211011 Adding other health services to the immunization platform: Potential benefits and risks

Tuesday, November 10, 2009: 11:35 AM

Aaron S. Wallace, MPH MBA , Global Immunization Division, US Centers for Disease Control & Prevention, Atlanta, GA
Margaret Watkins, MPH , US Centers for Disease Control & Prevention, Atlanta, GA
Elizabeth Luman, PhD , Global Immunization Division, US Centers for Disease Control & Prevention, Atlanta, GA
Tove Ryman, MPH , Global Immunization Division, US Centers for Disease Control & Prevention, Atlanta, GA
The WHO/UNICEF Global Immunization Vision and Strategy has integration of critical health interventions with immunization as one of its four main aims, and there are efforts to increase the coverage of several health interventions by integrating their delivery into child immunization services. However the theoretical strengths of delivery integration are yet to be rigorously proven and there is little robust information on the benefits and risks. Centers for Disease Control and Prevention's research includes 1) a review of the literature undertaken to assess benefits, challenges and characteristics of integrating child and maternal health services with immunization programs, 2) recent studies in which other health interventions were integrated into child immunization services, and 3) plans for future studies of integrated service delivery. Reviewed integrated services include vitamin A supplementation, bednet distribution, deworming tablet distribution, safe water/hygiene interventions, and referrals for family planning services. From the literature review, characteristics of successful implementation included compatibility between interventions and presence of a strong immunization service prior to integration. Rapid uptake of the linked intervention and decreased competition for resources were two benefits of integration described. Overburdened staff, unequal resource allocation and logistical difficulties were among risks of integration. When additional interventions are carefully selected for compatibility and receive adequate support, coverage of these interventions may improve, provided immunization coverage is already high. Evidence for the effectiveness of integration in increasing efficiency of resource use was considered insufficient. Future studies should attempt to quantify the benefits, challenges and costs of integrated versus vertical programs.

Learning Objectives:
Describe 2 key characteristics of successful integrated health services Identify 2 research gaps in how to best integrate health interventions with child immunization programs

Keywords: Immunizations, International Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have had training in MPH and MBA programs and have multiple years of experience in global immunizations work. I have also published an article on integration within immunization covering a review of the literature. This article was published in The Journal of International Health and Tropical Medicine.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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