Country-Level Assessment of Missed Opportunities for Vaccination in South Africa: Protocol for Multilevel Analysis (Preprint)

Abstract

BACKGROUND Vaccination is one of the greatest public health interventions of all time. The vaccination coverage in South Africa has shown a steady improvement in reaching the national target for vaccine coverage. However, while there is progress nationally, there are districts within the country that are below the set target for vaccine coverage. One of the main drivers of sub-optimal vaccination coverage is thought to be missed opportunities for vaccination (MOV). OBJECTIVE The aim of this study is to understand the magnitude and determinants of MOV in South Africa. METHODS We will conduct the study in two phases. In the first phase, we will obtain data from the 2016 South African Demographic and Health Survey (DHS) and conduct multilevel regression analyses to determine individual and contextual factors associated with MOV in South Africa. The second phase will consist of exit interviews and focus group discussions with caregivers of children attending primary healthcare facilities in the Eastern and Western Cape Provinces of South Africa, to understand their perspectives on MOV. This will facilitate comparison of factors associated with MOV in both urban and rural settings in the country. Insights to such factors will aid in designing tailor-made interventions to improve vaccination coverage in South Africa. RESULTS Not Applicable CONCLUSIONS Not Applicable CLINICALTRIAL N/A