Evaluation report
Evaluation of Integrated Child Health Days as a Catch-Up Strategy for Immunization in Three Districts in Uganda
Mansour Farahani, Tonny Tindyebwa, Nandita Sugandhi, Kirsten Ward, Youngjoo Park et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001Uganda's Integrated Child Health Days (ICHDs) are community vaccination events designed to improve children's access to immunizations, particularly as a catch-up strategy. Researchers surveyed 1,432 caregivers in three districts and found immunization coverage above 90% for most vaccines, with 79.4% of children who attended ICHDs receiving at least one vaccine. Community health workers and village health teams were the main sources of information about these events. The program showed promise despite facing coordination and supply challenges.
Key points
- Immunization coverage exceeded 90% for most vaccines, except measles-rubella (16.2%) and rotavirus second dose (88.3%)
- Of 631 children who attended ICHDs, 79.4% received at least one vaccine during the event
- Village Health Teams (49%), health workers (18.3%), and megaphone outreach (17.9%) were the main sources of information
- 69.4% of children were fully vaccinated for their age
- Key challenges included coordination, vaccine delivery, and mobilization issues
Limitations
The evaluation was cross-sectional and conducted in only three districts, so results may not represent all of Uganda. The study does not measure long-term sustainability, cost-effectiveness, or compare outcomes between children who attended ICHDs and those who did not.
Abstract
Background: Uganda’s Integrated Child Health Day (ICHD) initiative aims to improve children’s access to vaccinations. Although widely used as a catch-up vaccination strategy, the effectiveness of the ICHD program in increasing immunization coverage, especially among vulnerable populations, has not been recently evaluated. This study assessed the reach and uptake of ICHD for immunizations in Uganda. Methods: A mixed-methods evaluation was conducted in three districts (Rakai, Kayunga, and Bukedea) where ICHDs occurred. The data collection included a cross-sectional household survey using validated WHO-adapted questionnaires of 1432 caregivers of children under five years old, key informant interviews with 42 health managers and workers, and nine focus group discussions with caregivers between October and December 2022. The vaccines assessed were Bacillus Calmette–Guerin, oral polio, Pentavalent, pneumococcal conjugate, rotavirus (RV), and measles-rubella (MR). Results: The immunization coverage based on child health cards was over 90% for all vaccines except for the second dose of RV (88.3%) and MR (16.2%). Among the children, 2.3% had received no Pentavalent vaccine, and 69.4% were fully vaccinated for their age. Of the 631 children who attended ICHDs, 79.4% received at least one vaccine during the event. Village Health Teams (49%), health workers (18.3%), and megaphone outreach (17.9%) were the primary information sources. Key informants cited challenges with coordination, vaccine delivery, and mobilization. Conclusions: Despite operational challenges, ICHDs appear to have contributed to routine childhood vaccinations. Further research is needed to assess the sustainability and cost-effectiveness of the program.