{
  "abstract": "Introduction In May 2023, when the WHO declared that COVID-19 was no longer a public health emergency of international concern, countries began considering transitioning from the emergency phase to routine provision of COVID-19 vaccination. This paper presents the experience of seven countries with integrating COVID-19 vaccination into other health services and health system functions.Methods Data collection took place between August 2023 and April 2024 in Benin, Ethiopia, Ghana, India (Tamil Nadu State), Liberia, Mozambique and Nigeria using key informant interviews and focus group discussions. Interviewees included national and subnational representatives from across the Ministry of Health, COVID-19 task forces, civil society organisations and partners. Focus group discussions were conducted with health workers.Results While demand for vaccination was low at the time of data collection, six of seven countries had started integrating or planned to integrate COVID-19 vaccination with other health services. Relatively high integration was reported for certain health system functions such as supply chain, while others such as information systems were less integrated. The immunisation programme served as lead on integrating COVID-19 vaccination, but coordinating across other health programmes was a major challenge. Nearly all assessment countries relied on external funding for COVID-19 vaccines; none had plans to self-procure COVID-19 vaccines when external funding ends.Conclusion This article highlights challenges such as a lack of cross-programmatic coordination with clear roles and accountability mechanisms, absence of a clear strategy for sustainable procurement of COVID-19 vaccines, infodemics, as well as considerations countries face in transitioning from emergency response to a more routine approach to COVID-19 vaccination. Opportunities exist to focus COVID-19 vaccination integration efforts in a way that sets the stage for a strengthened life course approach to immunisation; lessons for future emergencies include designing for integration earlier to ensure systems and processes built are leveraged postemergency.",
  "authors": [
    {
      "affiliations": [
        "Results for Development Institute, Nairobi, Kenya"
      ],
      "name": "Cheickna Touré"
    },
    {
      "affiliations": [
        "Independent Consultant, Washington, District of Columbia, USA"
      ],
      "name": "Marty Makinen"
    },
    {
      "affiliations": [
        "Independent Consultant, Washington, District of Columbia, USA"
      ],
      "name": "Adriana Almiñana"
    },
    {
      "affiliations": [
        "Independent Consultant, Washington, District of Columbia, USA"
      ],
      "name": "Grace Chee"
    },
    {
      "affiliations": [
        "Independent Consultant, Washington, District of Columbia, USA"
      ],
      "name": "Natasha Kanagat"
    },
    {
      "affiliations": [
        "Independent Consultant, Washington, District of Columbia, USA"
      ],
      "name": "Rebecca Fields"
    },
    {
      "affiliations": [
        "Independent Consultant, Washington, District of Columbia, USA"
      ],
      "name": "Sakina Kudrati"
    },
    {
      "affiliations": [
        "Results for Development Institute, Washington, District of Columbia, USA"
      ],
      "name": "Laurel Hatt"
    },
    {
      "affiliations": [
        "Results for Development Institute, Washington, District of Columbia, USA"
      ],
      "name": "Leah Hughey Ewald"
    },
    {
      "affiliations": [
        "Consultant, Cotonou, Benin"
      ],
      "name": "Audrey Semevo Eunice Amoussou"
    },
    {
      "affiliations": [
        "Consultant, Cotonou, Benin"
      ],
      "name": "Roch Houngnihin"
    },
    {
      "affiliations": [
        "Republic of Benin Ministry of Health, Cotonou, Benin"
      ],
      "name": "Landry Kaucley"
    },
    {
      "affiliations": [
        "Consultant, Addis Ababa, Ethiopia"
      ],
      "name": "Mulugeta Tamire"
    },
    {
      "affiliations": [
        "Consultant, Addis Ababa, Ethiopia"
      ],
      "name": "Israel Mitiku Hatau"
    },
    {
      "affiliations": [
        "Ethiopia Ministry of Health, Addis Ababa, Ethiopia"
      ],
      "name": "Mebratu Massebo Cherinet"
    },
    {
      "affiliations": [
        "Ethiopia Ministry of Health, Addis Ababa, Ethiopia"
      ],
      "name": "Melkamu Ayalew Kokebie"
    },
    {
      "affiliations": [
        "Internal Medicine, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia"
      ],
      "name": "Aschalew Worku Ashagre"
    },
    {
      "affiliations": [
        "John Snow Inc, Addis Ababa, Ethiopia"
      ],
      "name": "Tewodros Alemayehu"
    },
    {
      "affiliations": [
        "Consultant, Accra, Ghana"
      ],
      "name": "Isaac Yeboah"
    },
    {
      "affiliations": [
        "Ghana Health Service, Accra, Ghana"
      ],
      "name": "Abraham R Oduro"
    },
    {
      "affiliations": [
        "Independent Consultant, Lucknow, Uttar Pradesh, India"
      ],
      "name": "Manish Jain"
    },
    {
      "affiliations": [
        "Directorate of Public Health and Preventive Medicine, Chennai, Tamil Nadu, India"
      ],
      "name": "Thirumalaichiry Sivaprakasam Selvavinayagam"
    },
    {
      "affiliations": [
        "Directorate of Public Health and Preventive Medicine, Chennai, Tamil Nadu, India"
      ],
      "name": "Vinay Kumar"
    },
    {
      "affiliations": [
        "John Snow India Private Limited, New Delhi, India"
      ],
      "name": "Deepak Kotebagilu Guddemane"
    },
    {
      "affiliations": [
        "John Snow India Private Limited, New Delhi, India"
      ],
      "name": "Anil Gupta"
    },
    {
      "affiliations": [
        "John Snow India Private Limited, New Delhi, India"
      ],
      "name": "Gopal Krishna Soni"
    },
    {
      "affiliations": [
        "Consultant, Monrovia, Liberia"
      ],
      "name": "Melvin B Moore"
    },
    {
      "affiliations": [
        "PATH, Maputo, Mozambique"
      ],
      "name": "Yara Voss De Lima"
    },
    {
      "affiliations": [
        "John Snow Inc, Maputo, Mozambique"
      ],
      "name": "Betuel Sigauque"
    },
    {
      "affiliations": [
        "Ministra da Saude, Maputo, Mozambique"
      ],
      "name": "Graça Matsinhe"
    },
    {
      "affiliations": [
        "Consultant, Enugu, Nigeria"
      ],
      "name": "Chinyere Okeke"
    },
    {
      "affiliations": [
        "National Primary Healthcare Development Agency, Abuja, Nigeria"
      ],
      "name": "Adejoke Kolawole"
    }
  ],
  "title": "Integrating COVID-19 vaccination into health systems: qualitative findings from seven countries",
  "uid": "c2bed420-f472-598f-b5f6-feb882f09fb0"
}