Immunization

Full Course of Immunizations

Caregivers complete a full course of timely vaccinations for infants and children under 2 years

Full course and timely immunizations prevent 1.5 million deaths of children under five every year.1UNICEF MICS
United Nations Children's Fund 
This is a periodic behavior that needs to be practiced at specific times before a child’s second birthday.

Key Points from Global Research

  • Easy access to services can encourage caregivers to start and complete recommended immunization schedules.
  • Engaging communities in outreach planning, supervision, and promotion activities can increase vaccination coverage.
  • Improving both caregiver perception of quality of care and regular availability of vaccines can improve immunization completion rates.

Behavior Profile Sample: Full Course of Immunizations

A Behavior Profile is a summary analysis of each behavior. This sample draws from global evidence and illustrates the result of using the Create Behavior Profiles Tool to analyze factors, supporting actors and strategies and to ensure logical pathways exist between strategies proposed and factors related to the practice of the behavior. This sample may be used as a starting point or reference for creating country-specific Behavior Profiles.

Create Behavior Profiles

Improve maternal and child survival
Caregivers complete a full course of timely vaccinations for infants and children under 2 years
Percentage of children 12-23 months who had received all 8 basic vaccinations

Behavior Analysis

Strategy

STEPS

What steps are needed to practice this behavior?
  1. Accept first course of vaccinations at birth or at the first well-baby visit
  2. Mobilize transport, resources, and logistics
  3. Seek immunizations on schedule from a qualified provider
  4. Complete all immunizations per age requirements

Click on any box
        to see the pathwaysA pathway illustrates how elements in the Behavior Profile are linked. When read from right to left, a pathway highlights how strategies are expected to address the factors to enable adoption of the Accelerator Behavior.  
        of the behavior.

FACTORS

What factors may prevent or support practice of this behavior? These should be analyzed for each country context.
Structural
Service Experience: Caregivers do not return for immunizations because vaccines were not available during past visits
Accessibility: Caregivers do not use immunization services because they are often located far from households and they lack transportation options
Accessibility: Caregivers are unable to immunize their children because of lack of vaccines
Service Provider Competencies: Caregivers do not visit health providers for vaccinations because they don’t trust them or believe they are doing a good job
Service Provider Competencies: Caregivers do not visit health providers because they feel mistreated by them
Social
Norms: Many caregivers do not take their child for vaccinations because of religious opposition
Internal
Attitudes and Beliefs: Many caregivers do not take their child for vaccinations because they fear side effects
Attitudes and Beliefs: Many caregivers do not take their child for vaccinations because they feel that immunization is not important and does not prevent illnesses
Knowledge: Caregivers do not adhere to the immunization schedule because they do not know about the need for immunizations
Knowledge: Caregivers do not adhere to the immunization schedule because they do not know when their child should return for their next vaccine

SUPPORTING ACTORS AND ACTIONS

Who must support the practice of this behavior?
Institutional
Policymakers: Ensure vaccinations are available through regular mobile outreach
Managers: Conduct regular supervision to reinforce competencies of providers
Providers: Discuss importance, schedule and any concerns regarding vaccinations with all new mothers
Logistics Personnel: Actively monitor stocks of vaccine and cold chain viability
Community
Religious Leaders: Actively support and encourage all new families to fully vaccinate their children
Household
Family Members: Encourage and provide support to caregivers to complete immunization schedule

POSSIBLE PROGRAM STRATEGIES

How might we focus our efforts based on this analysis?
Enabling Environment
Partnerships and Networks: Increase ownership and governance of programs by involving local communities in the planning and supervision of activities
Policies and Governance: Ensure vaccinations are offered for free and explore reimbursement or vouchers for transport
Policies and Governance: Ensure vaccine providers are both men and women or from religious groups to alleviate religious and cultural concerns
Systems, Products and Services
Quality Improvement: Implement pre and in-service education training and learning opportunities for health care providers that focus on vaccination, such as to proactively address caregiver concerns during consultations
Demand and Use
Communication: Highlight significant benefits of vaccinating children in communication activities to ensure that caregivers place high priority on immunization completion
Communication: Promote use of the Child Health Card to help families track immunizations

Global Status of Accelerator Behavior

Percentage of children 12-23 months who had received all 8 basic vaccinations

The DHS Program Indicator Data API, The Demographic and Health Surveys (DHS) Program

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