Project Period: May 2022 – March 2025

CIHEB-Kenya is implementing a Routine Immunization Implementation Science Study in Siaya County, aimed at improving the delivery of catch-up immunization services for children under 24 months of age. This three-phased project involves a baseline assessment, the design and implementation of targeted strategies, and a post-implementation evaluation to measure impact.

The study focuses on public immunizing health facilities in Siaya County and involves both facility-based and community-level approaches. Using a mixed-methods approach, the baseline assessment was conducted in 55 randomly selected public health facilities. The study targets include children under 2 years, their caregivers, healthcare workers (HCWs), and community health workers (CHWs).

Key Strategies Implemented:

1. Capacity Building

1. • Trained 1,577 health facility and community healthcare workers on catch-up vaccination.

2. Screening and Referral

1. • Strengthened community-facility linkages.

   • Screened and referred 7,934 immunization defaulters, with 4,740 (60%) confirmed to have reached the health facility and been vaccinated.

3. Appointment & Defaulter Management

1. • Systems were put in place to track and follow up with children who missed scheduled immunizations.

4. Caregiver Education

1. • Integrated key immunization messages into routine health talks at facilities to empower caregivers and promote timely vaccination.

5. Documentation and Reporting

1. • Strengthened data use and reporting systems across the facilities.

Data Collection Approaches:

Quantitative:

• Health facility assessments

• Vaccine stock and daily outpatient register (DOR) abstraction

• Immunization history reviews

• Exit interviews at health facilities

• Abstraction from home-based records

Qualitative:

• Key informant interviews with sub-county teams, facility administrators, and HCWs

• Focus group discussions with caregivers (both timely and untimely vaccinators) and community health promoters (CHPs)

Achievements So Far:

• A total of 10,479 catch-up vaccine doses have been administered to eligible children.

• Defaulter tracing and referral systems have been effectively integrated at community level.

• Caregiver education and health worker training have led to improved awareness and service uptake.

• Currently, a post-implementation assessment is underway to evaluate the impact of the interventions, including an analysis of associated costs.

This study provides practical insights for strengthening routine immunization delivery in underserved areas and contributes to ongoing efforts to close immunization gaps in Kenya.