Table 2

Describing characteristics of the included studies

AuthorCountrySummary of interventionEngagement typeStudy designDuration (in months)Outcomes
Admassie et al 200931EthiopiaFormation of a cadre of community-based health extension workers and using community resources for construction of health posts.
The study evaluates intervention effectiveness and cost-effectiveness.		Multiple (EII+EAI)PSM48FIC, BCG, DPT3, OPV1, OPV2, OPV3, measles, morbidity
Adamu et al 201932NigeriaQuality improvement programme where health workers use iterative processes to develop localised and contextually relevant plans to resolve health service delivery and demand bottlenecks.
The study evaluates intervention effectiveness.		Multiple (EID+EII)ITS1Dropouts
Alhassan et al 201933GhanaUsing a bottom-up approach, the intervention recruited and trained community groups to identify service delivery gaps in healthcare facilities.
The study evaluates intervention effectiveness.		Multiple (EII+EAI)RCT10FIC
Andersson et al 200934PakistanCommunity dialogues to address barriers to vaccination. The guidelines for the dialogue were created after consultation with the intended beneficiaries.
The study evaluates intervention effectiveness and cost-effectiveness.		Multiple (EID+EAI)RCT8Knowledge about immunisation, attitude about immunisation, community norms, readiness to vaccinate, household norms and decision-making measles, DPT3
Arifeen et al 200935BangladeshFormation of a cadre of village health volunteers and enlisting support of local religious leaders to convey messages about child health.
The study evaluates intervention effectiveness.		EAIRCT71Measles, mortality
Assegaai et al 201836South AfricaLay community-based workers were formalised as community health workers and served as a part of the outreach teams.
The study evaluates intervention effectiveness.		EAIDID36FIC, measles, morbidity
Banerjee et al 201037IndiaProvision of immunisation services and incentives to caregivers. A trusted community-based organisation was a key stakeholder in design and delivery of the intervention.
The study evaluates intervention effectiveness and cost-effectiveness.		Treatment 1: EAI
Treatment 2:
Multiple (EID+EAI)		RCT18FIC, BCG, partial immunisation
Banerjee et al 202038IndiaThis evaluation tested two different interventions:

  1. Incentives to caregivers. The community’s feedback was solicited on the kind of incentive.

  2. Community influencers were identified to spread information about immunisation.


The study evaluates intervention effectiveness and cost-effectiveness.		EID
EAI		RCT14Knowledge about immunisation, attitude about immunisation, FIC, DPT1, DPT2, DPT3, measles
Banwat et al 201539NigeriaFemale members of the community whose children are fully immunised were nominated in each community to serve as peer educators.
The study evaluates intervention effectiveness.		EAICBA–FIC, knowledge about immunisation, attitude about immunisation, readiness to vaccinate
Biemba et al 201640ZambiaA national policy to create a cadre of well-trained and motivated community-based health workers.
The study evaluates intervention effectiveness.		EAIDID23FIC, morbidity
Björkman et al 200941UgandaCommunities were involved in monitoring the quality of health services and the performance of health service providers.
The study evaluates intervention effectiveness and cost-effectiveness.		EIIRCT0.16FIC, BCG, OPV0, OPV3, DPT1, DPT3, measles, Partial routine immunisation, mortality
Bolam et al 199842NepalTraining for community health workers and midwives which was developed in collaboration with health workers and experts.
The study evaluates intervention effectiveness.		EIDRCT3FIC
Borkum et al 2014
Carmichael et al 2019 (linked study)43 44		IndiaPerformance-based incentives to frontline workers. The nature of incentives was decided on in consultation with the frontline workers.
The study evaluates intervention effectiveness and cost-effectiveness.		EIDRCT12Health card availability, CHW capacity, FIC, BCG, DPT1, DPT2, DPT3, OPV1, OPV2, OPV3, measles, partial immunisation, timeliness
Calderón-Ortiz and Mejía-Mejía 199645MexicoCreation of a community-based cadre of volunteers to register and track children in the community for immunisation.
The study evaluates intervention effectiveness.		EAICBA4FIC, BCG, DPT3, OPV3, measles
Carnell et al 201446EthiopiaFormation of a cadre of community health workers to mobilise the community and encourage uptake of health services.
The study evaluates intervention effectiveness and cost-effectiveness.		EAIDID60DPT3, measles
Costa-Font et al 201747IndiaEstablishment of the village health and sanitation committees to monitor health service provision at the community level.
The study evaluates intervention effectiveness.		EAIIV–BCG, DPT1, OPV0
Demilew et al 202048EthiopiaA poster/stamp system that reminded health workers of the child’s immunisation status and simultaneously encouraged caregivers to immunise their children. The intervention was designed in consultation with health workers.
The study evaluates intervention effectiveness and cost-effectiveness.		Multiple (EID+EAI)RCT17FIC, BCG, DPT1, DPT2, DPT3, partial immunisation
Dipeolu 201749NigeriaText message reminders to mothers regarding immunisation schedule. The messages were field tested with mothers to get the content right.
The study evaluates intervention effectiveness.		EIDDID9Knowledge about immunisation, attitude about immunisation, timeliness
Domek et al 201950GuatemalaSMS text messages to caregivers. A prior feasibility and acceptability study was conducted for the intervention.
The study evaluates intervention effectiveness.		EIDRCT2Timeliness
Engineer et al 201651AfghanistanPay-for-performance bonuses paid quarterly to health workers. The bonus amount was revised after receiving health worker feedback.
The study evaluates intervention effectiveness.		EIDRCT24Experience & satisfaction with health services, Formal HW motivation, capacity & performance, DPT3
Findley et al 201352NigeriaFormation of a cadre of community volunteers to facilitate group discussions on health and track/register women/children for health services.
The study evaluates intervention effectiveness and cost-effectiveness.		EAIDID24FIC
Gibson et al 201753KenyaSMS reminders and monetary incentives to caregivers. A feasibility study was conducted in 2013 for this intervention.
The study evaluates intervention effectiveness.		EIDRCT12Community norms, FIC, BCG, DPT1, DPT2, DPT3, OPV0, OPV1, OPV2, measles, timeliness
Goel et al 201254IndiaA multi-component campaign which involved women groups in awareness generation to improve health service uptake.
The study evaluates intervention effectiveness.		EAIDID48FIC
Gurley et al 202055IndiaCommunity members were trained to design and produce culturally appropriate, ‘hyperlocal’ videos to promote health seeking behaviours.
The study evaluates intervention effectiveness and cost-effectiveness.		Multiple (EID+EAI)RCT11Knowledge about immunisation, attitude about immunisation, FIC, DPT3, partial immunisation, timeliness, dropouts
Herrera-Almanza and Rosales-Rueda 201856MadagascarCommunity-based primary healthcare services intervention that included the deployment of volunteer community health workers in remote areas.
The study evaluates intervention effectiveness.		Multiple (EII+EAI)DID26Health card availability, OPV3, DPT3, measles, mortality, partial immunisation
Igarashi et al 201057ZambiaThe GMP+sessions were conducted by medical personnel from Public Health Centres. During these sessions, community volunteers provided some operational and managerial support to ensure the effective implementation of the sessions.
The study evaluates intervention effectiveness.		EIICBA43FIC, timeliness, attitude about immunisation, community norms
Janssens 201158IndiaDissemination of health promoting messages to women in the community who are encouraged to further spread the awareness.
The study evaluates intervention effectiveness.		EAIIV56.4DPT3, measles
Johri et al 202059IndiaInterventions, designed through formative research, to increase caregiver knowledge and adherence to childhood immunisation.
The study evaluates intervention effectiveness.		EIDRCT3Knowledge about immunisation, Awareness of place, time, schedule for vacc., attitude about immunisation
Lee 201560ZambiaCreation of a new cadre of frontline workers from the community, called community health assistants, to provide primary healthcare services.
The study evaluates intervention effectiveness.		EAURCT3Formal HW motivation, capacity & performance, BCG, OPV3, measles, timeliness, CHW capacity, morbidity
Mayumana et al 201761TanzaniaPayment-for-performance scheme for health facilities. Health workers and health facility governing committees decided the allocation of funds.
The study evaluates intervention effectiveness.		EIIDID30Stockouts
Memon et al 201562PakistanFormation of community health committees to promote perinatal and new-born care. Formative research informed the intervention design.
The study evaluates intervention effectiveness.		Multiple (EID+EAI)DID16FIC
Modi et al 201963IndiaThe mHealth intervention package consisting of mobile phone-based job aids for community health workers. The intervention was piloted in 2015.
The study evaluates intervention effectiveness and cost-effectiveness.		EIDRCT12DPT3, morbidity
Mohanan et al 202064IndiaSocial accountability interventions to promote community-based collective action to improve delivery of health and nutrition services to children.
The study evaluates intervention effectiveness and cost-effectiveness.		EAIRCT12Experience & satisfaction with health services, attitudes about health providers, formal health worker supply, FIC, BCG, DPT3, OPV1, OPV3, IPV, measles, morbidity, mortality
More et al 201265IndiaUrban slum-dweller women’s groups used community dialogues to address barriers to improving perinatal health.
The study evaluates intervention effectiveness.		EAIRCT36Mortality
More et al 201766IndiaThe intervention comprised multiple activities like home visits to caregivers, groups meetings, community events and other supportive services.
The study evaluates intervention effectiveness and cost-effectiveness.		EAIRCT24Health card availability, attitudes about health providers, FIC, BCG, measles, partial immunisation
Morris et al 200467HondurasMonetary vouchers to women in the communities and setting up of community-based committees to oversee health service quality and access.
The study evaluates intervention effectiveness and cost-effectiveness.		EAIRCT24DPT1, measles
Murthy et al 201968IndiaVoice call reminders to pregnant women and caregivers. The message content was tested for appropriateness through community focused groups.
The study evaluates intervention effectiveness.		EIDRCT21Knowledge about immunisation, FIC
Nagar et al 201869IndiaA digital pendant-based health record of the child and a voice call reminder system. A formative study was conducted in 2016 and communities were consulted on the design of the pendant.
The study evaluates intervention effectiveness.		EIDRCT3Timeliness
Nagar et al 202070IndiaA digital pendant-based health record of the child. Health providers used a mobile application to scan the pendant to update the child’s medical history. Prior formative research informed the intervention design.
The study evaluates intervention effectiveness and cost-effectiveness.		EIDRCT20FIC, DPT1, DPT2, DPT3
Nzioki et al 201771KenyaFormation of a cadre of community health workers.
The study evaluates intervention effectiveness.		EAICBA0FIC
Oche et al 201172NigeriaGroup meetings with caregivers and dialogues with community leaders to improve uptake of routine immunisation services.
The study evaluates intervention effectiveness.		EAIDID9Knowledge about immunisation, DPT1, DPT3, dropouts
Okeke et al 201773NigeriaA national scheme to create, train and deploy a cadre of midwives to serve underserved rural and remote populations in Nigeria.
The study evaluates intervention effectiveness.		Multiple (EII+EAI)DID40BCG, DPT3, OPV3, measles, mortality
Okoli et al 201474NigeriaA conditional cash transfer programme to encourage uptake of health services. Community groups were consulted while deciding the cash amount.
The study evaluates intervention effectiveness.		EIDITSseven to 18OPV0
Olayo et al 201475KenyaFormation of a cadre of community health workers who then facilitated dialogue at the community level and supported other community-based workers.
The study evaluates intervention effectiveness.		Multiple (EII+EAI)DID24Health card availability, DPT1, DPT3, measles
Olken et al 201476IndonesiaBlock grants for maternal and child health that incorporated relative performance incentives were implemented in villages through creation of village-level health committees.
The study evaluates intervention effectiveness and cost-effectiveness.		Multiple (EII+EAI)RCT18 to 30FIC, morbidity, mortality
Oyo-Ita et al 202077NigeriaA multi-component intervention involving traditional and religious leaders for engaging communities in planning and delivery of immunisation services.
The study evaluates intervention effectiveness and cost-effectiveness.		Multiple (EII+EAI)RCT18FIC, partial immunisation, Timeliness
Pramanik et al 202078IndiaTrained facilitators from local NGOs interacted with the communities to enable them to leverage their own strengths for addressing their concerns related to child health.
The study evaluates intervention effectiveness and cost-effectiveness.		EAIRCT13Knowledge about immunisation, attitude about immunisation, attitudes about health providers, health card availability, FIC, DPT1, DPT2, DPT3, timeliness, dropouts
Rahman et al 200879PakistanMental health support programme with counselling sessions for pregnant and post-partum women. Prior intervention pilots informed the intervention design.
The study evaluates intervention effectiveness.		EIDRCT11FIC, morbidity
Rahman et al 201680BangladeshNew cadre of community health workers delivered essential maternal, neonatal and child healthcare and nutrition services.
The study evaluates intervention effectiveness.		EAIDID48FIC, morbidity
Rao 201481IndiaCreation of a cadre of community health workers to improve basic health outcomes through community engagement.
The study evaluates intervention effectiveness.		EAIDID60BCG, DPT3, OPV3, measles, FIC, partial immunisation, supply of CHWs
Robertson et al 201382ZimbabweUse of cash transfers for behaviour change. Local NGO and community leaders were involved in beneficiary targeting and compliance monitoring. The intervention was also tested for feasibility during a prior study.
The study evaluates intervention effectiveness.		Multiple (EID+EII)RCT12FIC, community norms, OPV0
Roy et al 200883BangladeshRural maintenance programme recruited and trained women for road maintenance, health awareness, numeracy, human rights, gender equity, health and nutrition, and business management.EAIDID11FIC, BCG, DPT1, DPT2, DPT3, OPV0, OPV1, OPV2, OPV3, measles, partial immunisation
Saggurti et al 201884IndiaFormation of health-focused self-help groups with women of reproductive age coming from the most marginalised communities.
The study evaluates intervention effectiveness and cost-effectiveness.		EAIDID2Timeliness
Sankar 201385IndiaFormation of committees with representatives of the community, local government and service providers to ensure better convergence and coordination of service delivery.
The study evaluates intervention effectiveness.		Multiple (EII+EAI)DID30FIC, BCG, DPT1, DPT2, DPT3, OPV0, OPV1, OPV2, OPV3, measles, partial immunisation, timeliness
Seth et al 201886IndiaThe study evaluated two different interventions: role of compliance-linked incentives vs text messaging to improve childhood immunisations. Incentive amount was determined after input was received from the local investigators as well as the community workers.
The study evaluates intervention effectiveness and cost-effectiveness.		EIDRCT9.7Partial immunisation, timeliness, attitude about immunisation, attitudes about health providers
Shukla 201887AfghanistanCommunity representatives along with health officials identify the health needs of the communities and communicate those to the service providers.
The study evaluates intervention effectiveness.		EIIDID6Supply of CHWs, DPT3
Siddiqi et al 202088PakistanVisual reminders to caregivers in the form of wearable bracelets for the child. The bracelets were designed in consultation with the caregivers.
The study evaluates intervention effectiveness.		EIDRCT12DPT3, measles
Tandon et al 198889IndiaEnlisting community-based volunteers to motivate and encourage family members to use maternal and child health services.
The study evaluates intervention effectiveness.		EAICBA120FIC, BCG, DPT2, DPT3, OPV2
USAID 200890EthiopiaCreation of a cadre of community health promoters to carry out behaviour change communication activities in the communities.
The study evaluates intervention effectiveness.		EAICBA48FIC, BCG, DPT1, DPT3, OPV3, morbidity, health card availability, measles, dropouts
Webster et al 201991UgandaCommunity-based outreach and follow-up with caregivers to improve immunisation uptake and reduce defaulters.
The study evaluates intervention effectiveness and cost-effectiveness.		EIIRCT12Health card availability, BCG, DPT1, DPT2, DPT3, OPV0, OPV1, OPV2, OPV3, IPV, measles, partial immunisation, timeliness, attitude about immunisation, dropouts, morbidity, mortality
Younes et al 201492BangladeshThe intervention involved 162 women’s groups who used participatory approaches to discuss maternal and neonatal health issues.
The study evaluates intervention effectiveness.		EAIDID20FIC, morbidity

  • CBA, Controlled before-after; CHWs, community health workers; DID, Difference-in-difference; EAI, Engagement as intervention; EID, Engagement in Design; EII, Engagement in implementation autonomy; FIC, Full immunisation coverage; ITS, Interrupted time series; NGOs, Non-government organisations; RCT, randomised controlled trial.