IDEAS home Printed from https://ideas.repec.org/a/plo/pgph00/0000844.html
   My bibliography  Save this article

Identifying priority challenges and solutions for COVID-19 vaccine delivery in low- and middle-income countries: A modified Delphi study

Author

Listed:
  • Archchun Ariyarajah
  • Isha Berry
  • Victoria Haldane
  • Miranda Loutet
  • Fabio Salamanca-Buentello
  • Ross E G Upshur

Abstract

Background: The rapid implementation of global COVID-19 vaccination programs has surfaced many challenges and inequities, particularly in low- and middle-income countries (LMICs). However, there continues to be a lack of consensus on which challenges are global priorities for action, and how to best respond to them. This study uses consensus-based methods to identify and rank the most important challenges and solutions for implementation of COVID-19 vaccination programs in LMICs. Methods: We conducted a three-round modified Delphi study with a global panel of vaccine delivery experts. In Round I, panelists identified broad topical challenges and solutions. Responses were collated and coded into distinct items. Through two further rounds of structured, iterative surveys panelists reviewed and ranked the identified items. Responses were analyzed qualitatively and quantitatively to achieve consensus on the most important COVID-19 vaccine delivery challenges and solutions. Results: Of the 426 invited panelists, 96 completed Round I, 56 completed Round II, and 39 completed Round III. Across all three rounds there was equal representation by gender, and panelists reported work experience in all World Bank regions and across a variety of content areas and organizations. Of the 64 initially identified items, the panel achieved consensus on three challenges and 10 solutions. Challenges fell under themes of structural factors and infrastructure and human and material resources, while solutions also included items within themes of communication, community engagement, and access and planning, processes, and operations. Conclusion: COVID-19 vaccine delivery is challenged by long-standing and structural inequities that disadvantage health service delivery in LMICs. These findings can, and should, be used by global health organizations to efficiently and optimally direct resources to respond to these key challenges and solutions.

Suggested Citation

  • Archchun Ariyarajah & Isha Berry & Victoria Haldane & Miranda Loutet & Fabio Salamanca-Buentello & Ross E G Upshur, 2022. "Identifying priority challenges and solutions for COVID-19 vaccine delivery in low- and middle-income countries: A modified Delphi study," PLOS Global Public Health, Public Library of Science, vol. 2(9), pages 1-13, September.
    • Handle: RePEc:plo:pgph00:0000844
    DOI: 10.1371/journal.pgph.0000844
    as

    Download full text from publisher

    File URL: https://journals.plos.org/globalpublichealth/article?id=10.1371/journal.pgph.0000844
    Download Restriction: no
    File URL: https://journals.plos.org/globalpublichealth/article/file?id=10.1371/journal.pgph.0000844&type=printable
    Download Restriction: no
    File URL: https://libkey.io/10.1371/journal.pgph.0000844?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Solís Arce, Julio S. & Warren, Shana S. & Meriggi, Niccolò F. & Scacco, Alexandra & McMurry, Nina & Voors, Maarten & Syunyaev, Georgiy & Malik, Amyn Abdul & Aboutajdine, Samya & Adeojo, Opeyemi & Anig, 2021. "COVID-19 vaccine acceptance and hesitancy in low- and middle-income countries," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 27, pages 1-1.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Borisova, Ekaterina & Gründler, Klaus & Hackenberger, Armin & Harter, Anina & Potrafke, Niklas & Schoors, Koen, 2023. "Crisis experience and the deep roots of COVID-19 vaccination preferences," European Economic Review, Elsevier, vol. 160(C).
    2. Soheil Shayegh & Javier Andreu-Perez & Caroline Akoth & Xavier Bosch-Capblanch & Shouro Dasgupta & Giacomo Falchetta & Simon Gregson & Ahmed T Hammad & Mark Herringer & Festus Kapkea & Alvaro Labella , 2023. "Prioritizing COVID-19 vaccine allocation in resource poor settings: Towards an Artificial Intelligence-enabled and Geospatial-assisted decision support framework," PLOS ONE, Public Library of Science, vol. 18(8), pages 1-11, August.
    3. Abanoub Riad & Anna Jouzová & Batuhan Üstün & Eliška Lagová & Lukáš Hruban & Petr Janků & Andrea Pokorná & Jitka Klugarová & Michal Koščík & Miloslav Klugar, 2021. "COVID-19 Vaccine Acceptance of Pregnant and Lactating Women (PLW) in Czechia: An Analytical Cross-Sectional Study," IJERPH, MDPI, vol. 18(24), pages 1-24, December.
    4. Naotoshi Nakamura & Yurie Kobashi & Kwang Su Kim & Hyeongki Park & Yuta Tani & Yuzo Shimazu & Tianchen Zhao & Yoshitaka Nishikawa & Fumiya Omata & Moe Kawashima & Makoto Yoshida & Toshiki Abe & Yoshik, 2024. "Modeling and predicting individual variation in COVID-19 vaccine-elicited antibody response in the general population," PLOS Digital Health, Public Library of Science, vol. 3(5), pages 1-23, May.
    5. Wen Jiao & Peter Johannes Schulz & Angela Chang, 2024. "Addressing the role of eHealth literacy in shaping popular attitudes towards post-COVID-19 vaccination among Chinese adults," Palgrave Communications, Palgrave Macmillan, vol. 11(1), pages 1-11, December.
    6. Josh Bullock & Justin E. Lane & F. LeRon Shults, 2022. "What causes COVID-19 vaccine hesitancy? Ignorance and the lack of bliss in the United Kingdom," Palgrave Communications, Palgrave Macmillan, vol. 9(1), pages 1-7, December.
    7. Wu, Jian & Shen, Zhanlei & Li, Quanman & Tarimo, Clifford Silver & Wang, Meiyun & Gu, Jianqin & Wei, Wei & Zhang, Xinyu & Huang, Yanli & Ma, Mingze & Xu, Dongyang & Ojangba, Theodora & Miao, Yudong, 2023. "How urban versus rural residency relates to COVID-19 vaccine hesitancy: A large-scale national Chinese study," Social Science & Medicine, Elsevier, vol. 320(C).
    8. Bonsang, Eric & Pronkina, Elizaveta, 2023. "Family size and vaccination among older individuals: The case of COVID-19 vaccine," Economics & Human Biology, Elsevier, vol. 50(C).
    9. Hess, Stephane & Lancsar, Emily & Mariel, Petr & Meyerhoff, Jürgen & Song, Fangqing & van den Broek-Altenburg, Eline & Alaba, Olufunke A. & Amaris, Gloria & Arellana, Julián & Basso, Leonardo J. & Ben, 2022. "The path towards herd immunity: Predicting COVID-19 vaccination uptake through results from a stated choice study across six continents," Social Science & Medicine, Elsevier, vol. 298(C).
    10. (Kevin) Li, Shaobo & Chen, Nuoya & Chan, Elaine & Guo, Yang (Jenny), 2024. "Loss framing increases entity theorists’ vaccine uptake," International Journal of Research in Marketing, Elsevier, vol. 41(4), pages 745-760.
    11. Markhof, Yannick & Wollburg, Philip & Zezza, Alberto, 2025. "Beyond the records: Data quality and COVID-19 vaccination progress in low- and middle-income countries," Journal of Development Economics, Elsevier, vol. 174(C).
    12. Armand, Alex & Augsburg, Britta & Bancalari, Antonella & Kameshwara, Kalyan Kumar, 2024. "Religious proximity and misinformation: Experimental evidence from a mobile phone-based campaign in India," Journal of Health Economics, Elsevier, vol. 96(C).
    13. Bussolo, Maurizio & Sarma, Nayantara & Torre, Iván, 2023. "The links between COVID-19 vaccine acceptance and non-pharmaceutical interventions," Social Science & Medicine, Elsevier, vol. 320(C).
    14. Islam, Asad & Kusnadi, Gita & Rezki, Jahen & Sim, Armand & van Empel, Giovanni & Vlassopoulos, Michael & Zenou, Yves, 2024. "Addressing vaccine hesitancy using local ambassadors: A randomized controlled trial in Indonesia," European Economic Review, Elsevier, vol. 163(C).
    15. Nicholls, Nicky & Pleace, Michelle & Yitbarek, Eleni, 2024. "Trust in government, social media and willingness to vaccinate," Social Science & Medicine, Elsevier, vol. 360(C).
    16. Mishaal M. Almutairi & Mohammad Yamin & George Halikias & Adnan Ahmed Abi Sen, 2021. "A Framework for Crowd Management during COVID-19 with Artificial Intelligence," Sustainability, MDPI, vol. 14(1), pages 1-13, December.
    17. Albornoz, Facundo & Bottan, Nicolas & Cruces, Guillermo & Hoffmann, Bridget & Lombardi, María, 2024. "Backlash against expert recommendations: Reactions to COVID-19 advice in Latin America," Journal of Economic Behavior & Organization, Elsevier, vol. 228(C).
    18. Armand, Alex & Augsburg, Britta & Bancalari, Antonella & Kameshwara, Kalyan Kumar, 2022. "Social Proximity and Misinformation: Experimental Evidence from a Mobile Phone-Based Campaign in India," CEPR Discussion Papers 16492, C.E.P.R. Discussion Papers.
    19. Maureen Ayikoru, & Cole, Jennifer & Dodds, Klaus & Atcero, Milburga & Bada, Joseph K. & Petrikova, Ivica & Worodria, William, 2023. "Addressing vaccine concerns through the spectrum of vaccine acceptance," Social Science & Medicine, Elsevier, vol. 333(C).
    20. Koo, Moon Su & Lee, Yun Shin & Seifert, Matthias, 2025. "Investigating laypeople’s short- and long-term forecasts of COVID-19 infection cycles," International Journal of Forecasting, Elsevier, vol. 41(2), pages 452-465.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pgph00:0000844. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: globalpubhealth (email available below). General contact details of provider: https://journals.plos.org/globalpublichealth .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.