NDLI: Using qualitative systems mapping to analyze the linkages between the behavioral and social (BeSD) determinants of routine childhood immunization in LMICs

Content Provider	Springer Nature : BioMed Central
Author	Vadrevu, Lalitha Parsekar, Shradha S. Jain, Monica Taneja, Gunjan Menon, Shekhar
Abstract	Background Designing effective immunization programs requires a strong understanding of how the factors affecting vaccine uptake interplay. In this review, we analyze the relationships between the Behavioral and Social Drivers (BeSD) of routine immunization using qualitative systems mapping (QSM). Methods In this review, we analyzed 92 experimental and quasi-experimental impact evaluations (IEs) from 11 LMICs that were published between 2010 and 2020. Secondary literature on the study context or the intervention was also included. The WHO’s behavioral and social determinants (BeSD) framework was used to code the determinants identified in these IEs, and their relationships were mapped using qualitative systems mapping. We computed the in-degree (influenced by other determinants) and out-degree scores (influencing other determinants) to assess the extent of the influence of the BeSD determinants on one another. Results The results identified that knowledge regarding immunization, trust in the health system and quality of immunization services, and community engagement by the health workers was influenced by several other determinants and had a high in-degree score. Caregivers perceptions of quality of immunization services, health provider availability, religious leaders, community engagement by health workers, and physical accessibility had a high out-degree score. We also identified two feedback loops between health provider availability and physical accessibility, and trust and perceptions of immunization quality. Conclusions QSM analysis shows that the determinants of immunization uptake were interlinked with each other in complex ways. Our research identified BeSD drivers that affected multiple factors and can be viewed as key leverage points. Programs for improving vaccination uptake need to account for the strong role that caregivers’ experience of immunization services and their trust in the health system play in indirectly affecting immunization uptake. There is also a need to acknowledge that fear of vaccination is fear of the opportunity and monetary costs associated with vaccine side-effects. The results from this review can inform discussion and form the basis for context specific research on the factors affecting immunization.
Related Links	https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-024-20850-w.pdf
Ending Page	14
Page Count	14
Starting Page	1
File Format	HTM / HTML
ISSN	14712458
DOI	10.1186/s12889-024-20850-w
Journal	BMC Public Health
Issue Number	1
Volume Number	24
Language	English
Publisher	BioMed Central
Publisher Date	2024-12-18
Access Restriction	Open
Subject Keyword	Public Health Medicine Epidemiology Biostatistics Vaccine Environmental Health Routine immunization Qualitative systems mapping LMIC Causal loop diagrams QSM CLD Qualitative review Behavioral and social determinants of vaccination BeSD Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	3.9/2023

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

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