The effect of home visiting programmes on uptake of childhood immunization: a systematic review and meta-analysis

Background The aim of the study was to evaluate the effectiveness of home v isiting programmes on the uptake of childhood immunization. Methods A systematic review was carried out of the literature of controlled studies evaluating home visiting programmes involving at least one post-na tal visit, which included tasks within the remit of British health visiting and reporting outcomes relevant to British health visiting. Eleven studies were considered, nine of which used socio-economically disadvantaged famil ies. The outcome measure was uptake of a range of childhood immunizations. Results Eleven studies reported uptake of immunization. Effect sizes from n ine studies were included in the metaanalysis. Fixed effects models demonst rated a significant effect of home visiting for all studies and also for se veral subgroups of studies, but with significant heterogeneity of effect si zes. A random effects model failed to demonstrate an effect of home visitin g. Conclusions Home visiting programmes have not been shown to be effective in increasing the uptake of immunization. Other methods of increasing uptake and reducing inequalities in uptake will need to be explored.