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

Nonita Dudeja1, Tila Khan2, Deepak Thomas Varughese3

  • 1Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.

The Lancet Regional Health. Southeast Asia
|February 26, 2024
PubMed
Summary

Technologies like mobile reminders and community engagement improve immunization coverage in India. Newer digital tools show promise, but more research is needed for diverse populations and settings.

Keywords:
CoverageImmunizationIndiaSystematic reviewTechnology

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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.