The Governance of Childhood Vaccination Services in Crisis Settings: A Scoping Review
Nada Abdelmagid,
Rosamund J. Southgate,
Mervat Alhaffar,
Matab Ahmed,
Hind Bani,
Sandra Mounier-Jack,
Maysoon Dahab,
Francesco Checchi,
Majdi M. Sabahelzain,
Barni Nor,
Bhargavi Rao,
Neha S. Singh
Affiliations
Nada Abdelmagid
Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
Rosamund J. Southgate
Independent Consultant in Public Health, Oxfordshire OX4 4ER, UK
Mervat Alhaffar
Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
Matab Ahmed
School of Health Sciences, Ahfad University for Women (AUW), Omdurman P.O. Box 167, Sudan
Hind Bani
School of Health Sciences, Ahfad University for Women (AUW), Omdurman P.O. Box 167, Sudan
Sandra Mounier-Jack
Department of Global Health and Development, Faculty of Public Health and Policy, The London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
Maysoon Dahab
Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
Francesco Checchi
Department of Infectious Disease Epidemiology and International Health, Faculty of Epidemiology and Population Health, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
Majdi M. Sabahelzain
School of Health Sciences, Ahfad University for Women (AUW), Omdurman P.O. Box 167, Sudan
Barni Nor
Department of Women’s and Children’s Health, Uppsala University, 751 23 Uppsala, Sweden
Bhargavi Rao
Department of Global Health and Development, Faculty of Public Health and Policy, The London School of Hygiene & Tropical Medicine, London WC1H 9SH, UK
Neha S. Singh
Health in Humanitarian Crises Centre, The London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK
The persistence of inadequate vaccination in crisis-affected settings raises concerns about decision making regarding vaccine selection, timing, location, and recipients. This review aims to describe the key features of childhood vaccination intervention design and planning in crisis-affected settings and investigate how the governance of childhood vaccination is defined, understood, and practised. We performed a scoping review of 193 peer-reviewed articles and grey literature on vaccination governance and service design and planning. We focused on 41 crises between 2010 and 2021. Following screening and data extraction, our analysis involved descriptive statistics and applying the governance analysis framework to code text excerpts, employing deductive and inductive approaches. Most documents related to active outbreaks in conflict-affected settings and to the mass delivery of polio, cholera, and measles vaccines. Information on vaccination modalities, target populations, vaccine sources, and funding was limited. We found various interpretations of governance, often implying hierarchical authority and regulation. Analysis of governance arrangements suggests a multi-actor yet fragmented governance structure, with inequitable actor participation, ineffective actor collaboration, and a lack of a shared strategic vision due to competing priorities and accountabilities. Better documentation of vaccination efforts during emergencies, including vaccination decision making, governance, and planning, is needed. We recommend empirical research within decision-making spaces.
