A case study of Gavi'S human papillomavirus vaccine support programme

Castro, Aimee; Cinà, Margherita; Helmer-Smith, Mary; Vlček, Christian; Oghor, Collins; Cazabon, Danielle

doi:10.4103/2468-6360.198797

Cited by 5 publications

(3 citation statements)

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“…While Gavi has had a record of success in accelerating the national adoption of the other new vaccines [19], HPV vaccine introduction encountered a challenge of slow adoption. Twenty three countries completed demonstration projects by December 2016, but only 6 had advanced to national scale up phase by Dec 2017, a stark contrast to Gavi's planned target of 8 nationwide HPV vaccine introductions by 2015 [20]. Despite Gavi's effort to accelerate country uptake by removing the required demonstration project phase [21], only 18 LMICs countries have introduced HPV vaccines into their NIPs to date.…”

Section: Introductionmentioning

confidence: 99%

Global health systems partnerships: a mixed methods analysis of Mozambique’s HPV vaccine delivery network actors

et al. 2020

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Background: Global health partnerships have expanded exponentially in the last two decades with Gavi, the Vaccine Alliance considered the model's pioneer and leader because of its vaccination programs' implementation mechanism. Gavi, relies on diverse domestic and international partners to carry out the programs in low-and middle-income countries under a partnership engagement framework (PEF). In this study, we utilized mixed methods to examine Mozambique's Gavi driven partnership network which delivered human papillomavirus (HPV) vaccine during the demonstration phase. Methods: Qualitative tools gauged contextual factors, prerequisites, partner performance and practices while a social network analysis (SNA) survey measured the partnership structure and perceived added value in terms of effectiveness, efficiency and country ownership. Forty key informants who were interviewed included frontline Ministry of Health workers, Ministry of Education staff and supporting partner organization members, of whom 34 participated in the social network analysis survey. Results: Partnership structure SNA connectivity measurement scores of reachability (100%) and average distance (2.5), were high, revealing a network of very well-connected HPV vaccination implementation collaborators. Such high scores reflect a network structure favorable for rapid and widespread diffusion of information, features necessary for engaging and handling multiple implementation scales. High SNA effectiveness and efficiency measures for structural holes (85%) and low redundancy (30%) coupled with high mean perceived effectiveness (97.6%) and efficiency (79.5%) network outcome scores were observed. Additionally, the tie strength average score of 4.1 on a scale of 5 denoted high professional trust. These are all markers of a collaborative partnership environment in which disparate institutions and organizations leveraged each entity's comparative advantage. Lower perceived outcome scores for country ownership (24%) were found, with participants citing the prominent role of several out-of-country partner organizations as a major obstacle.

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Section: Introductionmentioning

confidence: 99%

Global health systems partnerships: a mixed methods analysis of Mozambique’s HPV vaccine delivery network actors

et al. 2020

View full text Add to dashboard Cite

show abstract

“…While Gavi has had a record of success in accelerating the national adoption of the other new vaccines (19), HPV vaccine introduction encountered a challenge of slow adoption. Twenty three countries completed demonstration projects by December 2016, but only 6 had advanced to national scale up phase by Dec 2017, a stark contrast to Gavi's planned target of 8 nationwide HPV vaccine introductions by 2015 (20). Despite Gavi's effort to accelerate country uptake by removing the required demonstration project phase(21), only 18 LMICs countries have introduced HPV vaccines into their NIPs to date.…”

Section: Introductionmentioning

confidence: 99%

A mixed methods analysis of Mozambique’s HPV vaccine delivery network actors.

Soi¹,

Shearer²,

Chilundo³

et al. 2020

Preprint

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Background: Global health partnerships have expanded exponentially in the last two decades with Gavi, the Vaccine Alliance considered the model’s pioneer and leader because of its vaccination programs’ implementation mechanism. Gavi, relies on diverse domestic and international partners to carry out the programs in low- and middle-income countries under a partnership engagement framework (PEF). In this study, we utilized mixed methods to examine Mozambique’s Gavi driven partnership network which delivered human papillomavirus (HPV) vaccine during the demonstration phase.Methods: Qualitative tools gauged contextual factors, prerequisites, partner performance and practices while a social network analysis (SNA) survey measured the partnership structure and perceived added value in terms of effectiveness, efficiency and country ownership. 40 key informants who were interviewed included frontline Ministry of Health workers, Ministry of Education staff and supporting partner organization members, of whom 34 participated in the social network analysis survey.Results: Partnership structure SNA connectivity measurement scores of reachability (100%) and average distance (2.5), were high, revealing a network of very well-connected HPV vaccination implementation collaborators. Such high scores reflect a network structure favorable for rapid and widespread diffusion of information, features necessary for engaging and handling multiple implementation scales. High SNA effectiveness and efficiency measures for structural holes (85%) and low redundancy (30%) coupled with high mean perceived effectiveness (97.6%) and efficiency (79.5%) network outcome scores were observed. Additionally, the tie strength average score of 4.1 on a scale of 5 denoted high professional trust. These are all markers of a collaborative partnership environment in which disparate institutions and organizations leveraged each entity’s comparative advantage. Lower perceived outcome scores for country ownership (24%) were found, with participants citing the prominent role of several out-of-country partner organizations as a major obstacle.Conclusions: While there is room for improvement on the country ownership aspects of the partnership, the expanded, diverse and inclusive collaboration of institutions and organizations that implemented the Mozambique HPV vaccine demonstration project was effective and efficient. We recommend that the country adapt a similar model during national scale up of HPV vaccination.

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“…The World Health Organization (WHO) recommends adoption of HPV vaccination in LMICs, such as Mozambique, where cervical cancer is a major public health priority [19]. Consequently in 2011, Gavi, the Vaccine Alliance (Gavi) added the HPV vaccine to its list of financing-eligible vaccines, paving the way for its inclusion in national immunization programs (NIPs) in LMICs [20]. However, a challenge was encountered: girls ages 9–13 years, the target group for HPV vaccination, are not routinely targeted for immunization and interface with the health system is limited because adolescent-specific health services are minimal to non-existent in these settings [21].…”

Section: Introductionmentioning

confidence: 99%

Implementation strategy and cost of Mozambique’s HPV vaccine demonstration project

et al. 2019

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BackgroundCost is an important determinant of health program implementation. In this study, we conducted a comprehensive evaluation of the implementation strategy of Mozambique’s school-based HPV vaccine demonstration project. We sought to estimate the total costs for the program, cost per fully immunized girl (FIG), and compute projections for the total cost of implementing a similar national level vaccination program.MethodsWe collected primary data through document review, participatory observation, and key informant interviews at all levels of the national health system and Ministry of Education. We used a combination of micro-costing methods—identification and measurement of resource quantities and valuation by application of unit costs, and gross costing—for consideration of resource bundles as they apply to the number of vaccinated girls. We extrapolated the cost per FIG to the HPV-vaccine-eligible population of Mozambique, to demonstrate the projected total annual cost for two scenarios of a similarly executed HPV vaccine program.ResultsThe total cost of the Mozambique HPV vaccine demonstration project was $523,602. The mean cost per FIG was $72 (Credibility Intervals (CI): $62 - $83) in year one, $38 (CI: $37 - $40) in year two, and $54 CI: $49 - $61) for years one and two. The mean cost per FIG with the third HPV vaccine dose excluded from consideration was $60 (CI: $50 - $72) in year one, $38 (CI: $31 - $46) in year two, and $48 (CI: $42 - $55) for years one and two. The mean cost per FIG when only one HPV vaccine dose is considered was $30 (CI: $27 - $33)) in year one, $19 (CI: $15–$23) in year two, and $24 (CI: $22–$27) for both years. The projected annual cost of a two-and one-dose vaccine program targeting all 10-year-old girls in the country was $18.2 m (CI: $15.9 m - $20.7 m) and $9 m (CI: $8 m - $10 m) respectively.ConclusionNational adaptation and scale-up of Mozambique’s school-based HPV vaccine strategy may result in substantial costs depending on dosing. For sustainability, stakeholders will need to negotiate vaccine price and achieve higher efficiency in startup activities and demand creation.

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A case study of Gavi'S human papillomavirus vaccine support programme

Cited by 5 publications

References 0 publications

Global health systems partnerships: a mixed methods analysis of Mozambique’s HPV vaccine delivery network actors

Global health systems partnerships: a mixed methods analysis of Mozambique’s HPV vaccine delivery network actors

A mixed methods analysis of Mozambique’s HPV vaccine delivery network actors.

Implementation strategy and cost of Mozambique’s HPV vaccine demonstration project

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