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91:oral The CAPACITI decision-support tool for national immunization programs prioritization or selecting among multiple vaccination products, services, or strategies
  1. Maarten Jansen1,
  2. Dijana Spasenoska1,
  3. Siobhan Botwright1,
  4. Birgitte K Giersing1,
  5. Martin I Meltzer2,
  6. Anna-Lea Kahn1,
  7. Mark Jit3,
  8. Rob Baltussen4,
  9. Nathalie El Omeiri5,
  10. Joseph N-M Biey6,
  11. Kelly L Moore7,
  12. Praveen Thokala8,
  13. Jason M Mwenda9,
  14. Melanie Bertram1,
  15. Raymond CW Hutubessy1
  1. 1World Health Organization, Geneva, Switzerland
  2. 2Centers for Disease Control and Prevention, Atlanta, GA, USA
  3. 3London School of Hygiene and Tropical Medicine, London, UK
  4. 4Radboud University Medical Center, Nijmegen, The Netherlands
  5. 5Pan American Health Organization, WHO Regional Office for the Americas, Washington, DC, USA
  6. 6Inter-Country Support Team, Regional Office for Africa, World Health Organization, Ouagadougou, Burkina Faso
  7. 7Vanderbilt School of Medicine, Nashville, TN, USA
  8. 8University of Sheffield, Western Bank, Sheffield, UK
  9. 9WHO Regional Office for Africa, Republic of Congo, Cite du D’Joue, Brazzaville, Congo


Objectives Immunization programs in low-income and middle-income countries (LMICs) are faced with an ever-growing number of vaccines of public health importance recommended by the World Health Organization, while also financing a greater proportion of the program through domestic resources. More than ever, national immunization programs must be equipped to contextualize global guidance and make choices that are best suited to their setting. The CAPACITI decision support tool has been developed in collaboration with national immunization program decision makers in LMICs to structure and document an evidence-based, context-specific process for prioritizing or selecting among multiple vaccination products, services, or strategies.

Methods The CAPACITI decision-support tool is based on multi-criteria decision analysis, as a structured way to incorporate multiple sources of evidence and stakeholder perspectives. The tool has been developed iteratively in consultation with 12 countries across Africa, Asia, and the Americas.

Results The tool is flexible to existing country processes and can follow any type of multi-criteria decision analysis or a hybrid approach. It is structured into 5 sections: decision question, criteria for decision making, evidence assessment, appraisal, and recommendation. The Excel-based tool guides the user through the steps and document discussions in a transparent manner, with an emphasis on stakeholder engagement and country ownership.

Conclusions Pilot countries valued the CAPACITI decision-support tool as a means to consider multiple criteria and stakeholder perspectives and to evaluate trade-offs and the impact of data quality. With use, it is expected that LMICs will tailor steps to their context and streamline the tool for decision making.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: .

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