Key Considerations for Integrating COVID-19 Vaccination Services: Insights from Iraq and Syria for the MENA Region

Abstract

With the COVID-19 pandemic well into its third year, governments and response partners are recognising that it no longer makes sense for COVID-19 services, including vaccination, to exist in isolation. There is growing recognition of the potential for integration with other services as the way forward for COVID-19 vaccination. This has recently begun to occur in various countries, but until now, there has been little evidence available as to the success of these initiatives.

Service delivery integration occurs where “managerial or operational changes to health systems bring together inputs, delivery, management, and organisation of particular service functions in ways that are contextually appropriate and person-centred with the aim of improving coverage, access, quality, acceptability, effectiveness, and cost-effectiveness” (Haldane et al. 2022)

This brief draws on evidence from academic and grey literature and consultations with partners working in the COVID-19 response to review current integration efforts (as of August 2022) and explore potentially effective ways to integrate COVID-19 vaccination into other services in the Middle East and North Africa (MENA) region. Recent guidance on integration from WHO has also been cross-referenced where relevant. Iraq is taken as a detailed case study due to the efforts already made there on integration of COVID-19 and routine immunisation (RI) services. Global integration experiences and a brief discussion of integration efforts in Syria are also included. The brief is part of the Social Science in Humanitarian Action Platform (SSHAP) series on social science considerations relating to COVID-19 vaccines and was written for SSHAP by Nadia Butler supported by Soha Karam (Anthrologica), Amaya Gillespie, Aarunima Bhatnagar and Elnur Aliyev (UNICEF). Verbal consultations and reviews of the draft were provided from response partners in Iraq and other locations within the region (IFRC MENARO, Iraq MoH, UNICEF Iraq, UNICEF MENARO, UNICEF Syria, WHO EMRO). The brief was requested by the UNICEF Middle East and North Africa Regional Office (MENARO) and is the responsibility of SSHAP.