Peer-reviewed article
Strategies for expanding vaccination coverage in children in Brazil: systematic literature review
Janaína Fonseca Almeida Souza, Thales Philipe Rodrigues da Silva, Camila Kümmel Duarte, Anna Luíza de Fátima Pinho Lins Gryschek, Elysângela Dittz Duarte et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This systematic review identified strategies to increase childhood vaccination coverage in Brazil, where vaccination rates have been declining. Six studies were analysed, examining approaches including conditional cash transfers, rapid vaccination monitoring, community health workers, and direct parent outreach. While the cash transfer programme alone did not ensure vaccination compliance, active case-finding by community health workers and rapid monitoring systems proved effective. The authors note that research on this topic remains limited in Brazil.
Key points
- Bolsa Família Program (conditional cash transfers) did not guarantee compliance with vaccination requirements despite being conditionality-based
- Rapid Vaccination Monitoring (MRV) and Community Health Agents Program (PACS) were identified as effective strategies
- Active search for absent families was highlighted as a key mechanism for effectiveness in MRV and PACS
- Only 6 studies met inclusion criteria from 4,824 initial search results, indicating a research gap
- Strategies involving direct engagement and active outreach to parents showed promise
Limitations
This review only included 6 studies, suggesting limited evidence base on this topic in Brazil. The review does not provide detailed data on the magnitude of effect for interventions, effectiveness varies by setting, and longer-term sustainability of strategies is unclear.
Abstract
OBJECTIVES: to identify the strategies found in the literature for increasing vaccination coverage among children in Brazil. It is justified mainly by the current scenario of falling vaccination coverage. METHODS: systematic literature review. The search was carried out in the Pubmed (MEDLINE), Embase and Scopus databases, following the PRISMA guidelines. RESULTS: initially, 4,824 results were returned. In the end, 6 studies were included for narrative synthesis using the SWiM methodology. Of these, 50% dealt with studies related to the Bolsa Família Program (PBF). The others explored strategies for approaching parents directly, Rapid Vaccination Monitoring (MRV) and the Community Health Agents Program (PACS). The PBF did not guarantee compliance with the conditionality of keeping vaccinations up to date. The MRV and PACS are effective strategies, especially because they allow active search for absentees. CONCLUSIONS: we conclude that more publications are needed on strategies to increase vaccination coverage among children in Brazil.