Localizing Commitments, Challenges, and Insights on the Road to Immunization Agenda 2030: Responses from 6,185 national and sub-national staff (Immunization Agenda 2030 Full Learning Cycle, 7 March - 20 June 2022)

# Localizing Commitments, Challenges, and Insights on the Road to Immunization Agenda 2030: Responses from 6,185 national and sub-national staff (Immunization Agenda 2030 Full Learning Cycle, 7 March - 20 June 2022)

## Abstract
This data set contains survey responses from over 6,000 national and subnational immunization staff who applied to participate in a 2022 Full Learning Cycle (FLC) learning programme of The Geneva Learning Foundation (TGLF), intended to contribute to the Movement for Immunization Agenda 2030. The 95-item questionnaire collected information on respondents' commitment to the movement's principles, demographics, work challenges, motivation and learning culture, and the impact of COVID-19 on routine immunization. The purpose was to understand applicants' priority challenges and readiness to engage in peer learning to advance country and global immunization goals. Questions addressed consent, identity confirmation, COVID-19 vaccination status, employer, role, system level, past participation in the sponsoring organization's programs, work and wellbeing, difficulties with COVID-19 vaccination, outbreak response, gender equity, and reaching zero-dose children. Applicants identified one priority challenge in their work that they would seek to address through the program. This data set offers insights into frontline perspectives on strengthening immunization programs. Secondary analysess were performed in 2022 and 2023 to illuminate human resource issues, gender barriers, pandemic recovery, and peer learning for change.

## Research Audience

Education and global health researchers with interest in human resources for health (HRH) and the characteristics, priority challenges, and experiences of national and sub-national immunization staff participating in the Movement for Immunization Agenda (IA) 2030.

## Credits

### Author

The Geneva Learning Foundation (TGLF)
18 Avenue Louis Casaï 
CH1209 Geneva, Switzerland
[e-mail]

### Principal Investigator and Corresponding Author
Reda Sadki, TGLF
[e-mail]

### Project Partners
- Biostat Global Consulting (BGC)
- Bridges to Development
- Centre for Change & Complexity in Learning (C3L)

### Partners' Roles and Responsibilities
- Design: TGLF
- Implementation (sample collection): TGLF
- Processing: TGLF, C3L
- Anonymization: BGC
- Data cleaning: Bridges to Development
- Submission: TGLF
- Maintenance of learning analytics database where data are stored: C3L

### Funding
Wellcome Trust, Bill & Melinda Gates Foundation (BMGF)

## Recommended Citation
The Geneva Learning Foundation, 2023. Full Learning Cycle (2022) Application for national and sub-national immunization staff to identify challenges and join the Movement for Immunization Agenda (IA 2030) (Version 1.0) [Data Set]. The Geneval Learning Foundation. [DOI:https://doi.org/10.5281/zenodo.8199552](https://zenodo.org/record/8199552)

## File List
IA2030_EN_FLC_2022_Application_Survey.README.md (this document)

20220211.IA2030-EN Movement application-FINAL.docx: List of questions included in the questionnaire. (Note: skip patterns are not shown.)

IA2030_EN_Application_Survey_Dataset.xlsx: English version of anonymized Application Survey Dataset. Version 1: Geneva Learning Foundation, 11 August 2023. (6,669 observations; 58 variables)

## Related Data Sets
This is a subset of data collected by The Geneva Learning Foundation (TGLF) during the first IA2030 Full Learning Cycle (FLC). The complete IA2030 Application Survey data set is more comprehensive, and includes information such as respondents' gender, employer, professional role, country, and health system level, as well as responses to open-text questions. 

Researchers who would like to analyze the full set of unredacted responses are invited to contact the Geneva Learning Foundation to inquire about a Data Sharing Agreement that would stipulate conditions of access ([e-mail]).

The Geneva Learning Foundation, 2023. Value Creation Stories (VCS) weekly feedback survey, 2022 Full Learning Cycle (FLC) of the Movement for Immunization Agenda 2030 (IA2030) (Version 1.0). [Data Set]. The Geneva Learning Foundation. DOI: https://doi.org/10.5281/zenodo.7763922 

Additional data sets for the first Full Learning Cycle (FLC) of the Movement for Immunization Agenda 2030 (IA2030) are available from TGLF's Insights Unit ().

## Survey Purpose

The Immunization Agenda 2030, the global immunization strategy for 2021-2030, set ambitious targets for global immunization coverage and other key indicators (World Health Organization [WHO], 2023a).

In response to the WHO Director-General's call for a social movement to ensure immunization remains a priority for global and regional health agendas and promote broad societal support for immunization (WHO, 2023b), TGLF, working with its global community of over 35,000 alumni, developed a learning programme intended to contribute to a “Movement for Immunization Agenda 2030 (IA2030)”.

In addition to participating in structured peer learning activities, applicants made a pledge to work towards IA2030 and their country's goals, adhere to the IA2030 core principles, and to provide support to their peers making similar commitments.

The purpose of the IA2030 Application Survey was to collect demographic and organizational information from immunization workers who work at the national or sub-national level interested in applying for the 2022 Learning Cycle and for membership in the Movement for IA2030.

## Survey Questionnaire
The survey questionnaire consisted of both quantitative (Likert) and qualitative (open-text) responses to 95 questions documenting respondents' commitment to joining the Movement for IA2030 and adhering to relevant principles, demographic characteristics, information about work history and role, work and well-being, learning culture and performance, COVID-19 recovery efforts through vaccination campaigns and routine immunization (including outreach), priority work-related challenges, and most important reason for wanting to join the Movement for IA2030.

Survey content was informed by TGLF's six years of experience working with thousands of immunization workers from over 90 countries.

The survey was administered in English and French. While most of questions were required, several items, including questions about work and well-being and COVID-19 vaccination status, were optional.

### Question Scaling and Response Options
Most questions were asked with a 'select one response' instruction, but several encouraged the respondent to 'select all that apply'.
- AP_CAR_20    Which of these job categories apply to you?
- AP_ENV_55    Where you work, what strategies have been put in place to reach under immunized or zero-dose children?
- AP_CHA_63    Is your challenge related to any of these?
- AP_ENV_78    What actions are being taken at your level of the health system to strengthen RI or PHC that specifically takes advantage of some aspect of COVID-19 vaccine introduction?
- AP_ENV_87    Select all activities used for catch-up.
- AP_ENV_91    What were the disruptions related to?

Each person's several responses are stored in a single text variable and separated by commas. Some data management will be necessary to divide these strings of text into individual variables to represent each response option.

## Overview of questionnaire for respondents
The following information was shared with all applicants to provide an overview of the questions and their rationale.

First, we ask you for:
- Consent to share your data, to confirm your supervisor’s support, and to make commitments to follow country and WHO guidelines on COVID-19 and immunization
- Your legal name and birthdate to confirm your identity for certification.
- Your WhatsApp number to connect you with other participants in the Movement.
- Your organization, role, and health system level, and if you are a TGLF alum.
- We ask you about your work and well-being: Before we ask you about the challenges you face, we ask about your work and well-being, especially your motivation and how learning is being supported where you work.
- We ask about the challenges you face: In 2020, global immunization coverage levels for infants dropped back to 2009 levels. It is like we lost 11 years of hard work. So we ask you about the challenges you face: COVID-19 vaccination, epidemic outbreaks (measles, yellow fever, etc.), gender barriers, and zero-dose children.
- We ask you to pick the challenge that you will work on in the Movement: Then we ask you to identify your most difficult and important challenge. This is the one that you will focus on in the Movement. (You can always change later.)
- Are you truly committed to learning with colleagues from all over the world? Because the Movement is about learning, sharing experience, and collaborating with others, we ask you to confirm to what extent this is what you want to do.
- We ask you to share your successes, ideas, and lessons learned: Because we know that you have many strengths, we ask you if you want to share a success story, and idea, or a lesson learned with colleagues.
- We ask you if you want to help build and shape the Movement for IA2030: We ask you if you want to join the Organizing Committee to help build the Movement for Immunization Agenda 2030.
- Global partners request your help: Finally, we ask you to answer questions that IA2030 global partners are specifically interested in, about the effect of COVID-19 on routine immunization, catch-up activities, and your own COVID-19 vaccination. (You can choose to skip these questions.)

### Specific questions that respondents were encouraged to reflect upon before writing out their answers
- Tell us more about your work and well-being. What are the worst and best parts of your job? Where do you find the motivation to continue your work? What helps you feel involved in your work?  How has the COVID-19 pandemic changed how you feel about your work? What makes you lose or gain your motivation? 
- Tell us more about the effect of the introduction of the COVID-19 vaccine for routine immunization (RI) and primary health care (PHC) services in the area where you work. Explain what has happened. What measures, if any, have been taken to mitigate disruptions or potential disruptions to health workers involvement in routine immunization due to COVID-19 vaccination activities where you work?
- Do you have a story about gender barriers to immunization that you would like to share?
- Tell us more about what you are doing to reach zero-dose children and missed communities. 
- Tell us more about how we can better support you. What are the barriers for you to tackle the challenge you face? For your challenge, what kind of support would be most helpful to you? Why? Tell us more about your motivation to join the Movement for Immunization Agenda 2030. What do you hope to gain? What do you want to contribute? How will participating in this Movement help you improve your work?
- Do you have something that you want to share with colleagues? What you share does not need to be a “big” idea. We are interested in what you are doing that helps you to continue or improve your immunization work, even in a small way.

## Ethical Considerations
Prior to fielding of the survey, the survey instrument and protocol were subjected to ethical and legal review by TGLF.

Prior to beginning the survey, prospective respondents reviewed a User Agreement and a summary of TGLF's Privacy Policy (https://www.learning.foundation/pages/privacy), which provides information about the personal information the Foundation collects; the ways in which the Foundation uses personal information; and TGLF's procedures for protecting the loss, misuse or alteration of personal information.

Participants who chose to respond to the items relevant to work and well-being and organizational culture were promised that their responses would be strictly confidential and that only anonymous, aggregated data would be shared with others.

## Recruitment Process and Description of the Sample
Members of TGLF's immunization learning community were invited to participate in the survey by email and were encouraged to invite relevant colleagues (immunization workers who work at either the national or sub-national level) to participate by sharing the invitation.

Respondents accessed the survey via the Internet by clicking on the survey link contained in the email.

Inclusion criteria for participation in the survey included being an immunization worker who works at the national or sub-national level.

Only individuals who indicated their direct supervisor at work agreed with their participation and who completed the consent form were permitted to complete a survey.

## Survey Design and Administration
This one-time Internet-based survey was administered as part of the launch of the IA2030 Movement.

The survey was available from February 22, 2022 - June 17, 2022.

Respondents did not receive any incentives for completing the survey.

The survey was hosted on the Typeform server. The survey itself and all information collected for the survey was secured with multiple levels of encryption and access controls to guarantee participant confidentiality, per Typeform policy (https://www.typeform.com/help/a/security-at-typeform-360029259552/?tid=200afff9-65b2-46e2-9553-0063f2c808b6).

## Data Processing and Cleaning
Duplicate surveys were identified using respondents' email addresses and were removed from the data file.

When a duplicate survey was submitted, only the most recent survey data were retained.

## Data Privacy and Anonymization
The data file shared on this site is intentionally incomplete.  Columns holding personally identifying information (e.g., email address, gender, country) have been deleted.

Out of an abundance of caution, columns that could potentially hold personally identifying information (i.e., responses to open-text questions) have been deleted.

In accordance with the privacy policy noted in the questionnaire, responses to questions related to work and well-being and organizational culture have also been redacted.

A complete list of the variables that have been redacted from the data file is provided in the data file "Summary" tab.

Each respondent's record holds a unique identifier in the column named AP_DAT_99.

## Data Availability and Accessibility
This data set is being made available through Zenodo, an open access repository. There are no restrictions on access to open data except those stated in the copyright and license. Researchers who would like to analyze the full set of unredacted responses are invited to contact the Geneva Learning Foundation to inquire about a Data Sharing Agreement that would stipulate conditions of access ([e-mail]).

## Copyright and License
© The Geneva Learning Foundation 2022.

This data set and all associated files are licensed under the Creative Commons Attribution-ShareAlike 4.0 International (CC BY-SA 4.0)

Some rights reserved. This work is available under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International; https://creativecommons.org/licenses/by-nc-sa/4.0/.

Under the terms of this license, you may copy, redistribute and adapt the data set for non-commercial purposes, provided the work is appropriately cited, as indicated above. In any use of this data set, there should be no suggestion that the Foundation endorses any specific organization, products, or services. Any mediation relating to disputes arising under the license shall be conducted in accordance with the mediation rules of the World Intellectual Property Organization.

General disclaimers. The designations employed and the presentation of the data set do not imply the expression of any opinion whatsoever on the part of the Foundation concerning the legal status of any country, territory, city or area or of its authorities. The mention of specific companies or of certain manufacturers' products does not imply that they are endorsed or recommended by the Foundation in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of all reasonable precautions have been taken by the Foundation to verify the information contained in this data set. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for interpretation and use of the material lies with the reader. In no event shall the Foundation be liable for damages arising from its use.

The data set contains individual views and does not necessarily represent the decisions or the policies of the Foundation.

Version 1.0 (11 August 2023).

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