➡️ Our new high-resolution population & #vaccination maps show nearly 1 million West & Central African children unvaccinated.
Reach the Unreached project - funded by #UNICEF - working with in-country stakeholders, #CartONG and #MapAction
#ZeroDose
This article is excerpted from the Gavi Zero-Dose Learning Hub publication “Knowledge Translation for Zero-Dose Immunization Research”.
In its role as the Learning Innovation Unit (LIU) lead, The Geneva Learning Foundation (TGLF) conceptualized a baseline strategy for knowledge translation (KT).
TGLF developed the following recommendations to support the Country Learning Hubs’ (CLH) KT work.
The recommendations are intended to improve the use of evidence generated by research, ensuring it effectively informs practices, policies, and interventions targeting vaccine equity.
Each recommendation is accompanied by a rationale and example.
Together, these recommendations aim to build a robust and efficient approach to KT that maximizes the impact of research findings on identifying and reaching ZD and UI children, ultimately contributing to improved immunization equity. This toolkit provides researchers with a list of steps for planning for KT with guiding
Table 1. KT Recommendations from TGLF
RecommendationExamplePerform a rapid capacity audit for KT to inform strategies. Diagnose organizational capacity for KT and builds on available infrastructure and expertise, while tailoring strategies to address limitations.Rapid capacity audit questions include: (1) what percent of resources are committed to KT?, (2) what competencies are needed for KT?, and (3) what networks are needed for KT?Integrate KT planning from the research inception. Get buy-in from stakeholders, and capitalize on emerging insights. This will also allow sufficient time for capacity strengthening, prevent lags between results and translation, and create efficiencies.Establish KT goals at the beginning of the project, and consider the KT goals while designing evaluation frameworks and stakeholder engagement plans.Engage intended stakeholders/audiences throughout the evidence generation process. Drive relevance, applicability, and shared ownership of emerging findings.Include sub-national practitioners on advisory committees, and engage stakeholders and communities in developing research questions.Implement co-creation and participatory processes. Foster a culture that values active listening; encourages engagement with diverse viewpoints; and supports questioning, feedback, and experimentation. This approach underpins the development of a shared vision for collective progress and innovation.Involve a diverse group of stakeholders. Explore rapid feedback mechanisms. Establish platforms or forums for peer-to-peer exchange, where individuals can share their success stories and challenges.Tailor methods and communications materials to the audience(s). Contribute to the effectiveness and impact of KT efforts.Identify audience(s) and their preferred mode(s) of communication and needs (i.e., busy policymakers may prefer short, non-technical policy briefs).Leverage informal networks and create continuous learning opportunities to translate evidence. Tap into peer learning and try new ideas; facilitate cost-effective diffusion that enables adaptation.Identify influencers. Support sharing through professional networks and learning collaboratives.Capture user feedback systematically on value and use. Demonstrate the value and use of the translated knowledge.Distribute short usage surveys when research outputs are accessed (post-webinar/event surveys, follow-up email/surveys after sharing resources).Monitor changes in policies and practices beyond dissemination metrics.Facilitate evidence uptake and measurable improvements from application.Establish key indicators on changes adopted across networks based on research findings.Share experiences. Encourage learning from real-world examples of how evidence-based practices have been adapted and implemented. This can inform efforts to tailor interventions to unique settings, fostering innovation and problem-solving.Develop and disseminate case studies that highlight the pathway from learning to action, facilitating peer-to-peer learning and accelerating the adoption of effective practices.Image: The Geneva Learning Foundation Collection © 2024
Share this:
#complexProblemSolving #Gavi #IRMMA #knowledgeTranslation #peerExchange #ZDLHX #zeroDose #ZeroDoseLearningHub
Gavi Zero-Dose Learning Hub’s innovative model for inter-country peer learning and knowledge translation
This article about inter-country peer learning and knowledge translation is excerpted from the Gavi Zero-Dose Learning Hub publication “Knowledge Translation for Zero-Dose Immunization Research”.
The Geneva Learning Foundation (TGLF) hosted the first ZDLH Inter-Country Peer Learning Exchange session (ZDLH-X), in May 2023 with a focus on Bangladesh and Mali.
The second online peer learning exchange, ZDLH-X2, in September 2023 focused on Nigeria and Uganda.
The ZDLH-X events were the centerpiece of a learning programme that includes three general steps.
- First, registrants completed a questionnaire, provided by TGLF, on local ZD challenges, practices, and priorities.
- Second, there was a series of online events to share and curate zero-dose practices.
- Finally, there were follow-up knowledge translation events online for reflection on learning, and participants completed post-event questionnaires.
Through this process, TGLF identified stories to be featured in a January 2024 ZDLH webinar event. The stories reveal how practitioners in Bangladesh, Mali, Nigeria, and Uganda are developing local solutions to increase equity in immunization.
The peer learning events provide a framework for addressing the complex problem-solving required to address the zero-dose challenge.
The ZDLH-X approach uses multidisciplinary participation, narrative-based mental model building, peer inspiration, reflective sessions, and collaborative activities to address multidimensional challenges like reaching zero-dose children.
Watch the complete Gavi Zero-Dose Learning Hub Webinar: Equity in Action: Local Strategies for Reaching Zero-Dose Children and Communities. Here is an excerpt, focused on the ZDLH-X inter-country learning model and its relevance for knowledge translation.
Table 5. ZDLH-X Peer Exchange as a Knowledge Translation Model
Driver for complex problem-solvingHow ZDLH-X provides a modelLearning from each otherThe events connected over 3,000 practitioners working on ZD issues globally, enabling inter-country peer exchange of insights from across contexts. This diversity of knowledge and perspectives mirrors the need identified by research to assimilate inputs from different domains when solving complex problems.Utilizing mental models (reflective thinking)Through presentations, participants shared local strategies for reaching communities with ZD children. These stories and visuals helped others envision new ways to make a difference, showcasing the power of learning from peers to expand the problem-solving toolkit.Enabling metacognition (thinking about thinking)Q&A sessions encouraged participants to think critically about their current methods and attitudes. These reflective conversations are crucial for understanding and improving thought processes, a key element in tackling complex issues.Managing affective factors (motivation)Peer testimonials provided motivation through relatable stories of overcoming barriers, such as vaccine hesitancy or gender-related barriers. Psychology research links such motivation and emotional regulation to complex problem-solving success.Supporting collaborationThe event facilitated group discussions, allowing for a collective examination of challenges specific to different communities. Research shows that collaborative efforts lead to better outcomes in solving complex problems, thanks to a shared understanding among team members.Prior TGLF research on immunization learning culture revealed continuous learning as the weakest dimension, characterized by few opportunities, low risk tolerance, limited incentives, and a focus on tasks over capacity strengthening.
By incorporating evidence-based strategies to strengthen continuous learning, the ZDLH-X inter-country peer learning events were designed to provide the missing elements through blended peer, social, remote, and networked learning.
Value Creation Framework
A value creation framework measured the ZDLH-X events’ impact across five areas: professional change, social connections, practice improvement, influence, and mindset shifts.
Value creation questions provide a method to assess value of inter-country peer learning through both quantitative and qualitative responses.
These evidence-based inquiries, made optional to encourage participation, can provide deeper understanding of how resources or events facilitate knowledge application, ensuring more accurate evaluation of the effectiveness of KT activities.
Respondents rated agreement with statements in each area.
Results were benchmarked against a 10,000-participant cohort.
Across all five areas assessed, ZDLH-X participants reported substantially higher value creation versus the benchmark, demonstrating the effectiveness of the peer learning approach.
Sample value creation questionsParticipation changed me as a professional (change in skills, attitudes, identity, self-confidence, feelings, etc.).
Participation helped my professional practice (get new ideas, insights, materials, procedures, etc.)
Participation made me see my world differently (change in perspective, new understandings of the situation, redefine success, etc.)
Relating Learning to Performance
Previous large-scale TGLF research (n=6,185) demonstrated significant predictive relationships between strengthening immunization learning culture and enhancing knowledge and mission performance.
These causal links contextualize ZDLH-X outcomes within a broader performance framework.
When asked about applying learnings, 99 percent of ZDLH-X respondents expressed intent to use new ZD strategies.
Post-event knowledge translation feedback included examples of adaptations based on ideas gained, illustrating tangible practice changes.
This evidence indicates that structured, blended peer learning can reliably extract practical insights on local ZD solutions from frontline staff and spur knowledge translation.
Quantitatively and qualitatively, the methodology generated value for participants while enabling continuous learning.
Coupled with prior research demonstrating a strong correlation between learning culture and performance, it is reasonable to hypothesize that such methods may positively influence coverage outcomes.
Additional research should replicate these findings across contexts and connect observed practice changes to immunization results.
The ZDLH-X model leverages peer exchange to sustainably strengthen continuous learning and identify how to better reach ZD children through inter-country peer learning.
Initial findings suggest this approach could complement traditional learning agendas to build immunization system resilience.
Wider application and validation is warranted based on the events’ promising outcomes.
Practitioners gained the knowledge of relevant solutions while advancing the learning culture needed to continuously adapt and perform in our complex world.
ZDLH-X Recommendations to Support Engagement Conducive to Effective Knowledge Translation
Table 6. ZDLH-X Recommendations to Support Engagement Conducive to Effective Knowledge Translation
Virtual Peer Exchange Model RecommendationsImplementation Guidance and QuestionsHelp ZD practitioners relate their own experiences to what is shared.Ask: “When you listen to your colleague, how different is this from the ZD challenge you face? Tell us about this challenge.”Explain the role of global and national-level experts as a guide on the side rather than sage on the stage.Remind them to listen attentively to each person sharing their experience: “Examine this experience in light of your global expertise. Identify questions for follow-up to clarify the story. Share short, specific feedback first, and then generalize to bring in the big picture. Be concise and get to the point. The longer you speak, the less we will learn from ZD practitioners.”Emphasize that participant experience is valued and recognized as legitimate.Share that there will be no slide presentations. Instead, participants are invited to share stories and respond to stories shared. National/ global staff are invited to listen, learn, and contribute as a guide on the side.Provide explicit guidance to help participants structure their thinking to act as scaffolding for knowledge translation.Tell participants, “Prepare to listen and share your feedback. As you listen to fellow ZD practitioners, reflect on your own experience. What experience do you want to share and why? How do you think this experience will be helpful to colleagues working on ZD? Be concise.”Share rules of engagement to ensure all participants are included and feel recognized.Reminder: if a person from one country or region has spoken, the next person should be from a different country or region. When possible, if a man has spoken, the next person should be a woman. Tell participants, “We will be very strict about timing. Remember that you can also share your thoughts by writing in the comments. Respect diversity and differences, and one another as peers.”Acknowledge connectivity challenge in a frontline event to encourage participation.Remember that practitioners from remote areas may have connectivity issues, despite interest and motivation. Consider organizing “viewing parties” where staff gather to watch and listen from a location with reliable internet.Share supportive messaging to help build engagement that increases motivation to translate knowledge into practice.Tell participants, “We are here to listen and learn from you. Trust your experience. Focus on what you know because you are there every day. Do not forget to introduce yourself: who you are and where you work. Be concise. You will be asked questions by the facilitation team, by guides on the side, and by attendees. It is okay if you do not have all the answers. Listen to the experiences of your peers, as you will be asked questions about them.”Emphasize the value proposition of the opportunity to translate knowledge into practice.Tell participants, “Learn from the experiences of other immunization professionals on how they have successfully identified and reached ZD and UI communities; gain understanding about the specific tools and interventions that were effective in other contexts and be able to adapt them to your context. Share your own experience, including success stories, lessons learned and challenges; reflect on your own ZD practices and identify areas for improvement.”Share criteria to help participants share relevant experience.Advise participants, “Be as precise and concrete as possible. Describe what you did and why, step by step. How do you know it worked? What did you do that is new or different? What facilitated and complicated this intervention? How does what you did connect to broader health system components (e.g., HRH, data/monitoring, planning, financing, supply chain/logistics)? For challenges that are relevant to others: In what specific ways does your intervention impact a ZD problem? What other challenges relate to this one (e.g., gender, conflict, urban/rural, demand, finance)? What about your intervention do you think is common or relevant to others— in your country or in another country?”Provide guiding questions to help practitioners share their ZD experience.Ask: “What is the ZD situation where you work? How do you know? What are you doing about it, why, and how? How is it different from what you did before? How has it turned out so far? How do you know what you are doing is successful?”Consider the determinants of KT for individuals.When trying to translate knowledge into practice: Give me enough time to work on knowledge translation. Ensure progress is monitored by my supervisor. Make available someone to coach or mentor me. Facilitate access to fellow practitioners for guidance and support. Encourage co-workers to support. Make job aids available for guidance. Periodically remind of need for change in practice.Share relevant content with platforms, with an invitation to disseminate and report back on KT.Follow up with each platform to analyze KT effectiveness and lessons learned.Learn more: Access the ZDLH-X recordings, synthesis reports, a list of frequently asked questions, and conceptual framework.
Image: The Geneva Learning Foundation Collection © 2024
Share this:
#complexProblemSolving #Gavi #JSI #knowledgeTranslation #peerExchange #ZDLH #ZDLHX #zeroDose #ZeroDoseLearningHub
#african nations bear a disproportionate burden in #vaccination, with 18.7% of #children classified as #zerodose, doubling the global average. "
https://indianf.com/childhood-vaccination-low-in-conflict-zones/#:~:text=African%20nations%20bear%20a%20disproportionate%20burden%2C%20with%2018.7%25%20of%20children%20classified%20as%20zero%2Ddose%2C%20doubling%20the%20global%20average.
In #Conflict zones worldwide, the percentage of #children who have never received routine #vaccinations, known as “#zerodose” #children, is alarmingly high."
https://indianf.com/childhood-vaccination-low-in-conflict-zones/#:~:text=In%20conflict%20zones%20worldwide%2C%20the%20percentage%20of%20children%20who%20have%20never%20received%20routine%20vaccinations%2C%20known%20as%20%E2%80%9Czero%2Ddose%E2%80%9D%20children%2C%20is%20alarmingly%20high.
The WHO Director General’s report to the 154th session of the Executive Board on progress towards the Immunization Agenda 2030 (IA2030) goals paints a “sobering picture” of uneven global recovery since COVID-19.
As of 2022, 3 out of 7 main impact indicators remain “off-track”, including numbers of zero-dose children, future deaths averted through vaccination, and outbreak control targets.
Current evidence indicates substantial acceleration is essential in order to shift indicators out of the “off-track” categories over the next 7 years.
While some indicators showed recovery from pandemic backsliding, the report makes clear these improvements are generally insufficient to achieve targets set for 2030.
While some indicators have improved from 2021, overall performance still “lags 2019 levels” (para 5).
Specifically, global coverage of three childhood DTP vaccine doses rose from 81% in 2021 to 84% in 2022, but remains below the 86% rate achieved in 2019 before the pandemic (para 5).
The number of zero-dose children fell from 18.1 million in 2021 to 14.3 million in 2022. However, this number is still 11% higher compared to baseline year 2019, when there were 12.9 million zero-dose children (para 10).
Furthermore, the report stresses that recovery has been “very uneven” (para 6), with minimal gains observed in low-income countries:
“As a group, there was no increase in DTP3 coverage across 26 low-income countries between 2021 and 2022.” (para 6)
Regions are also recovering unevenly, especially Africa.
“In the African Region, the number of zero-dose children increased from 7.64 million in 2021 to 7.78 million in 2022 − a 25% increase since baseline year 2019.” (para 6)
Inequities within countries also continue expanding, with gaps widening “between the best-performing and worst-performing districts” since 2019 (para 6).
The top priorities (para 34) include:
1) “Catch-up and strengthening” immunization activities
2) “Promoting equity” to reach underserved communities
3) “Regaining control of measles” with intensified responses
4) Advocacy for “increased investment in immunization, integrated into primary health care”
5) “Accelerating new vaccine introduction” in alignment with WHO recommendations
6) “Advancing vaccination in adolescence” such as HPV vaccine introduction
The report stresses that “coordinated action” on these priorities can get countries back on track towards IA2030 targets in the wake of COVID-19 disruptions (para 27). This action must be “grounded in local realities” (para 32) to reach underserved areas thus far left behind.
Given this context, this document asks: “What actions can global partners take to support countries to accelerate progress in the six priority areas highlighted?” (para 37).
In response, WHO contends that “the operational model under IA2030 must continue shifting focus to the regional level, to facilitate coordinated and tailored support to countries.”
It is unclear how devolution to the regional level could truly respond to highly localized barriers and enablers.
Such a claim may best be understood with respect to the internal equilibrium between WHO’s Headquarters (HQ) and the Regional Offices, with IA2030 being initially driven by HQ.
What other changes might be needed? And what are the barriers that might hinder global immunization partners from recognizing and supporting such changes?
Reference: Tedros Adhanom Ghebreyesus, 2023. Progress towards global immunization goals and implementation of the Immunization Agenda 2030. Report by the Director-General, Executive Board 154th session Provisional agenda item 9. World Health Organization, Geneva, Switzerland.
https://redasadki.me/2024/02/05/widening-inequities-immunization-agenda-2030-remains-off-track/
#COVID19 #equity #IA2030 #immunization #ImmunizationAgenda2030 #TedrosAdhanomGhebreyesus #WorldHealthOrganization #zeroDose
RT @DigitalScholarX: Faiza Rabbani (Pakistan) established a free primary health facility in her urban area to create awareness of importance of vaccination. Even after 2 years, people hardly seek guidance on vaccination. #ZeroDose girls often come quite late and for treatment of general ailments… https://t.co/U4pvvo5uIj
RT @DigitalScholarX: Zero-Dose Insights Live 2: Early learning from health workers in Nigeria and Uganda @gavi
Follow this link to watch Insights Live https://t.co/dn7xoR0iNe
#VaccinesWork #ZeroDose #Uganda #Nigerian #insights #GlobalHealth
ZDLH Insights Live is a rapid, fast-paced discussion of… https://t.co/v9uPd13OaS
Learning from the frontlines - enabled by @DigitalScholarX's unique peer learning approach #zerodose #vaccineswork #IA2030 @gavi
Learn more about Gavi's Zero-Dose Learning Hub here https://t.co/47tquQg048 https://t.co/sEK0sgfiTl
New #research paper led by Edson Utazi - #Mapping the distribution of zero-dose children to assess the performance of #vaccine delivery strategies and their relationships with #measles incidence in #Nigeria - funded by #gatesfoundation #zerodose #Bayesian #Geostatistics #Modelling https://doi.org/10.1016/j.vaccine.2022.11.026
Webinar: On #GISDay2022 Research Fellow Dr Edson Utazi spoke on childhood #vaccination - how #GIS helps reach #zerodose children at the
Library of Congress, Geography & Map Division, Exploring Humanitarian GIS event. Dr Utazi reported on work funded by #gavi #WorldHealthOrganisation #gatesfoundation and #UNICEF
#SDGs #LMICs
https://youtu.be/906j_zwILW4?t=3013
We're hiring! #GIS technician needed for new #zerodose #population project until Feb 2023.
MUST be registered with UniWorkforce for casual work assignments at the University of Southampton
https://southampton.ac.uk/hr/services/uniworkforce/index.page#sign_up_and_register
https://jobs.soton.ac.uk/Vacancy.aspx?ref=U2059622WR
#30DayMapChallenge
Day 11: Red
Identifying where un/under-vaccinated children are is essential to improve routine vax rates. Mapped here for conflict-affected locations, the estimated proportion of under 1s (2019) without DTP1 #conflict #zerodose
Source: Wigley et al (2022)
https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0001126
Client Info
Server: https://mastodon.social
Version: 2025.04
Repository: https://github.com/cyevgeniy/lmst