Bate-papo Vacina! (Lets talk about Vaccines!) Expansion Study

Despite significant progress of the Expanded Program on Immunization in preventing fatal diseases in children in low and middle-income countries, coverage has stagnated over the past decade.

We propose a community based participatory and mixed methods research project in diverse settings in Mozambique and Malawi to determine drivers of childhood immunization dropouts as well as context-specific v. scalable solutions to improve full immunization coverage. The research sites will include both urban informal and rural settings.

In site selection, we have considered the different ways in which vaccination services are provided.

We will implement this study in four- iterative phases: - Identify barriers to childhood immunization access and uptake - Co-develop solutions with communities and understand communities’ roles in generating evidence and solutions - Implement the co-created solutions for up to one year - Evaluate the implementation and early impact of the co-created solutions We will collaborate with community members, health workers and government stakeholders as participants and partners, and leverage existing partnerships at the global level.

Our collaborative approach of engaging caregivers as co-researchers, ensures tailored approaches, which account for context considerations in solution development and promotes community buy-in and commitment to solutions. Tools and learnings will be packaged for broad dissemination.