Building on community outreach for childhood vaccination to deliver maternal and child health services in Laos: a feasibility assessment

Jacobs, Bart; Lindelöw, Magnus; Xayyavong, Phoxay; Sackett, Philippa

doi:10.1016/s0968-8080(12)40649-8

Cited by 11 publications

(11 citation statements)

References 14 publications

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“…The review showed that GRT mothers understood the value of immunization, however, were restricted by practical barriers, such as access, transient residency, and competing priorities [22]. To overcome this, community outreach programs should regularly offer health promotion and vaccination to these hard-to-reach populations [47]. Improving and maintaining high MMR coverage also involves adequate surveillance and monitoring; this helps to identify under-vaccinated populations, send reminders for vaccination, and monitor progress in immunization coverage.…”

Section: Barriersmentioning

confidence: 99%

Resurgence of Measles in Europe: A Systematic Review on Parental Attitudes and Beliefs of Measles Vaccine

Wilder-Smith¹,

Qureshi²

2019

JEGH

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Background and Objectives: Europe has experienced a major resurgence of measles in recent years, despite the availability and free access to a safe, effective, and affordable vaccination measles, mumps and rubella vaccine (MMR). The main driver for this is suboptimal vaccine coverage. Parental attitudes and beliefs toward measles vaccination are of paramount importance in influencing vaccine coverage. The three objectives of this study are to synthesize and critically assess parental attitudes and beliefs toward MMR uptake, to develop strategies and policy recommendations to effectively improve MMR vaccine uptake accordingly, and ultimately to identify areas for further research. Methods: A systematic review was conducted using primary studies from PubMed, Medline, Embase, and Scopus published between 2011 and April 2019. Inclusion criteria comprised primary studies in English conducted in Europe and studying parental attitudes and behavior regarding MMR uptake. Data were extracted using an inductive grounded theory approach. Results: In all, 20 high-quality studies were identified. Vaccine hesitancy or refusal were mainly due to concerns about vaccine safety, effectiveness, perception of measles risk and burden, mistrust in experts, and accessibility. Factors for MMR uptake included a sense of responsibility toward child and community health, peer judgement, trust in experts and vaccine, and measles severity. Anthroposophical and Gypsy, Roma, and Traveler populations presented unique barriers such as accessibility. Conclusion: A multi-interventional, evidence-based approach is vital to improve confidence, competence, and convenience of measles vaccination uptake. Healthcare professionals need an understanding of individual contextual attitudes and barriers to MMR uptake to tailor effective communication. Effective surveillance is needed to identify under-vaccinated populations for vaccination outreach programs to improve accessibility and uptake.

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Section: Barriersmentioning

confidence: 99%

Resurgence of Measles in Europe: A Systematic Review on Parental Attitudes and Beliefs of Measles Vaccine

Wilder-Smith¹,

Qureshi²

2019

JEGH

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“…Despite these efforts, Lao PDR faces significant disparities in MNCH services coverage among urban and rural residents and also within the urban and rural residents [6,14]. Factors associated with individual MNCH service have been studied for antenatal care (ANC), delivery place, and vaccinations [14–18]. However, factors associated with the level of continuity of MNCH services and postnatal care (PNC) are still unknown [18].…”

Section: Introductionmentioning

confidence: 99%

Determinants of continuum of care for maternal, newborn, and child health services in rural Khammouane, Lao PDR

et al. 2019

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Introduction The concept of continuum of care has gained attention as measures to improve maternal, newborn, and child health. However, little is known about the factors associated with the coverage level of continuum of care in Lao PDR. Therefore, this study was conducted 1) to investigate the coverage level of continuum of care and 2) to identify barriers and promoting factors that are associated with mothers’ continuation in receiving services in rural Lao PDR. Methods A community-based, cross sectional study was conducted in a rural district in Khammouane Province, Lao PDR, using a structured questionnaire. The outcome to the express continuum of care was assessed by the modified composite coverage index (CCI) that reflects ten maternal and child health services. Results In total, 263 mothers were included in the final analyses. Only 6.8% of mothers continued to receive all MNCH services. Five factors were shown to have statistically significant associations with modified CCI score: higher educational attainment (B = 0.070, p<0.001), being a farmer (B = -0.078, p = 0.003), receiving the first antenatal care within the first trimester (B = 0.109, p<0.001), longer distance from district hospital (B = -0.012, p<0.001), and discussion with husband or family members (B = 0.057, p = 0.022). Conclusions In this study, we introduced the modified CCI to better explain the utilization of preventive maternal and child health services along with the continuum of care. By utilizing the modified CCI, we identified five factors as determinants of continuum of care. Furthermore, new and modifiable promoting factors were identified for continuum of care: receiving the first antenatal care within the first trimester and family and male involvement. Such demand side actions should be encouraged to improve the continuity of MNCH service use.

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“…In Laos, the burden of maternal and child mortality was high due to low coverage of MNCH services in difficult-to-access regions. To increase the coverage of MNCH services, integration was done using the more established platform of immunization outreach programs This campaign was positively received by women since it lifted the burden of having to travel to the city to access antenatal care services, while simultaneously being ‘good for the babies’ ( Jacobs et al. , 2012 ).…”

Section: Resultsmentioning

confidence: 99%

“…The most common facilitator of successful implementation mentioned by the included documents was the establishment of community ownership ( Mihigo et al , 2015 ; Jacobs et al. , 2012 ; Deardorff et al.…”

Section: Resultsmentioning

confidence: 99%

A scoping review on integrated health campaigns for immunization in low- and middle-income countries

Ahmed,

Haider,

Hanif

et al. 2023

Health Policy and Planning

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Health campaign integration is a key implementation strategy outlined by the World Health Organization to achieve universal health coverage. This scoping review synthesizes the evidence on Integrated Health Campaigns (IHC) in the field of immunization in low- and middle-income countries (LMICs) regarding the most common strategies, facilitators and barriers. Four reviewers followed a systematic approach to identify, screen and analyse relevant articles. The team used three search engines (PubMed, Scopus and Google Scholar) to identify peer-reviewed journal articles as well as select institutional websites for grey literature publications. Full-text articles using any study design and across any time frame were included. Data were extracted following a predefined matrix, analysed deductively and presented in a narrative synthesis. Thirty articles (20 academic and 10 grey) were included in the final review. All studies included identified IHCs as effective when planning or implementation is integrated. The common strategies were: using resources efficiently in remote locations; using national immunization days to maximize impact; targeting specific age groups by selecting intervention sites that are frequented by that age group; building community ownership over the integrated program; and integrating programs that already share common elements. The key facilitators were: closing the gap between services and communities; planning, coordination and resource management both before and during integration; cost-effectiveness; and utilization of pre-existing infrastructure. The common barriers included seemingly optimized initial cost to appear feasible only in the short term and additional responsibilities on the field staff. This review finds IHCs a common practice in immunization and identifies gaps in evidence on evaluation; indicating the need for additional research. Strong evidence accounts IHCs to increase coverage, improve community acceptance of health services and strengthen the community models of health service delivery.

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Building on community outreach for childhood vaccination to deliver maternal and child health services in Laos: a feasibility assessment

Cited by 11 publications

References 14 publications

Resurgence of Measles in Europe: A Systematic Review on Parental Attitudes and Beliefs of Measles Vaccine

Resurgence of Measles in Europe: A Systematic Review on Parental Attitudes and Beliefs of Measles Vaccine

Determinants of continuum of care for maternal, newborn, and child health services in rural Khammouane, Lao PDR

A scoping review on integrated health campaigns for immunization in low- and middle-income countries

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