Enhancing vaccine delivery in Africa with implementation science

Complex contextual factors hinder the optimal delivery of recommended vaccines to target populations in the World Health Organization (WHO) African Region. As a consequence, vaccination coverage for multiple antigens continues to fall short of the recommended benchmark for herd immunity across countries. This is precipitating frequent outbreaks of vaccine-preventable diseases with concomitant morbidity and mortality. If this problem is allowed to continue unchecked, it will delay progress toward achieving the child survival targets of the sustainable development goals for both individual countries and the entire region. Implementation science offer tools that country immunization programmes can leverage to address challenges with vaccine delivery. It has frameworks that can enable better understanding of the contextual barriers that affect effective vaccine delivery. It provides models that can foster the use of tailored interventions and strategies to address identified barriers of effective vaccine delivery while generating evidence on real-world effectiveness. There are also models for facilitating adaptation and spread of context-relevant best practices for enhancing vaccine delivery across diverse settings (whether in health facilities or communities) to improve vaccine uptake. In this opinion article, we reflexively outlined some key recommendations to spur greater use of implementation science in addressing challenges with vaccine delivery that are faced by immunisation programmes in the WHO African Region and beyond.