Peer-reviewed article
A Protocol of National Mixed-Methods Assessment of Childhood and Maternal Immunization.
Seyed Aria Nejadghaderi, Paria Dehesh, Mehran Nakhaeizadeh, Mohammadreza Rajabalipour, Faeze Tahrudi et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This paper describes a protocol for a national survey in Iran to measure vaccination coverage among children under 3 years and mothers who gave birth in the past year. The study will use a mixed-methods approach combining quantitative surveys across all 31 provinces with qualitative interviews to understand barriers to vaccination. The research aims to identify gaps in coverage that administrative data might miss and provide evidence for targeted interventions to improve vaccine uptake equitably.
Key points
- The study will assess about 9,200 children aged 0-35 months and 2,109 mothers across all 31 Iranian provinces
- Vaccination status will be verified from home-based records and electronic registries, supplemented by caregiver recall
- The survey will measure coverage, dropout rates, timeliness of vaccination, and missed opportunities
- Qualitative data from 30-40 in-depth interviews will explore determinants of vaccination uptake
- Iran's Expanded Programme on Immunization has achieved high coverage, but administrative estimates may mask disparities
Limitations
This document is a protocol only and presents no empirical results or findings. The actual outcomes of the survey, coverage rates, barriers identified, or effectiveness of any interventions cannot be assessed from this paper.
Abstract
BACKGROUND AND AIMS: Accurate measurement of routine immunization coverage is essential for detecting immunity gaps, guiding programmatic responses, and supporting equitable vaccine delivery. Iran's Expanded Programme on Immunization has achieved high coverage, but administrative estimates can mask some disparities. The aim of this protocol is to evaluate coverage among children under 3 years old and mothers who have given birth within the last 12 months. METHODS: We will conduct a national, cross-sectional, mixed-methods survey on vaccination coverage across all 31 provinces of Iran. A multistage, stratified cluster design will target about 9200 children aged 0-35 months (1325 clusters) and 2109 mothers who delivered in the past 12 months (211 clusters), with oversampling of smaller strata and an allocated proportion for non-Iranian residents. Vaccination status will be verified preferentially from home-based records and electronic registries, supplemented by caregiver recall. Digital data capture and photographed records will be used alongside supervisory quality checks. Quantitative analyses will apply complex survey weighting to estimate coverage, dropout, timeliness, and missed opportunities. Also, thematic analysis of 30-40 in-depth interviews will show determinants of vaccination. RESULTS: This manuscript describes the protocol for a national mixed-methods study. No empirical results are presented. CONCLUSIONS: The findings from this mixed-methods study will deliver high-quality, disaggregated evidence on immunization coverage and its drivers in Iran, enabling policymakers and programme managers to design and implement targeted interventions to close equity gaps and support sustained uptake of both established and newly introduced vaccines.