Technologies for strengthening immunization coverage in India: a systematic review.

Area of Science:

• Public Health
• Health Informatics
• Health Systems Strengthening

Background:

• Immunization coverage in India exhibits significant disparities across various settings, geographic areas, and populations.
• Technological interventions offer a potential strategy to mitigate these coverage gaps and improve equitable access to vaccines.
• This systematic review adheres to PRISMA guidelines to comprehensively analyze technologies aimed at enhancing immunization coverage within India.

Purpose of the Study:

• To systematically review and examine existing technologies utilized for strengthening immunization coverage across India.
• To identify effective technological interventions that can reduce disparities in immunization access and uptake.
• To provide insights into the current landscape and future directions for technology adoption in India's immunization programs.

Main Methods:

• A systematic literature search was conducted in Medline (PubMed), Cochrane Library, and Google Scholar for studies published between January 1, 2011, and July 31, 2021.
• Included were observational and experimental studies in English, focusing on technologies for immunization in India across diverse populations (children, pregnant women, adults, elderly, healthcare personnel, caregivers, vulnerable groups).
• Data extraction and quality appraisal using the Mixed Methods Appraisal Tool were performed by two independent reviewers, with the primary outcome being technologies that improved immunization coverage.

Main Results:

• Out of 6592 screened titles, 23 India-specific studies were included, with 22/23 demonstrating average or above-average quality.
• Identified effective technologies include reminder systems (automated mobile phone reminders, immunization due-lists), capacity building, community engagement (mobilization, campaigns), and computerized data tracking.
• Emerging technologies such as Jyotigram Yojana, Digital Near-field Communication Pendants, 'Reaching Every District' Programme, and 'My Village My Home' tool were also noted, though their effectiveness varied.

Conclusions:

• Technologies supporting immunization systems, capacity building, and community engagement are demonstrably effective in improving vaccine coverage.
• Newer technologies related to vaccine delivery, mapping, and cold chain logistics require further evaluation in the Indian context.
• Limited research exists for populations beyond children and pregnant women, highlighting a need for future studies to assess technology effectiveness across diverse settings and demographics.