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The problem
Intervention: Multiple strategies including: health education, patient reminders (phone calls, short messages, wearable reminders), home-based records, household incentives, immunisation outreach sessions, home visits, supportive supervision, integration of immunisation with other services, payment for performanc
Who it was tested with: Children under five years, caregivers, and healthcare providers in low- and middle-income countries (four upper-middle-income, 11 lower-middle-income, and three lower-income countries); 100,747 total participants across 41 studies.
Children or communities are compared with a group that did not receive the intervention, or followed over years. This is the design that best separates what the intervention did from everything else that changed.
"Eligible studies were randomised controlled trials (RCTs), non-randomised RCTs (nRCTs), controlled before-after studies, and interrupted time series conducted in low- and middle-income countries." The systematic review used GRADE to assess evidence certainty and meta-analyses to synthesise results across multiple studies with rigorous methodology.
Certainty of evidence ranged from low to very low for most interventions. Nine studies had low risk of bias, eight had unclear risk, and 24 had high risk of bias. Single-study findings for some interventions limit generalisability. Authors note further rigorous RCTs are required for high-certainty evidence.
Across countries and designs
1 study · 12 countries
