Building on success--potential to improve coverage of multiple health interventions through integrated delivery with routine childhood vaccination.
BACKGROUND
Integrating delivery of nonvaccine interventions with childhood vaccinations has been suggested as a mechanism to accelerate progress toward Millennium Development Goals.


METHODS
Demographic health surveys from 28 sub-Saharan African countries were analyzed to determine potential coverage with 5 nonvaccine interventions that could be delivered to children, mothers, and families during routine infant vaccinations. Potential coverage levels were calculated among households with children aged 12-23 months, based on existing coverage of interventions and vaccinations.


RESULTS
Most (>60%) children in families that had not received nonvaccine interventions had been vaccinated. If nonvaccine interventions could be delivered with vaccinations, the median percentage of households owning a bed net could increase from 46% to 92% and those with improved or treated sources of water from 55% to 91%. The median percentage of children who had received vitamin A supplementation could increase from 66% to 90%. Mothers who have been tested for human immunodeficiency virus could increase from 16% to 86%.


CONCLUSIONS
In Africa, vaccination programs could provide a platform to substantially increase coverage of nonvaccine interventions. Studies are needed to investigate programmatic approaches to optimize the selection, adoption, and long-term utilization of these interventions and to assess the impact on vaccination and other intervention coverage.
Global Immunization Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS E05, Atlanta, GA 30333, USA. aanand@cdc.gov
Abhijeet
A
Anand
Elizabeth T
ET
Luman
Patrick M
PM
O'Connor
D017954:Africa South of the Sahara; D019033:Delivery of Health Care, Integrated; D006801:Humans; D007223:Infant; D014611:Vaccination