advanced search

<< Back To Home

CAN LAY HEALTH WORKERS INCREASE VACCINATION COVERAGE?

Monday, 8th of August 2011

‘Lay health workers could make an important contribution to achieving the Millennium Development Goal for child health. However, more high-quality studies are needed, particularly from LMICs. More studies are also needed to assess the effects of using LHWs to vaccinate children themselves.’

Full text, with figures, is at http://onlinelibrary.wiley.com/doi/10.1111/j.1365-3156.2011.02813.x/full

Can lay health workers increase the uptake of childhood immunisation? Systematic review and typology

Claire Glenton1, Inger B. Scheel1, Simon Lewin2, George H. Swingler3

Tropical Medicine & International Health

Volume 16, Issue 9, pages 1044–1053, September 2011

Glenton, C., Scheel, I. B., Lewin, S. and Swingler, G. H. (2011), Can lay health workers increase the uptake of childhood immunisation? Systematic review and typology. Tropical Medicine & International Health, 16: 1044–1053. doi: 10.1111/j.1365-3156.2011.02813.x

Author Information

1  SINTEF Health Research, Department of Global Health and Research, Norway

2  Norwegian Knowledge Centre for the Health Services, Oslo, Norway

3  Department of Paediatrics & Child Health, University of Cape Town, South Africa

*Correspondence: Corresponding Author Claire Glenton, Global Health Unit, Norwegian Knowledge Centre for the Health Services, Boks 7004 St. Olavsplass, N-0130 Oslo, Norway. Tel.: +47 46 400 415 /416 516 58; Fax: +47 23 25 50 10; E-mail: claire.glenton@kunnskapssenteret.no

Objectives  Lay health workers (LHWs) are used in many settings to increase immunisation uptake among children. However, little is known about the effectiveness of these interventions. The objective of this review was to assess the effects of LHW interventions on childhood immunisation uptake.

Methods  We searched Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, British Nursing Index and Archive, AMED, POPLINE and WHOLIS, reference lists of included papers and relevant reviews, and contacted the authors of relevant papers. We selected randomised and non-randomised controlled trials, controlled before–after studies, and interrupted time series of any intervention delivered by LHWs and designed to increase childhood immunisation uptake. Two authors independently extracted data using a standard form and assessed risk of bias and evidence quality.

Findings  We identified twelve studies, ten of which were randomised controlled trials. Seven studies were conducted among economically disadvantaged populations in high-income countries. Five studies were from low- and middle-income countries. In ten studies, LHWs promoted childhood immunisation. In two studies, LHWs vaccinated children themselves. In most of the studies, the control group populations received no intervention or standard care. Most of the studies showed that LHWs increased immunisation coverage. However, study settings were diverse, allowing us to carry out only one meta-analysis including four studies.

Conclusion  LHWs could make an important contribution to achieving the Millennium Development Goal for child health. However, more high-quality studies are needed, particularly from LMICs. More studies are also needed to assess the effects of using LHWs to vaccinate children themselves.