Seeking Synchrony for Immunization, Family Planning and Growth Monitoring

Organization: 
Family Health International (FHI 360)
Organization Location: 
Durham, NC, USA

The six-week well-baby visit is crucial to the health of the postpartum mother and her baby. For the infant, the visit includes growth monitoring and crucial immunizations. Many mothers also accept family planning (FP) at this time (typically DMPA or pills in sub-Saharan Africa). After the six-week visit, the follow-up schedule for both immunization and FP includes three more visits during the first year, but not a single one of these six visits overlaps! Why not consider adjusting the vaccination schedule to avoid extra clinic visits, improve the infant growth monitoring schedule and potentially improve both immunization coverage and FP uptake? Such a change sounds radical, but, in fact, there is flexibility in vaccination schedules worldwide. We propose to work with immunologists and vaccinologists to model the potential outcomes of “synchronized scheduling” to immunization coverage and protection, FP uptake, and growth monitoring success. We will also conduct research with immunization stakeholders in Africa to assess the acceptability of such a change. If both modeling and research are positive, we will hold a technical meeting to reach consensus on whether and how to move forward with a trial to formally assess the feasibility, acceptability and effectiveness of adjusted immunization schedules. If found to be feasible, acceptable and effective, this transformational new service delivery approach could be scalable at low cost. It is, however, a bold departure from current practice, and will be controversial within an immunization community concerned about stigma and reluctant to tamper with current schedules.

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