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Outcomes and Lessons Learned From Immunization in Practice Training.

Aeasha Karnik1, Falah Wadi2, Sumeet Juneja3

  • 1Clinical Psychology, Chung-Ang University, Erbil, IRQ.

Cureus
|June 8, 2026
PubMed
Summary

Immunization training in Iraq significantly improved vaccinator knowledge. Future sessions should focus on practical skills and learner-centered approaches for sustained impact in the immunization workforce.

Keywords:
adult learningcapacity building programmeexpanded programme of immunization (epi)immunization providersimmunization trainingin-service trainingkurdistan region of iraqtraining quality assessment

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Area of Science:

  • Public Health
  • Medical Education
  • Global Health

Background:

  • Immunization service delivery in Iraq's Kurdistan Region is hindered by workforce shortages and inadequate training.
  • Most vaccinators lack formal training, leading to knowledge and skill gaps.
  • The Kurdistan Region Ministry of Health, with UNICEF support, implemented World Health Organization Immunization in Practice (IIP) training.

Purpose of the Study:

  • To assess knowledge improvement among vaccinators after IIP training.
  • To analyze participant feedback on the training sessions.
  • To evaluate the training modality based on adult learning principles.

Main Methods:

  • A retrospective quantitative study analyzed 23 IIP training sessions (October 2024-January 2025) involving 474 vaccinators.
  • Data collected via pre- and post-tests, feedback forms, and training observations.
  • Quantitative data analyzed using descriptive statistics and paired t-tests; qualitative data provided context.

Main Results:

  • Significant immediate knowledge score improvements were observed in both Erbil (+4.20 points) and Sulaymaniyah (+3.31 points) (p < 0.001).
  • Participant feedback was largely positive, particularly regarding trainer performance.
  • Areas for improvement included content relevance, technical clarity, and the training environment.

Conclusions:

  • IIP training effectively enhanced vaccinators' immediate knowledge and was positively received.
  • Future training should incorporate more skill-based activities and a learner-centered approach.
  • Improving logistical preparedness is crucial for maximizing the impact and sustainability of immunization workforce training.