Evaluation of Interventions to Improve Vaccination Coverage Among Children Aged 12–23 Months in Urban Slum Areas of Bangladesh Using the WHO Interactive Evidence to Decision (iEtD) Framework: A Stakeholder Perspective

Abstract

Childhood vaccination is the most cost-effective public health intervention; however, coverage in slum-like areas remains a significant challenge because of unique socio-economic disparities and logistical barriers. We aimed to evaluate the interventions from the literature on improving vaccination coverage among children aged 12–23 months in slum areas using the WHO iEtD framework and the TOPSIS-Entropy method for decision-making in Bangladesh and identify stakeholders ranks and felt needs of interventions across study slums. This cross-sectional study was conducted in six slums in two city corporation areas in Dhaka, Bangladesh involving 67 demand-side and 35 supply-side stakeholders. Rating scores ranged from 0 to 1, indicating priority interventions. Our study highlights that demand-side stakeholders favour incentive interventions, whereas supply-side stakeholders support multicomponent strategies. For all stakeholders, educational interventions were ranked highest with a score of 0.745, followed by multicomponent interventions (score 0.666), incentive (score 0.651), and reminder/recall scoring (score 0.305). Educational interventions were identified as a shared priority (common ground), addressing the felt needs of both demand- and supply-side stakeholders. These findings support tailored context-specific approaches to enhance vaccination coverage and child health in vulnerable communities.