Despite significant progress in global immunisation efforts, challenges persist in ensuring every child receives essential vaccinations, particularly in low- and middle-income countries like Bangladesh. In a recent research conducted by the researcher from International Initiative for Impact Evaluation (3ie) and Bill & Melinda Gates Foundation, India – we get to learn about various interventions that have been implemented to address these challenges, aiming to improve vaccination rates and overcome behavioural and social barriers. 

Current Challenges in Bangladesh

In Bangladesh, like many LMICs, ensuring widespread childhood immunisation remains a critical public health goal. According to recent data, while significant strides have been made, coverage gaps persist, particularly in underserved and remote areas. These gaps are often exacerbated by socio-economic disparities, limited access to health services, and cultural beliefs. 

Effective Interventions Implemented

Behavioural and Social Drivers: To tackle attitudinal and knowledge-related barriers among caregivers, Bangladesh has implemented sensitisation and educational campaigns. These campaigns utilise multimedia approaches including video-assisted teaching, face-to-face health education, and community discussions. Studies have shown these efforts to be effective in improving immunisation rates by enhancing maternal knowledge and awareness.

Incentivised Interventions: Conditional cash transfers (CCT) and non-monetary incentives have been utilised to encourage caregivers to adhere to vaccination schedules. These incentives, such as mobile phone credits and food coupons, have proven effective in motivating families to prioritise immunisation visits.

Health System Strengthening: Enhancing the capacity and performance of healthcare workers through training programs and performance-based incentives has also been crucial. Programs like the Integrated Management of Childhood Illnesses (IMCI) have been integrated to improve service delivery and quality, particularly in rural and hard-to-reach areas.

Lessons from Other Countries

Drawing from successful strategies in other LMICs, Bangladesh can consider expanding its use of mobile-based reminders and comprehensive community engagement strategies. Countries like India and Nigeria have effectively used mobile phone reminders to notify caregivers about upcoming vaccinations, significantly improving adherence to immunisation schedules.

Future Directions

Looking ahead, further investment in health system infrastructure and strategic planning is essential. Strengthening community engagement through local partnerships and empowering community health workers could amplify outreach efforts. Lessons from interventions in conflict-affected and disaster-prone regions, similar to Bangladesh’s context, could provide insights into adapting strategies for challenging environments.

Conclusion

While Bangladesh has made commendable progress in childhood immunisation, sustained efforts are needed to achieve universal coverage. By continuing to innovate and adapt evidence-based interventions tailored to local contexts, Bangladesh can further reduce immunisation gaps and ensure every child receives life-saving vaccines. By leveraging these strategies and lessons learned from global experiences, Bangladesh can move closer to achieving its immunisation targets, ensuring a healthier future for its children.

Source: Parsekar SS, Vadrevu L, Jain M, Menon S, Taneja G. Interventions addressing routine childhood immunisation and its behavioural and social drivers. Front Public Health [Internet]. 2024;12. Available from: http://dx.doi.org/10.3389/fpubh.2024.1364798