Salisbury Nicole, Hossain Iqbal, Oskouipour Parysa, Hong Audry, Ebeling Elan, Shearer Jessica C, Grapa Emily
PATH, Seattle, WA 98121, USA.
JSI Research and Training Institute, Arlington, VA 22202, USA.
Vaccines (Basel). 2024 Dec 4;12(12):1370. doi: 10.3390/vaccines12121370.
Microplanning is widely recognized as a critical tool for improving immunization coverage and equity and is considered a core component of routine immunization. However, there is limited evidence on how microplans are developed and implemented and the effectiveness of microplanning. As such, this study sought to review the existing evidence on implementation and institutionalization of microplanning; identify strategies to improve microplanning; and document evidence on new approaches to microplanning, including digitally enhanced and integrated microplanning.
We employed a three-stage mixed-method approach. First, we conducted a literature review on microplanning for routine immunization. Second, we administered an online survey to gather insights into the factors that constrained and enabled microplanning in low-resource settings. Third, we conducted key informant interviews to better understand the barriers and enablers.
We found a paucity of published literature describing the drivers and effectiveness of microplanning and how to sustain it over time. Our review indicates that factors at both the development and implementation stages influence implementation and whether the process is sustained over time. These include the level of community engagement and health care worker ownership, access to data, the complexity of the microplanning tools, and the extent to which supervisors follow up on the plans.
Our review indicates that microplanning is successful when health care workers and communities are engaged in the development process. While these findings highlight the benefits of a 'bottom-up' approach to microplanning, this may be more resource-intensive, and there remains a need for more research on the costs and benefits.
微观规划被广泛认为是提高免疫接种覆盖率和公平性的关键工具，并且被视为常规免疫的核心组成部分。然而，关于微观规划如何制定和实施以及微观规划的有效性的证据有限。因此，本研究旨在回顾关于微观规划实施和制度化的现有证据；确定改进微观规划的策略；并记录关于微观规划新方法的证据，包括数字化增强和综合微观规划。
我们采用了三阶段混合方法。首先，我们对常规免疫的微观规划进行了文献综述。其次，我们开展了一项在线调查，以深入了解在资源匮乏环境中制约和促进微观规划的因素。第三，我们进行了关键信息人访谈，以更好地理解障碍和促进因素。
我们发现已发表的文献很少描述微观规划的驱动因素和有效性以及如何长期维持它。我们的综述表明，开发和实施阶段的因素都会影响实施情况以及该过程能否长期维持。这些因素包括社区参与程度、医护人员的主人翁意识、数据获取情况、微观规划工具的复杂性以及监督人员对规划的跟进程度。
我们的综述表明，当医护人员和社区参与到开发过程中时，微观规划是成功的。虽然这些发现突出了微观规划“自下而上”方法的好处，但这可能需要更多资源，并且仍需要对成本和收益进行更多研究。
