LAYVAC: Lay health worker programmes for vaccine uptake in low and middle income countries: Developing a global knowledge-base

Background: Lay health workers (LHWs), who carry out healthcare functions but have no professional healthcare qualifications, are used widely and have the potential to improve vaccination uptake in low and middle income countries (LMICs). However, data on their effects, cost-effectiveness and sustainability is needed. Aim: To develop a global knowledge-base on the effects of LHW interventions for vaccination uptake. Objectives: - To assess the effectiveness of LHWs in improving vaccination uptake and heal th care delivery and health care outcomes in LMICs - To synthesize cost-effectiveness data from randomised controlled trials (RCTs) of LHW programmes to promote vaccination uptake - To explore contextual micro- and macro-level factors influencing the effe cts of LHW interventions to promote vaccination uptake - To contribute to the development of methods for synthesizing qualitative and quantitative data on the effects of community-based health care interventions - To identify policy options for the use of LHWs in vaccination programmes and other priority areas across different settings Methodological approaches and challenges: - Systematic review of RCTs of LHW interventions to assess their effectiveness - Review of cost-effectiveness studies of LHW inte rventions - Synthesis of qualitative studies to explore factors influencing the effects of LHW programmes - Case studies of LHW programmes to explore the generalisability of findings - Narrative synthesis of findings to identify factors influencing the e ffectiveness of LHW programmes and develop policy recommendations Outcomes: - High quality evidence for policy and practice on the effects and cost-effectiveness of LHW vaccination programmes - A better understanding of factors influencing the effects and sustainability of LHW programmes for vaccination uptake and other priority health issues - Better methods for assessing the effects of complex health interventions