Fig. 1

Vaccine policy formulation and implementation process in Kenya. Note: KENITAG, Kenya National Immunization Technical Advisory Group; MoH, Ministry of Health; NIICC, National Immunization Interagency Coordinating Committee. Domestication refers to the process of deliberating on the national policy document by county committees and coming up with a county policy document (adaptation) in line with the national policy. National policy processes involve problem identification, policy formulation, and policy evaluation. County policy processes involve vaccine policy adaptation. Shared policy process between national and county: vaccine policy implementation. Dotted lines are feedback loops illustrating information flow for issues arising during policy implementation and evaluation processes, communicated back to national level for consideration or action