Innovations in Increasing Immunisation Evidence Programme

A major challenge in the fight against vaccine-preventable deaths and diseases is the limited evidence available on innovative and successful community-based approaches for expanding immunisation coverage in countries with low or stagnating vaccination rates. To help fill this evidence gap, 3ie is supporting seven formative evaluations and seven impact evaluations.

Arne Hoel, World Bank

Evidence from this programme will identify what works to engage communities in increasing immunisation and test the feasibility and effectiveness of innovative and new interventions. 3ie has awarded two types of grants:

  • Formative evaluation of pilot programmes that use previously untried or untested approaches in engaging communities in Pakistan, Myanmar and two grants each in Ethiopia, Nigeria; and 
  • One impact evaluation grant each in Ethiopia, Nigeria and Uganda, and four grants in India.

This programme is supported by the Bill & Melinda Gates Foundation.

Sharing learning on evaluations of innovations in increasing immunisation
3ie, with support from the Bill & Melinda Gates Foundation, hosted a midterm learning and synthesis workshop on 11-12 July 2017 in New Delhi, India. Participants discussed the challenges associated with implementing technology-enabled interventions in real-world contexts; training front-line health workers with high workloads but limited literacy, skills and exposure to innovations; and experiences with integrating interventions into existing healthcare systems at the institutional and financial levels. To read the workshop report, click here.


Drawing lessons on community-ownership from immunisation intervention in Assam, India
Rituu Nanda (Constellation) shares insights from a 3ie-supported evaluation of a participatory approach to increasing immunisation rates in Assam, India. The strength-based approach adopted by the team led to community ownership of the needs assessment and design component of the intervention.  She talks about how fostering ownership is essential to evaluation evidence being taken-up and why communities should ask critical questions about programmes affecting their lives. Read the blog here.

Related content

Community-led video education to increase vaccination coverage in Uttar Pradesh, India: a cluster-randomised controlled trial

Impact evaluation 3ie

Publication type: Ongoing 3ie Funded Studies
Author: Jessica Shearer, Sudip Mahapatra , Michelle Desmond
Sector: Health Nutrition and Population

Engaging communities for increasing immunisation coverage: what do we know?

Engaging communities for increasing immunisation coverage: what do we know?

Scoping report 3ie 2015

Immunisation coverage rates continue to stagnate or even decline in some parts of the world.

Collaborative immunisation quality checklists, Myanmar

Collaborative immunisation quality checklists, Myanmar

Formative Impact Evaluation

Principal Investigators: Christopher Morgan, Hnin Kalyar Kyaw, Jessica Davis, Poe Poe Anug and Stanley Luchters
Research organisation: Burnet Institute, Myanmar

This formative evaluation tests a new approach to educate and involve communities in the provision of immunisation services. The intervention involves getting health care providers to use a simple World Health Organisation quality checklist for ensuring that the immunisation session is effective and safe. The checklist is also adapted for use by community members, particularly families that use immunisation services. By simultaneously introducing a quality assurance checklist with health staff and their clients, the study aims to help community members increase their understanding of what is needed to provide good quality service. This study will be conducted in three villages in rural Myanmar.


International Rescue Committee’s Fifth Child community engagement strategy, Ethiopia

Formative Impact Evaluation

Principal Investigators: Heidi Larson, Jeannie Annan and Shiferaw Demissie
Research organisation: International Rescue Committee

This formative evaluation assesses International Rescue Committee (IRC)’s Fifth Child integrated community engagement strategy as a potential solution to the problem of low and stagnating immunisation coverage in Ethiopia. The intervention uses a community engagement strategy that involves existing community-based health workers placed at health posts known as Health Extension Workers (HEWs), and Health Development Army members (HDAs) who are also community members. The HEWs and the HDA members will conduct home visits and use a specially developed colour-coded calendar called Mama’s Matawesha tool. The calendar is designed to promote five key health-seeking behaviours for improving the uptake of immunisation as well as maternal health services and family planning during pregnancy and the postnatal period. The intervention also includes a user-friendly, data collection and defaulter tracing tool for recording and quick analysis of the number of defaulters. The tool is a simple paper-based document template with three built-in carbon copies used at the health post level for recording basic infant and caregiver information and antigens missed for defaulters. It will be used by the HEWs, HDAs and community leaders to directly identify and follow-up with the caregivers of the defaulters. This formative evaluation will conducted in three out of 114 kebeles or wards where the intervention is currently taking place.

Video: A Mother’s Dream: Immunization in Ethiopia


Vaccine Indicator and Reminder band, Nigeria

Formative Impact Evaluation

Principal investigators: Sachiko Ozawa, Noor Rakshani, Jamila Bello-Malabu, Chizoba Wonodi, Chhhinedu Chugbo
Research organisation: Health Strategy and Delivery Foundation, Nigeria

The study will assess the feasibility of community-based distribution of VIR bands to infants. The VIR band is a low-cost, durable, wearable ankle band that contains a hardcopy of the vaccination record of the infant or child. The built-in reminder system on the band serves to give visual cues for vaccination due dates to the parents. To reach out to infants and children who are born outside a health facility, the VIR band will be distributed to all eligible infants in the community using trained traditional birth attendants and village health workers. Trained health workers will activate the VIR band when the infant or child is taken to a health facility to initiate vaccinations. The duration of the study is 18 weeks and will be carried out in the Kebbi state in north-western Nigeria.

Community health strategy, Kenya

Community health strategy, Kenya

Formative Impact Evaluation

Community engagement through the community health strategy for the improvement of immunisation coverage in pastoral and nomadic communities in Kenya

Principal investigators: Careena Otieno, Charles Wafula, Dan Kaseje, John Alwar and Margaret Kaseje
Research organisation: Tropical Institute of Community Health and Development, Kenya

This formative study will assess the community health strategy (CHS) targeted at marginalised communities, primarily comprising pastoralists. Currently, the health system in Kenya strives to deliver health services to such communities through a network of community health extension workers at the health post level and through community health workers or volunteers based within the communities. The intervention involves the recruitment and training of locally identified community members to form a cadre of community health assistants (CHAs). The CHAs will be given training that is certified and conducted in accordance with the guidelines set by the Ministry of Health. They will also be equipped with a basic immunisation kit. The intervention will involve systematic engagement for mobilising communities into community units and establishing community-health system linkage committees. The strategy will also focus on relaying important information, such as service utilisation and morbidity trends to the community. The study sample will consist of 1,260 households in the counties of Mandera, Garissa, and Kajiado.

There are no impact evaluations
There are no systematic reviews
There are no evidence gap maps
There are no replication studies
There is no related content.