The role of Zambia’s expansive Inter-agency Coordinating Committee (ICC) in supporting evidence-based vaccine and health sector programming

New vaccines, technologies, and regulations, alongside increased demand for vaccines, all require prioritization and coordination from key players within the vaccine sector. Inter-agency Coordinating Committees (ICC) support decision-making and coordination at the national-level and act as key drivers for sustainable improvements in vaccination programming. We employed a qualitative case study design to investigate critical success factors for the high routine immunization coverage in Zambia from 2000-2018. Qualitative data were collected between October 2019 and February 2020, including key informant interviews (n=66) at the national, provincial, district, and health facility levels. Thematic analysis was applied to understand the role of the Zambian ICC and its impact on the policy environment overtime. Throughout our study period, the Zambian ICC demonstrated the following improvements: 1) expanded membership to include diverse representation; 2) expanded scope and mandate to include maternal and child health in decision-making; and 3) collaboration with the ZITAG through distinct roles. The diverse and expansive membership of the Zambian ICC, along with its ability to foster government commitment and lobby for additional resources, supported improvements in immunization programming. The Zambian ICC holds considerable influence on government agencies and external partners which facilitates procurement of funding, policy decisions, and strategic planning. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Funding from the Bill and Melinda Gates Foundation. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the University of Zambia Biomedical Research Ethics Committee (Federal Assurance No. FWA00000338, REF. No. 166-2019), the National Health Research Authority in Zambia, and the Institutional Review Board committee of Emory University, Atlanta, Georgia, USA (IRB00111474). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Available upon request