People don’t like waiting in line, whether in a supermarket or in a clinic waiting room. Long wait times have been associated with failure to complete an immunization course*; busy parents don’t have the time to waste. In Lagos, Nigeria, one initiative to address high dropout rates took a careful look at the intake process of a local health clinic.

After mapping the journey of a patient, the researchers identified an opportunity to make a simple change to the patient intake experience. They divided the waiting room into two groups: mothers coming to immunize children were separated from all other patients. The clinic created a special immunization station where carers were directed after checking in at reception.** There was no need for the usual procedures of taking a patient’s history and administering a physical examination.

This slight tweak in the process led to a 24% increase in monthly vaccinations performed — with no cost increase whatsoever. The percent of registered children fully immunized by age 1 increased by 18% and after age 1 by 32%. A small, deliberate change to the clinic environment yielded outsized changes in outcomes.

Sources: Ekunwe (1984), Expanding immunization coverage through improved clinic procedures
*Favin et al (2012), Why children are not vaccinated: a review of the grey literature
**The intervention also worked with heathcare workers to ensure that all children were receiving immunization, regardless of whether or not they were ill or healthy.