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Cited by 16Vaccine Coverage and HesitancyGlobal Maternal and Child HealthImmune responses and vaccinations

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Of Money and Men: A Scoping Review to Map Gender Barriers to Immunization Coverage in Low- and Middle-Income Countries

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Kalbarczyk, Anna, Brownlee, Natasha, Katz, Elizabeth·2024·Vaccines
DOI 10.3390/vaccines12060625PMC PMC11209140
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Abstract

Among the multiple factors impeding equitable childhood immunization coverage in low- and middle-income countries (LMICs), gender barriers stand out as perhaps the most universal. Despite increasing recognition of the importance of gender considerations in immunization programming, there has not yet been a systematic assessment of the evidence on gender barriers to immunization. We conducted a scoping review to fill that gap, identifying 92 articles that described gender barriers to immunization. Studies documented a range of gender influencers across 43 countries in Africa and South Asia. The barrier to immunization coverage most frequently cited in the literature is women’s lack of autonomous decision-making. Access to immunization is significantly impacted by women’s time poverty; direct costs are also a barrier, particularly when female caregivers rely on family members to cover costs. Challenges with clinic readiness compound female caregiver’s time constraints. Some of the most important gender barriers lie outside of the usual purview of immunization programming but other barriers can be addressed with adaptations to vaccination programming. We can only know how important these barriers are with more research that measures the impact of programming on gender barriers to immunization coverage.

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Figure 1 PRISMA diagram.
Figure 1 PRISMA diagram.CC BY · PubMed Central
Figure 2 Map of documented gender drivers of immunization.
Figure 2 Map of documented gender drivers of immunization.CC BY · PubMed Central

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Metadata

Authors
Kalbarczyk, A., Brownlee, N., & Katz, E.
Affiliations
  • Johns Hopkins University (US)
  • Global Center for Gender Equality, Washington, DC 20036, USA
  • University of San Francisco (US)
Corresponding author
Kalbarczyk, Anna
ORCID
Venue
Vaccines
Publisher
MDPI AG
Published
2024-06-05
Volume
12
Issue
6
Pages
625
ISSN
2076-393X (ISSN-L)
DOI
10.3390/vaccines12060625
PMC
PMC11209140
OpenAlex
W4399358766
Cited by
16
References
1
Citations by year
2026: 6 · 2025: 10
FWCI
1.53
Type
journal article
Language
en
Open access
Licence
Locations
  • Vaccines (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
Bill and Melinda Gates Foundation (INV-043797)
Topics
  • Social Sciences › Health › Vaccine Coverage and Hesitancy
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
Keywords
gender barriers, childhood immunization, vaccination coverage, women's decision-making autonomy, time poverty, women caregivers, vaccine cost, gender equity in health, low- and middle-income countries

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