Geospatial Planning and the Resulting Economic Impact of Human Papillomavirus Vaccine Introduction in Mozambique

Abstract

Background Research has shown that the distance to the nearest immunization location can ultimately prevent someone from getting immunized. With the introduction of human papillomavirus (HPV) vaccine throughout the world, a major question is whether the target populations can readily access immunization. Methods In anticipation of HPV vaccine introduction in Mozambique, a country with a 2015 population of 25,727,911, our team developed Strategic Integrated Geo-temporal Mapping Application) to determine the potential economic impact of HPV immunization. We quantified how many people in the target population are reachable by the 1377 existing immunization locations, how many cannot access these locations, and the potential costs and disease burden averted by immunization. Results If the entire 2015 cohort of 10-year-old girls goes without HPV immunization, approximately 125 (111–139) new cases of HPV 16,18-related cervical cancer are expected in the future. If each health center covers a catchment area with a 5-km radius (ie, if people travel up to 5 km to obtain vaccines), then 40% of the target population could be reached to prevent 50 (44–55) cases, 178 (159–198) disability-adjusted life years, and US $202,854 (US $140,758–323,693) in health care costs and lost productivity. At higher catchment area radii, additional increases in catchment area radius raise population coverage with diminishing returns. Conclusions Much of the population in Mozambique is unable to reach any existing immunization location, thereby reducing the potential impact of HPV vaccine. The geospatial information system analysis can assist in planning vaccine introduction strategies to maximize access and help the population reap the maximum benefits from an immunization program.

Approaches to defining health facility catchment areas in sub-Saharan Africa

“…Across the studies, a range of techniques were implemented as sensitivity analyses for the derived HFCA. These included deriving several HFCA for the same study area while using different; i) methods [23,34,59], ii) assumptions on healthcare-seeking behaviour [38], iii) population thresholds [80], iv) travel speed [71,88], v) radii for the buffer approach [54,73], vi) several teams validating the generated HFCA [81], and vii) using information criterion to select the best statistical model [35]. Finally, AccessMod and ArcMap were the most used software to derive HFCA.…”

Using Simulation Modeling to Guide the Design of the Girl Scouts Fierce & Fit Program

“…For example, during the 2009 H1N1 influenza pandemic, computational simulation models helped national, state, and local decision-makers answer questions about whether to close schools, how antiviral medications should be used, and who should get vaccines first when vaccines were in short supply (21)(22)(23)(24)(25). Computational models have also helped decision-makers plan new vaccine introductions (26,27), determine how best to design vaccine-carrying devices (28,29), and determine how to redesign health product supply chains (30,31). The use of computational models to directly guide program design in other health areas is relatively new.…”

High-resolution disease maps for cancer control in low-resource settings: A spatial analysis of cervical cancer incidence in Kampala, Uganda

“…Understanding with specificity where cancer burdens are concentrated has the potential to greatly enhance the efficiency of cancer prevention and control efforts. Geospatial mapping of population-based cancer registry data, used commonly in high-resource settings, has not been widely used in LMICs [ 14 ], with notable exceptions, primarily outside of SSA [ 15 - 20 ]. High-resolution cancer maps could provide clear targets for cancer prevention and control efforts in SSA and other low-resource settings, optimizing service delivery for maximal benefit.…”