Coverage and equity of routine immunisation in children under the age of 2 years old Not Applicable
Conditions
Interventions
Study Goal: The overall goal of the study will be to evaluate the impact and cost-effectiveness of Zindagi Mehfooz, a suite of digital health immunisation interventions, on increasing the proportion o
Sponsors
Gavi
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Participants are employed by the Government of Sindh and/or IRD or are caregivers of children brought in for immunisation and enrolled within the ZM system. They will be associated with districts and facilities prioritized through the quantitative analysis process segmented as follows: 1. High ZM use and high Immunisation coverage 2. High ZM use and low Immunisation coverage 3. Low ZM use and high Immunisation coverage 4. Low ZM use and low Immunisation coverage The target will be 1 district per category with 3 facilities per district for an estimate of 12 facilities and 3 vaccinators per facility and their associated supervisors and district health managers.
Exclusion criteria
Exclusion criteria: Does not consent
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| All outcome measures will be assessed from 2017 to 2019 in alignment with Multiple Indicator Cluster Surveys (MICS) 6 from 2018-2019 and MICS 5 in 2014: 1. Programme reach is measured as the percentage of eligible vaccinators registered in the system - number of vaccinators registered in ZM/ total number of vaccinators. 2. Provider use is measured as the proportion of registered vaccinators who register one client per vaccination day 3. Registry coverage is measured as the percentage of children registered in ZM / total number of eligible children based on census data 4. Data use is measured as the percentage of supervisors, managers, and government stakeholders who log into ZM to use ZM data/ total number of registered supervisors, managers, and government stakeholders 5. Impact of the use of ZM on immunisation coverage - the proportion of children 12-23 months whose caregivers report receiving (both reported and from card) BCG, DTP3, IPV/OPV3, and Measles1 immunisation in MICS-6 2018-19 to those who reportedly received BCG, DTP3, IPV-1/OPV3, Measles1 in MICS-5 2014 (full immunization) & proportion of children 12-23 months who did not receive DPT 1 between MICS-6 2018-19 and MICS-5 2014 (zero dose vaccination). 6. Equity - the estimates of zero dose immunisation, full immunization, and timeliness of immunisations MICS- 6 2018-2019 and MICS 5 2014 compared across the wealth quintiles, by the child’s gender, levels of mother’s/father’s education, and other sociodemographic characteristics. 7. Cost-effectiveness - the lives saved tool is used to model the incremental lives saved associated with changes in immunisation outcomes for the calendar year 2019 as compared to 2014 & Estimate the incremental cost per life saved and cost per Disability Adjusted Life Year Averted of ZM implementation in calendar years 2019-20 versus status quo of 2014 (pre-implementation). Probabilistic sensitivity analyses conducted to identify key cost drivers and assess uncertainty. | — |
Secondary
| Measure | Time frame |
|---|---|
| User perceptions of benefits and challenges with ZM as measured through in-depth interviews with vaccinators, supervisors, managers, and caregivers and ZM implementation team conducted in January-March 2022, reflecting on experiences with ZM from 2017-2019 and during COVID-19 2020-2022 | — |
Countries
Pakistan
Contacts
Public ContactPatricia Mechael
Outcome results
None listed