Most countries have developed communication and social mobilization strategies to increase demand for immunization services as well as to encourage care givers to utilize existing services. However, community engagement and participation are usually limited to short-term successes, such as mobilization during immunization campaigns or new vaccine introductions.
Structural issues are more difficult to overcome, such a≠s a lack of health education staff, particularly at the sub-national levels. Demand creation interventions for routine immunization have been compromised due to a lack of both human and financial resources.
There is also a lack of data to monitor the effectiveness of demand-creating activities. The existing data management systems do not incorporate indicators for communication strategies and community demand for immunization, nor is there a systematic monitoring of community engagement and participatory processes promoted by countries for demand creation.
While demand creation is a crucial issue, accountability on the supply side of immunization is also important. Once communities demand vaccinations, the health system must be able to provide these needs. It is thus critical to build strong, reliable and trustworthy healthy systems in order to achieve and sustain increased immunization coverage.