COVID-19 and routine childhood immunization in Africa: Leveraging systems thinking and implementation science to improve immunization system performance
One of the routine health services that is being disrupted by coronavirus disease 2019 (COVID-19) in Africa is childhood immunization. This is because the immunization system relies on functioning health facilities and stable communities to be effective. Its disruption increases the risk of epidemic...
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doaj-4b80af89ed394eb0b5a5796a7cf068382020-11-25T03:26:09ZengElsevierInternational Journal of Infectious Diseases1201-97122020-09-0198161165COVID-19 and routine childhood immunization in Africa: Leveraging systems thinking and implementation science to improve immunization system performanceAbdu A. Adamu0Rabiu I. Jalo1Desire Habonimana2Charles S. Wiysonge3Cochrane South Africa, South African Medical Research Council, Francie Van Zijl Drive, Parrowvallei, Tygerberg, 7505, Cape Town, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie Van Zijl Drive, Parrowvallei, Tygerberg, 7505, Cape Town, South Africa; Corresponding author at: Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Parrowvallei, Tygerberg, 7505, Cape Town, South Africa.Department of Community Medicine, Bayero University/Aminu Kano Teaching Hospital, Zaria Road, Kano State, NigeriaResearch and Innovation Unit, Department of Community Medicine, Faculty of Medicine, University of Burundi, Bujumbura, BurundiCochrane South Africa, South African Medical Research Council, Francie Van Zijl Drive, Parrowvallei, Tygerberg, 7505, Cape Town, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie Van Zijl Drive, Parrowvallei, Tygerberg, 7505, Cape Town, South Africa; School of Public Health and Family Medicine, University of Cape Town, Observatory, 7925, Cape Town, South AfricaOne of the routine health services that is being disrupted by coronavirus disease 2019 (COVID-19) in Africa is childhood immunization. This is because the immunization system relies on functioning health facilities and stable communities to be effective. Its disruption increases the risk of epidemics of vaccine-preventable diseases, which could increase child mortality. Therefore, policymakers must quickly identify robust and context-specific strategies to rapidly scale-up routine immunization in order to mitigate the impact of COVID-19 on their national immunization performance. To achieve this, we propose a paradigm shift towards systems thinking and use of implementation science in immunization decision-making. Systems thinking can inform a more nuanced and holistic understanding of the interrelationship between COVID-19, its control strategies, and childhood immunization. Tools like causal loop diagrams can be used to explicitly illustrate the systems structure by identifying feedback loops. Once mapped and leverage points for interventions have been identified, implementation science can be used to guide the rapid uptake and utilization of multifaceted evidence-based innovations in complex practice settings. As Africa re-strategizes for the post-2020 era, these emerging fields could contribute significantly in accelerating progress towards universal access to vaccines for all children on the continent despite COVID-19.http://www.sciencedirect.com/science/article/pii/S1201971220305075Implementation scienceSystems thinkingImmunizationAfricaCOVID-19 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Abdu A. Adamu Rabiu I. Jalo Desire Habonimana Charles S. Wiysonge |
spellingShingle |
Abdu A. Adamu Rabiu I. Jalo Desire Habonimana Charles S. Wiysonge COVID-19 and routine childhood immunization in Africa: Leveraging systems thinking and implementation science to improve immunization system performance International Journal of Infectious Diseases Implementation science Systems thinking Immunization Africa COVID-19 |
author_facet |
Abdu A. Adamu Rabiu I. Jalo Desire Habonimana Charles S. Wiysonge |
author_sort |
Abdu A. Adamu |
title |
COVID-19 and routine childhood immunization in Africa: Leveraging systems thinking and implementation science to improve immunization system performance |
title_short |
COVID-19 and routine childhood immunization in Africa: Leveraging systems thinking and implementation science to improve immunization system performance |
title_full |
COVID-19 and routine childhood immunization in Africa: Leveraging systems thinking and implementation science to improve immunization system performance |
title_fullStr |
COVID-19 and routine childhood immunization in Africa: Leveraging systems thinking and implementation science to improve immunization system performance |
title_full_unstemmed |
COVID-19 and routine childhood immunization in Africa: Leveraging systems thinking and implementation science to improve immunization system performance |
title_sort |
covid-19 and routine childhood immunization in africa: leveraging systems thinking and implementation science to improve immunization system performance |
publisher |
Elsevier |
series |
International Journal of Infectious Diseases |
issn |
1201-9712 |
publishDate |
2020-09-01 |
description |
One of the routine health services that is being disrupted by coronavirus disease 2019 (COVID-19) in Africa is childhood immunization. This is because the immunization system relies on functioning health facilities and stable communities to be effective. Its disruption increases the risk of epidemics of vaccine-preventable diseases, which could increase child mortality. Therefore, policymakers must quickly identify robust and context-specific strategies to rapidly scale-up routine immunization in order to mitigate the impact of COVID-19 on their national immunization performance. To achieve this, we propose a paradigm shift towards systems thinking and use of implementation science in immunization decision-making. Systems thinking can inform a more nuanced and holistic understanding of the interrelationship between COVID-19, its control strategies, and childhood immunization. Tools like causal loop diagrams can be used to explicitly illustrate the systems structure by identifying feedback loops. Once mapped and leverage points for interventions have been identified, implementation science can be used to guide the rapid uptake and utilization of multifaceted evidence-based innovations in complex practice settings. As Africa re-strategizes for the post-2020 era, these emerging fields could contribute significantly in accelerating progress towards universal access to vaccines for all children on the continent despite COVID-19. |
topic |
Implementation science Systems thinking Immunization Africa COVID-19 |
url |
http://www.sciencedirect.com/science/article/pii/S1201971220305075 |
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