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A study by doctoral student Raoul Kamadjeu and Associate Professors Katarzyna Wyka and Elizabeth Kelvin suggests that strengthening governance structures and processes could have significant positive impacts on immunization programs and public health in general.
For the study, the researchers evaluated the impact of governance on immunization coverage across 54 African countries between 2012 and 2021, using linear mixed models and focusing on three vaccines: the first and third doses of the diphtheria-tetanus-pertussis vaccine and the first dose of the measles vaccine.
The research team found that countries with better governance tend to have higher immunization coverage rates, while those with poorer governance struggle to achieve and maintain high coverage.
The study revealed significant regional differences in governance and immunization performance. North African countries generally had better governance scores and higher immunization coverage, while Sub-Saharan African countries, particularly those in Central Africa, faced greater challenges in both governance and immunization coverage.
The findings suggest that international aid and support for immunization programs should consider governance factors to maximize effectiveness.
“This study highlights the complex relationship between governance and public health outcomes, specifically in the context of routine immunization programs in Africa,” says Kamadjeu. “There is a need for a holistic approach to improving immunization coverage that includes efforts to enhance governance alongside traditional health system strengthening initiatives.”
