Learning from innovations in increasing immunisation

3ie organised a one-day conference to share lessons learned from our evidence programme on innovations to increase immunisation coverage in New Delhi on 27 February. 3ie's programme team and the participating researchers shared insights from the recently completed studies of innovative immunisation interventions in Ethiopia, India, Myanmar, Nigeria, Pakistan and Uganda. The sessions highlighted how community engagement and technology-based interventions that respond to context-specific barriers can increase immunisation coverage in low- and middle-income countries.

Start Date: 27 February 2020 End Date: 27 February 2020
Learning from innovations in increasing immunisation

Conference participants discussed best practices in facilitating the use of evidence and carrying out useful cost-effectiveness analysis. This was followed by a discussion of insights from 3ie's synthesis of formative studies testing the relevance, feasibility and acceptability of innovative interventions targeting barriers to immunisation. Conference participants also discussed upcoming 3ie projects, including the preliminary findings from 3ie's immunisation evidence gap map.

Read more about 3ie’s work on immunisation.

Conference sessions, 27 February 2020

Chair: Arindam Ray, Gates Foundation.
Panellists: Monica Jain, 3ie; Sandra Albert, Indian Institute of Public Health, Shillong; Harini Kannan, J-PAL South Asia; Jessica Shearer, PATH

With the Indian government’s mission-mode routine immunisation campaign and many other global milestones, the panellists noted that 2020 was an important year for improving immunisation. They suggested inquiring into context-specific barriers to immunisation that may or may not involve only demand-side or supply-side stumbling blocks in low- and middle-income countries. They shared insights from the 3ie-supported evaluations of the less successful community engagement-based interventions, particularly the process lessons, that highlighted the importance of context in breaking through stagnation in immunisation coverage and reach the hitherto under-served or unreached (‘zero-dose’) children.

Chair: Mark Engelbert, 3ie
Panellists: Elizabeth Brown, CEGA; Harini Kannan, J-PAL South Asia; Sanjeev Tak, Udaipur Zone Deputy Director, Govt. Of Rajasthan, India

Liz Brown began by saying that without rigorous cost-effectiveness analysis, impact findings provided only partial economic analysis to decision-makers faced with budget constraints. All panellists agreed that cost-effectiveness analyses are useful to prioritise interventions to scale-up from among multiple ways of achieving similar outcomes. One panellist stressed that, just like equity-oriented sub-group analysis, cost-effectiveness analysis should be integral to the evaluation of interventions. The panellists highlighted the importance of planning collection and analysis of cost data in the earliest stages, in collaboration with frontline decision makers. They suggested that incentives and supportive networks for researchers and sensitisation for decision makers are also necessary to overcome the current ‘teething troubles’ with conducting useful cost-effectiveness analysis.

Moderator: Sapna Desai, Population Council
Panellists: Arup Deb Roy, John Snow Inc.; Ved Prakash, NHM, UP, India; Ruchit Nagar, Khushi Baby Inc.

Panellists agreed that evidence-based research is important to help policymakers design interventions that can be scaled up. Deb Roy remarked how studies conducted before and after immunisation drives can help compare and analyse the impact of vaccines. They also discussed the need to align qualitative feedback and cost and sustainability analysis in impact findings to inform effective scale up of interventions. There is a need for more evidence and analysis to understand the differences in immunisation coverage across contexts. According to the panellists, such insights can help governments to focus and scale their interventions.

Moderator: Mark Engelbert, 3ie
Chair: Stuti Tripathi, 3ie
Panellists: Ngozi Erondu, Chatham House, United Kingdom; Hailay Teklehaimanot, Center for National Health Development in Ethiopia; Phone Myint Win, Burnet Institute, Myanmar

Stuti Tripathi presented lessons from a synthesis of 3ie-supported formative evaluations. All panellists agreed that formative stage studies help uncover and unbox the mechanisms underlying interventions, which remains a black box in impact evaluations. However, they noted that formative studies can be challenged by researchers’ biases that might affect (in a positive or negative manner) the structuring of the learning from these evaluations. The panellists, all of whom led formative studies for innovative interventions, credited 3ie for providing analytical and stakeholder engagement tools that helped to analyse findings as objectively as possible and establish connections to improve and refine stakeholder engagement. They reiterated that formative phase research makes it easier for study teams to engage with a wide range of stakeholders.

Chair: Stuti Tripathi, 3ie
Presenter: Mark Engelbert
Panellists: Tracey Chantler, The London School of Hygiene & Tropical Medicine; Ngozi Akwataghibe, Royal Tropical Institute, The Netherlands; Jyoti Joshi, The Centre for Disease Dynamics, Economics and Policy

Mark Engelbert provided an overview of 3ie’s EGMs, including the framework, how the platform works and shared findings from 3ie’s upcoming map on interventions to improve immunisation coverage. The panellists shared their perceptions of this tool, how these maps are or can be useful to the research that they are doing, what is excluded or not covered in preparation of the gap maps and how they can be improved. Panellists and the audience had an opportunity to ask questions and doubts related to EGMs. Most of the panellists agreed that EGMs are a useful resource, particularly because they are easy to understand and draw attention to existing literature. They also discussed how EGMs do not synthesise evidence and how nuances may be lost when studies, other than impact evaluations and systematic reviews, are excluded in the process.