Strengthening the engagement of private health providers in immunization programs across Africa and the role of implementation research

Given the lag in performance of many immunization programs in Africa, as highlighted in the 2024 World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) Estimates of National Immunization Coverage (WUENIC), coupled with the sharp decline in global health funding, health system leaders on the continent must take bolder and more ambitious steps to integrate vaccination into primary health care to improve program efficiency with fewer resources. A key leverage point in primary health care that requires serious attention is engagement with private health sector providers. This is because, in most countries, routine vaccination services are primarily delivered by the public sector, with limited involvement from private healthcare providers. Meanwhile, a substantial proportion of people in Africa depend on private healthcare providers for essential health services. Engaging private health sector providers in immunization programs is a low-hanging fruit, as many African countries already have mixed health systems. This article suggests using public-private mix models to involve private health sector providers in immunization efforts, fostering shared commitment and ownership. Involving private providers can also create broader positive ripple effects on the health system, such as enhancing resilience, sustainability, and equitable access to new, existing, and pipeline vaccines. There is a need for thorough contextual insights to guide decisions on private-sector engagement for vaccination. Therefore, systems learning, based on implementation research, should be closely integrated into engagement strategies. It is essential that the learning agenda carefully considers the experience level of national immunization programs in involving the private sector for vaccination services. Moving forward, greater collaboration among implementation researchers, immunization decision-makers, and field practitioners within African countries should be promoted to hasten the translation of learning outcomes into effective policies and practices.