Integrating Health Inequality Monitoring and Equity-Focused Policy Analysis for Immunization: A Conceptual Framework...

Although global immunization coverage has increased substantially, significant inequalities persist. Despite the availability of disaggregated data, inequality evidence is rarely translated into equity-oriented policy action. This gap reflects the weak integration between Health Inequality Monitoring (HIM) and Health Policy Analysis (HPA), which limits the use of data in immunization decision-making.

This paper presents a conceptual framework and accompanying protocol that integrates HIM with equity-focused HPA. The framework is supported by public health informatics to enable the systematic translation of immunization inequality evidence into actionable policy.

The framework adopts a mixed-methods approach aligned with World Health Organization (WHO) standards. Quantitative Health Inequality Monitoring (HIM) is used to measure absolute and relative inequalities in key immunization indicators, including DTP3 coverage and zero-dose prevalence, across socio-economic and geographic dimensions. Qualitative policy analysis draws on the Health Policy Analysis (HPA) triangle and the Health Equity Assessment Policy (HEAP) framework to examine the actors, policy content, processes, and contextual factors underlying these disparities. Public health informatics connects these components by enabling data interoperability, real-time visualization, and the routine embedding of inequality evidence within digital health information systems.

The resulting informatics-enabled data-to-policy pathway formalizes the link between measurement and policy action. Key outputs include automated equity dashboards and stakeholder-informed policy briefs, which are designed to support evidence-based prioritization, planning, and resource allocation.

By integrating health inequality monitoring, policy analysis, and public health informatics, this framework directly addresses the 'know-do' gap in immunization equity. It offers a scalable and practical model for operationalizing the Immunization Agenda 2030, particularly in resource-constrained health systems.