While ensuring healthy lives for all ages is among the top Sustainable Development Goals, progress towards achieving this objective has recently decelerated as far as children are concerned. There has been an alarming, sustained decline in child vaccinations due to the COVID-19 pandemic and other ongoing crises, putting millions of children at risk from preventable diseases and death. According to 2023 WHO figures, 21 million children failed to receive life-saving diphtheria, pertussis and tetanus (DPT) vaccines, and the overall coverage of DPT vaccine in 2023 had not recovered to pre-COVID levels from 2019. Studies have shown that COVID-19 vaccination efforts strained health systems in 2020 and 2021, and the delivery of vaccination services were adversely affected.
Although there have been setbacks in child immunization, existing evidence shows that some interventions are effective in improving the vaccination rates of young children. A 3ie systematic review of reviews shows that home visits by frontline health workers can improve vaccination rates and can be used in catch-up vaccination campaigns or outreach services to limit the harmful consequences of missed vaccinations. In addition, efforts can be made to improve the information that parents have on when and where to take their children for vaccination, which can also be a bottleneck. Effective interventions have delivered this information via voice or text messages using mobile phones, or via printed materials such as mother-and-child handbooks, flyers, or stickers.
Another major barrier to vaccination has been hesitancy among parents to vaccinate their kids. A recent study estimates that a significant proportion of parents across the world are hesitant to get their child routinely vaccinated. To improve people's knowledge about vaccines and diseases, public campaigns focusing on benefits of vaccines, places of vaccination, and vaccination schedules have been implemented in various low- and middle-income countries. These short, fixed-duration campaigns have been done in various ways: video-assisted teaching packages; face-to-face health education and counselling sessions delivered through discussions; and tools like posters, leaflets and flipcharts. They have been conducted either at homes or at community spaces like schools, places of workshop and community centres or at health facilities. Such sensitization and education campaigns have been found to be effective in improving vaccination rates of young children.
Another effective way to counteract the decline in routine child immunization could be to use community engagement approaches, which feature prominently in global immunisation strategies. A 3ie systematic review of community engagement approaches found that they are effective in improving coverage and timeliness of routine child vaccines, including for DPT3 and measles. The positive effects of these interventions can be expected across a variety of settings, although some engagement approaches appear to be more effective than others. For example, the review shows that community engagement features such as holding community dialogues or involving community leaders, and non-community engagement features such as local supportive supervision, are effective strategies across a wide range of settings.
These approaches, backed by rigorous evidence showing their effectiveness, have the potential to help the world achieve the 3rd Sustainable Development Goal, ensuring healthy lives and promoting well-being for all.
