Can lay health workers increase the uptake of childhood immunisation? Systematic review and typology
Open accessAbstract
Summary: 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.
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Evidence of the effectiveness of adequately trained and supported CHWs in providing quality health services and improving population health continues to grow.
“Evidence of the effectiveness of adequately trained and supported CHWs in providing quality health services and improving population health continues to grow [13, 20–23].”
From Community health workers at the dawn of a new era: 11. CHWs leading the way to “Health for All” (2021) · cites this paper as [23]
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Self-citation
- Authors
- Glenton, C., Scheel, I. B., Lewin, S., & Swingler, G. H.
- Affiliations
- SINTEF (NO)
- Nasjonalt Kunnskapssenter for Helsetjenesten (NO)
- University of Cape Town (ZA)
- Corresponding author
- Glenton, Claire
- Venue
- Tropical Medicine & International Health
- Publisher
- Wiley
- Published
- 2011-06-28
- Volume
- 16
- Issue
- 9
- Pages
- 1044-1053
- ISSN
- 1360-2276 (ISSN-L)
- 1365-3156
- OpenAlex
- W1908372592
- Cited by
- 90
- References
- 22
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 7 · 2023: 6 · 2022: 7 · 2021: 12 · 2020: 12 · 2019: 9 · 2018: 4 · 2017: 2 · 2016: 4 · 2015: 8 · 2014: 5 · 2013: 6 · 2012: 2
- FWCI
- 0.75
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Tropical Medicine & International Health (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Norges Forskningsråd
- Topics
- Social Sciences › Health › Vaccine Coverage and Hesitancy
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Keywords
- lay health workers, childhood immunization, vaccine uptake, vaccination coverage, community health workers, health promotion interventions, low- and middle-income countries, Millennium Development Goals, child health
- MeSH terms
- Allied Health Personnel, Child, Preschool, Community Health Workers, Community Health Services, Female, Health Promotion, Humans, Male, Patient Education as Topic, Primary Health Care, Immunization Programs, Developed Countries, Information Dissemination
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