A systematic literature review of missed opportunities for immunization in low- and middle-income countries

Sridhar, Shruti; Maleq, Nadira; Guillermet, Élise; Colombini, Anaïs; Gessner, Bradford D.

doi:10.1016/j.vaccine.2014.10.063

Cited by 112 publications

(123 citation statements)

References 31 publications

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“…Some vaccines are only administered when there are a good number of children to be vaccinated with the aim of limiting loss of vaccines. This situation enhances missed opportunities of vaccines as shown during the analysis of reasons of incomplete vaccination [31]. Linked to these are organisational problems, especially the permanence of services, the functioning of health personnel, rupture of vaccines supply, and false contraindications of vaccination given by health care providers [31].…”

Section: Determinants Related To the Health Care Services Geographicmentioning

confidence: 99%

“…This situation enhances missed opportunities of vaccines as shown during the analysis of reasons of incomplete vaccination [31]. Linked to these are organisational problems, especially the permanence of services, the functioning of health personnel, rupture of vaccines supply, and false contraindications of vaccination given by health care providers [31]. Parents also make reserves as regards to the health services assistance or delivery [7].…”

Section: Determinants Related To the Health Care Services Geographicmentioning

confidence: 99%

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Factors Influencing Routine Vaccination of Children of Mothers Live-Stock Retailers in the Markets of Yaoundé

Félicitée¹,

Tassadong²,

Dongmo³

et al. 2016

WJV

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Background: The job of mothers though having a positive impact on the family could be detrimental to children's health due to her unavailability. Methodology: A cross-sectional study was carried out from March to August 2014. Mothers of children aged 11 -48 months were interviewed to determine factors which could influence the vaccination of their children. Results: A total of 265 mothers were interviewed. Despite their occupations, they completely vaccinated all of their children. The vaccination coverage of tracer antigens (third dose of DPT/HiB/HepB) was high 97.7% as well as the proportion of children completely vaccinated (91.7%). A mastery of the vaccination calendar of the site, and resumption of activities when the children were more than 4 months old, significantly influenced the completion of vaccination. Only 6 children (2.3%) were not correctly or incompletely vaccinated. The reason given by their mothers were: the lack of time (45.0%), the adverse effects of vaccines (27.0%), forgetfulness (18%), and shortage of vaccines supplies (5.0%). Conclusions: Occupation was not a hindrance to the vaccination of children of live-stock retailers. The problem of absent or incomplete vaccination could be overcome by improving the strategies of social mobilisation, permitting the sensitisation of mothers hesitant to vaccinate their children. A regular supply of vaccines will reduce the missed opportunities, thus maintaining high vaccination coverage in this social group.

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Section: Determinants Related To the Health Care Services Geographicmentioning

confidence: 99%

Section: Determinants Related To the Health Care Services Geographicmentioning

confidence: 99%

Factors Influencing Routine Vaccination of Children of Mothers Live-Stock Retailers in the Markets of Yaoundé

Félicitée¹,

Tassadong²,

Dongmo³

et al. 2016

WJV

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“…Studies have found associations between wastage practices and MOV [5,13]. WHO recommends that vaccines be administered anytime an eligible child presents for vaccination, irrespective of the total number of children present in the clinic (i.e.…”

Section: Introductionmentioning

confidence: 99%

Vaccine wastage in Nigeria: An assessment of wastage rates and related vaccinator knowledge, attitudes and practices

Wallace

Willis²,

Nwaze

et al. 2017

Vaccine

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Introduction The introduction of new vaccines highlights concerns about high vaccine wastage, knowledge of wastage policies and quality of stock management. However, an emphasis on minimizing wastage rates may cause confusion when recommendations are also being made to reduce missed opportunities to routinely vaccinate children. This concern is most relevant for lyophilized vaccines without preservatives [e.g. measles-containing vaccine (MCV)], which can be used for a limited time once reconstituted. Methods We sampled 54 health facilities within 11 local government areas (LGAs) in Nigeria and surveyed health sector personnel regarding routine vaccine usage and wastage-related knowledge and practices, conducted facility exit interviews with caregivers of children about missed opportunities for routine vaccination, and abstracted vaccine stock records and vaccination session data over a 6-month period to calculate wastage rates and vaccine vial usage patterns. Results Nearly half of facilities had incomplete vaccine stock data for calculating wastage rates. Among facilities with sufficient data, mean monthly facility-level wastage rates were between 18 and 35% across all reviewed vaccines, with little difference between lyophilized and liquid vaccines. Most (98%) vaccinators believed high wastage led to recent vaccine stockouts, yet only 55% were familiar with the multi-dose vial policy for minimizing wastage. On average, vaccinators reported that a minimum of six children must be present prior to opening a 10-dose MCV vial. Third dose of diphtheria-tetanus-pertussis vaccine (DTP3) was administered in 84% of sessions and MCV in 63%; however, the number of MCV and DTP3 doses administered were similar indicating the number of children vaccinated with DTP3 and MCV were similar despite less frequent MCV vaccination opportunities. Among caregivers, 30% reported being turned away for vaccination at least once; 53% of these children had not yet received the missed dose. Discussion Our findings show inadequate implementation of vaccine management guidelines, missed opportunities to vaccinate, and lyophilized vaccine wastage rates below expected rates. Missed opportunities for vaccination may occur due to how the health system’s contradicting policies may force health workers to prioritize reduced wastage rates over vaccine administration, particularly for multi-dose vials.

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“…Parents are not expected to know the recommended vaccination schedule. Instead, it appears that system issues as a lack of outreach, incomplete health records, not flagging vaccines due at visits, availability of vaccine (identified in 8%) and provider variables (awareness of recommended childhood vaccine schedules, failure to review vaccine records, and ordering and administration of recommended vaccine (s) at all visits) are the main sources of low uptake of influenza, and likely other, vaccine in this setting [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Influenza vaccine: Delayed vaccination schedules and missed opportunities in children under 2 years old

Gentile

Juárez

Hernández

et al. 2015

Vaccine

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A systematic literature review of missed opportunities for immunization in low- and middle-income countries

Cited by 112 publications

References 31 publications

Factors Influencing Routine Vaccination of Children of Mothers Live-Stock Retailers in the Markets of Yaoundé

Factors Influencing Routine Vaccination of Children of Mothers Live-Stock Retailers in the Markets of Yaoundé

Vaccine wastage in Nigeria: An assessment of wastage rates and related vaccinator knowledge, attitudes and practices

Influenza vaccine: Delayed vaccination schedules and missed opportunities in children under 2 years old

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A systematic literature review of missed opportunities for immunization in low- and middle-income countries

Cited by 112 publications

References 31 publications

Factors Influencing Routine Vaccination of Children of Mothers Live-Stock Retailers in the Markets of Yaound&#233;

Factors Influencing Routine Vaccination of Children of Mothers Live-Stock Retailers in the Markets of Yaound&#233;

Vaccine wastage in Nigeria: An assessment of wastage rates and related vaccinator knowledge, attitudes and practices

Influenza vaccine: Delayed vaccination schedules and missed opportunities in children under 2 years old

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Product

Resources

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Factors Influencing Routine Vaccination of Children of Mothers Live-Stock Retailers in the Markets of Yaoundé

Factors Influencing Routine Vaccination of Children of Mothers Live-Stock Retailers in the Markets of Yaoundé