The Importance of Service Experience

After increasing for more than two decades, RI coverage rates began to stagnate again around 2010, with an estimated 19.4 million children under the age of one year who did not receive basic vaccines in 2018. Immunization services have historically focused on supply and delivery functions. However, more recent constraints in maintaining and increasing vaccination rates have highlighted the crucial components of demand generation and client-centered design which are needed to ensure uptake and encourage access, trust, and motivation to vaccinate and reach every child.



Published systematic reviews of the drivers of vaccine hesitancy and acceptance have found two main factors that influence parental decision making on vaccination: social norms and caregiver-provider interactions. These have a critical impact on caregivers’ (and individual’s) trust in and subsequent acceptance, motivation and pursuit of vaccination for their children or themselves. In line with this evidence, the first pillar of the Gavi Alliance demand framework is “Service Quality and Accountability”, and the Immunization Agenda 2030 also includes “Commitment and Demand” as a strategic priority. To foster a people-centered model for vaccination, services must be brought closer to people (with enhanced service quality and accountability), consider health worker and client perspectives and needs, and subsequently bring people to services with community engagement and development of a social norm.



The available research identifies people-centred approaches which have exhibited some success, including: interpersonal communication and interaction skills development, community participation and ownership, supportive supervision, group problem solving, and technical skill development. Consolidation of existing resources and learnings on the user experience for immunization- as well as in and beyond the health sector, and adaptation of these learnings with implementation research in local immunization service contexts can empower countries to improve immunization and health service quality and reach.


It is critical that positive service experience is well managed as part of the health system in order to maintain a sustainable and resilient immunization program.


New issues that impact service delivery have also emerged with the global COVID-19 pandemic. Given severe disruptions to services, clear and consistent communication is critical, notably on when and where to go when services are resumed. Understanding existing challenges for health workers and clients, as well as the needs that may emerge further when the pandemic subsides, require thoughtful contemplation to shape the future of immunization service experience. 



Our Workstream Objectives

The Service Experience workstream aims to inform a new direction in people-centered quality immunization service delivery by incorporating principles of human-centered design to re-orient immunization service delivery to include caregiver and client perspectives and needs. This includes:

  • A common and detailed understanding of people-centered service experience for immunization by all actors and partners.
  • Unified vision of guidance and technical support needs that align with the role and capacity of the service Experience workstream
  • Roadmap for technical support and guidance to be provided by partners of the Service Experience workstream for the coming two years (and longer-term considerations)



Our Current Initiatives

  • Global literature review of immunization service quality and experience research and guidance
  • Immunization service experience scoping document identifying key themes and questions in this area
  • Rapid country insight gathering on service experience through key informant interviews and specified literature reviews
  • Partner co-creation workshop to review service experience in the immunization service delivery model

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