The CAPACITI Decision-Support Tool for National Immunization Programs.

Area of Science:

• Global Health
• Health Policy
• Decision Science

Background:

• Low- and middle-income countries (LMICs) face increasing vaccine recommendations and domestic funding responsibilities.
• National immunization programs require tools to adapt global guidance to local contexts.
• Prioritizing vaccines is crucial for effective public health strategies in resource-limited settings.

Purpose of the Study:

• To introduce the CAPACITI decision-support tool, designed for national immunization programs in LMICs.
• To provide a structured, evidence-based process for prioritizing or selecting among multiple vaccination options.
• To facilitate context-specific decision-making in immunization program planning.

Main Methods:

• The CAPACITI tool employs multi-criteria decision analysis (MCDA) to integrate diverse evidence and stakeholder perspectives.
• Developed iteratively with 12 countries across Africa, Asia, and the Americas.
• Structured into five sections: decision question, criteria, evidence assessment, appraisal, and recommendation.

Main Results:

• The Excel-based tool guides users through a transparent process, emphasizing stakeholder engagement and country ownership.
• It accommodates various MCDA approaches, including hybrid models, and integrates flexibly with existing country processes.
• Pilot countries recognized its value in evaluating trade-offs and the impact of data quality.

Conclusions:

• The CAPACITI tool supports evidence-based, context-specific decision-making for vaccine prioritization in LMICs.
• It empowers national immunization programs to tailor global recommendations to their unique settings.
• Iterative use and adaptation are expected to streamline decision-making processes and enhance country ownership.