Enhancing immunization during second year of life by reducing missed opportunities for vaccinations in 46 countries

Hanson, Celina M.; Mirza, Imran; Kumapley, Richard; Ogbuanu, Ikechukwu U.; Kezaala, Robert; Nandy, Robin

doi:10.1016/j.vaccine.2018.04.070

Cited by 31 publications

(28 citation statements)

References 20 publications

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“…This suggests the occurrence of MOV, as children had contact with health services to receive some, but not all vaccines they were eligible for [17]. As seen from these reports, previous studies assessing MOV or factors related to MOV have been limited in scope and have used varying methodologies, leading to limitations in comparability and varying interpretations [15,16,[18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Qualitative insights into reasons for missed opportunities for vaccination in Kenyan health facilities

Tabu

Shendale

et al. 2020

PLoS ONE

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Background In 2016, Kenya conducted a study of missed opportunities for vaccination (MOV)-when eligible children have contact with the health system but are not fully vaccinated-to explore some of the reasons for persistent low vaccination coverage. This paper details the qualitative findings from that assessment. Methods Using the World Health Organization MOV methodology, teams conducted focus group discussions among caregivers and health workers and in-depth interviews of key informants in 10 counties in Kenya. Caregivers of children <24 months of age visiting the selected health facilities on the day of the assessment were requested to participate in focus group discussions. Health workers were purposively sampled to capture a broad range of perspectives. Key informants were selected based on their perceived insight on immunization services at the county, sub-county, or health facility level. Results Six focus group discussions with caregivers, eight focus group discussions with health workers, and 35 in-depth interviews with key informants were completed. In general, caregivers had positive attitudes toward healthcare and vaccination services, but expressed a desire for increased education surrounding vaccination. In order to standardize vaccination checks at all health facility visits, health workers and key informants emphasized the need for additional trainings for all staff members on immunization. Health workers and key informants

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Section: Introductionmentioning

confidence: 99%

Qualitative insights into reasons for missed opportunities for vaccination in Kenyan health facilities

Tabu

Shendale

et al. 2020

PLoS ONE

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“…The practice of not opening vials unless a certain minimum number of children were present has been observed in other resource-limited settings [26][27][28][29]. In an analysis of 46 countries, including Burkina Faso, one study revealed that missed opportunities to vaccinate children with MCV were more frequent than for diphtheria-pertussis-tetanus (DPT) vaccine or oral polio vaccine; this may in part be due to the fact that MCV is a lyophilized vaccine and must be discarded within a 6-to 8-h window once reconstituted or at the end of the immunization session, whichever comes first, whereas DPT and polio vaccines can be used as long as the Vaccine Vial Monitor is valid or the vaccine is not expired [30]. These findings point to the need to emphasize the WHO recommendation [31] to open a multi-dose vial for even one eligible child in order to decrease missed opportunities for vaccination [31]; health worker training should be done for new hires along with in-service training of existing staff to reinforce appropriate practices [32].…”

Section: Discussionmentioning

confidence: 99%

Health workers’ perceptions and challenges in implementing meningococcal serogroup a conjugate vaccine in the routine childhood immunization schedule in Burkina Faso

et al. 2020

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Background: Meningococcal serogroup A conjugate vaccine (MACV) was introduced in 2017 into the routine childhood immunization schedule (at 15-18 months of age) in Burkina Faso to help reduce meningococcal meningitis burden. MACV was scheduled to be co-administered with the second dose of measles-containing vaccine (MCV2), a vaccine already in the national schedule. One year following the introduction of MACV, an assessment was conducted to qualitatively examine health workers' perceptions of MACV introduction, identify barriers to uptake, and explore opportunities to improve coverage. Methods: Twelve in-depth interviews were conducted with different cadres of health workers in four purposively selected districts in Burkina Faso. Districts were selected to include urban and rural areas as well as high and low MCV2 coverage areas. Respondents included health workers at the following levels: regional health managers (n = 4), district health managers (n = 4), and frontline healthcare providers (n = 4). All interviews were recorded, transcribed, and thematically analyzed using qualitative content analysis. Results: Four themes emerged around supply and health systems barriers, demand-related barriers, specific challenges related to MACV and MCV2 co-administration, and motivations and efforts to improve vaccination coverage. Supply and health systems barriers included aging cold chain equipment, staff shortages, overworked and poorly trained staff, insufficient supplies and financial resources, and challenges with implementing community outreach activities. Health workers largely viewed MACV introduction as a source of motivation for caregivers to bring their children for the 15-to 18-month visit. However, they also pointed to demand barriers, including cultural practices that sometimes discourage vaccination, misconceptions about vaccines, and religious beliefs. Challenges in co-administering MACV and MCV2 were mainly related to reluctance among health workers to open multi-dose vials unless enough children were present to avoid wastage.

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“…Unvaccinated and under-vaccinated children and pregnant women may access health services to seek care, and such a visit becomes a missed opportunity if immunization is not addressed. This could quite easily be rectifiedbyhealthfacilitystaffinbothnon-immunization and immunization services reviewing the vaccination status of all clients presenting or accompanying others and providing any missed doses [47,48]. Recent work has shown that immunization coverage increases of 10%, and more can be achieved with relatively simple measures.…”

Section: Promoting Integration Of Immunization In the Health Sectormentioning

confidence: 99%

New immunization strategies: adapting to global challenges

Mantel

Cherian²

2019

Bundesgesundheitsbl

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Enhancing immunization during second year of life by reducing missed opportunities for vaccinations in 46 countries

Cited by 31 publications

References 20 publications

Qualitative insights into reasons for missed opportunities for vaccination in Kenyan health facilities

Qualitative insights into reasons for missed opportunities for vaccination in Kenyan health facilities

Health workers’ perceptions and challenges in implementing meningococcal serogroup a conjugate vaccine in the routine childhood immunization schedule in Burkina Faso

New immunization strategies: adapting to global challenges

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