: ESSAY 1
Interventions for Improving Childhood Immunization Coverage in Middle and Low Income
Countries
Name of Student:
Name of University:
Author Note:

1ESSAY 1
Summary of the Rationale and Problems the Interventions will address.
The health strategy meant for the improvement of child survival through fighting
killer diseases is Immunization. Every year millions of children belonging to the low and
middle income countries do not get the full doses of required vaccine as mentioned in the
national routine for immunization schedule. The essay is a discussion on the Cochrane review
published in the year 2011. The review mainly focuses on the interventions on improvement
of immunization for children in the low and middle-income countries (LMICs). The
objectives of the essay is to ensure effective evaluation of interventions strategies for
sustaining and boosting high coverage of immunization for children in low and middle
income countries.
The Cochrane review is done with the aim to evaluate the impacts of the various
intervention strategies for increasing the number of immunized children from prevention of
infectious disease in LMICs. Therefore, researchers in Cochrane analyzed and collected the
relevant studies to find an answer, and finally concluded with 14 studies that were relevant
(Oyo-Ita 2016). Although strategies for improving childhood vaccination does not work
much but initiatives like providing information about the importance of the vaccine to the
community members and the parents does make a difference. There should also be provisions
for specially designed cards for vaccination reminder, rewards and identification of children
yet to be receive a vaccine and sending them to health clinics on an immediate basis can drive
more children to receive a vaccination in LMICs. Integration of immunization service to
other services can also lead to the improvement of the scenario. In this context, it can
however be said that offering money to the parents for vaccinating their children in the
middle and low-income countries will not lead to an improvement in the scenario. Majorly
the findings are not certain and therefore there is a need for research in this area that needs
well conduction.

2ESSAY 1
The studies eligible for the incorporating the intervention strategies for increasing the
number of immunization for children in the middle and low- income countries were based on
randomized controlled trials, also known RCT, controlled before and after studies, non RCT
and interrupted time -series that mainly included caregivers, children between the age 0 to 4
years, providers of healthcare. However, for the data analysis there was independent
screening of the output found through research, full text review of articles that were eligible,
assessment of risk bias and solving discrepancies through consensus. Finally, random affects
Meta analyses used for accessing the certainty of the evidence.
The inclusion criteria involved conclusion from 14 studies, 10 of which were RCT
cluster whereas there were four individual RCT. There was one study each from countries
like Ghana, Honduras, Georgia, Mali, Mexico, Nicaragua, Zimbabwe and Nepal that was
used as inputs. In addition to this, there were two studies from India and four studies from
Pakistan (Oyo-Ita 2016). The risk bias for one study was unclear while the thirteen other
studies had high-risk bias. Out of 14 studies, three studies each involving evaluation on health
education based on community and facilities, three studies on household incentives, one
study each on outreach sessions for regular immunization, supportive supervision, home
visits and one study each on supportive supervision, information campaign and integration of
immunization services for malaria prevention.
PICOT Table i.e., the ‘Methods for Considering Studies for the Review’.
PICOT Table
P Patients The patients considered here are the children of the low and middle