Abstract

Despite good progress in increasing immunization coverage, missed opportunities for vaccination, sub-optimal care-giver knowledge and conflicting priorities (Favin et al., 2012, Sridhar et al., 2014) mean 20% of children globally continue to miss out in many settings. International research suggests that improved community engagement is key to addressing vaccine hesitancy and increasing coverage (LaFond et al., 2015). There is global evidence that the use of quality checklists by health providers can improve service quality and health outcomes (Gawande 2010). The World Health Organization (WHO) has developed service quality checklists for use by health providers in surgery, safe motherhood and most recently immunization (Van Klei et al., 2012, Spector et al. 2012, WHO 2015). Operational research also suggests that community scorecards can increase health service transparency, accountability and help build collaborative relationships between health providers and communities (Post and Venugopal, 2014). In Myanmar, health authorities are committed to increasing vaccination in all settings, especially hard-to-reach communities. Therefore, they agreed to test a new approach that combines both checklist and community feedback mechanisms, as a complement to other continuing work to improve immunization service quality and access.

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