Polio Supplementary Immunization Activities and Equity in Access to Vaccination: Evidence From the Demographic and Health Surveys

Helleringer, Stéphane; Abdelwahab, Jalaa’; Vandenent, Maya

doi:10.1093/infdis/jiu278

Cited by 28 publications

(43 citation statements)

References 32 publications

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“…Supplementary Immunization Activities (SIAs), also referred to as mass-immunization campaigns, employed to improve protection at population levels via increased coverage, or to achieve global elimination goals or contain outbreaks, have also shown value in reducing inequity within populations [1,[50][51][52]. However, while SIAs have shown to be effective in improving uptake, as seen in childhood polio vaccination [53] a proportion of children may still be missed in such activities [54].…”

Section: Reducing Within-country Inequities In Access To Immunizationmentioning

confidence: 99%

“…Integrating health interventions may also help improve coverage. Immunization program managers and field-based health workers should routinely use each and every contact with a child to verify their (and mother's) immunization status, with appropriate vaccination as required, as part of the Missed Opportunities for Vaccination Strategy [53,55]. Furthermore, immunization can benefit the other health intervention delivery.…”

Section: Reducing Within-country Inequities In Access To Immunizationmentioning

confidence: 99%

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Introducing new vaccines in low- and middle-income countries: challenges and approaches

Guignard

Praet

Jusot

et al. 2019

Expert Review of Vaccines

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Introduction: The number of new vaccine introductions (NVIs) in low and middle-income countries (LMICs) has markedly increased since 2010, raising challenges to often overstretched and underfunded health care systems. Areas covered: We present an overview of some of these challenges, focusing on programmatic decisions, delivery strategy, information and communication, pharmacovigilance and post-licensure evaluation. We also highlight field-based initiatives that may facilitate NVI. Expert commentary: Some new vaccines targeting populations other than infants require alternative delivery strategies. NVIs impact upon existing supply chain management, in particular vaccines with novel characteristics. A lack of understanding about immunization and misconceptions may be detrimental to NVI, as well as insufficient or poorly trained health care workforce. Many barriers exist to achieving good vaccination coverage. Real-world evaluation of vaccine safety, effectiveness and impact in LMICs may be limited by lack of robust demographic and disease epidemiology data, as well as limited health care and surveillance infrastructure. A thorough planning phase is crucial to define the most suitable delivery strategy based on the vaccine's and country's specificities. A communication plan and social mobilization are essential. Implementation research and innovative approaches applied to logistics, delivery, communication and program evaluation can facilitate NVI. ARTICLE HISTORY

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Section: Reducing Within-country Inequities In Access To Immunizationmentioning

confidence: 99%

Section: Reducing Within-country Inequities In Access To Immunizationmentioning

confidence: 99%

Introducing new vaccines in low- and middle-income countries: challenges and approaches

Guignard

Praet

Jusot

et al. 2019

Expert Review of Vaccines

View full text Add to dashboard Cite

show abstract

“…Equity is a key criterion for health technology assessments in many countries [55,56] and by organizations such as the Bill & Melinda Gates Foundation [57]. Up to now, most of the literature around vaccines and equity has focused on socioeconomic [58][59][60] and geographical [61][62][63] dimensions of equity. Additionally, suggestions to address gender equity and female empowerment as part of the Sustainable Development Goals have focused on policies around dimensions of gender equity, rather than health [17].…”

Section: Discussionmentioning

confidence: 99%

The impact of vaccination on gender equity: conceptual framework and human papillomavirus (HPV) vaccine case study

Portnoy

Clark

Ozawa

et al. 2020

Int J Equity Health

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Background: Although the beneficial effects of vaccines on equity by socioeconomic status and geography are increasingly well-documented, little has been done to extend these analyses to examine the linkage between vaccination and gender equity. In this paper, evidence from the published literature is used to develop a conceptual framework demonstrating the potential impact of vaccination on measures of gender equity. This framework is then applied to human papillomavirus (HPV) vaccination in three countries with different economic and disease burden profiles to establish a proof of concept in a variety of contexts. Methods: We conducted a literature review examining evidence on the linkage between health outcomes and dimensions of gender equity. We utilized the Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model to estimate cervical cancer incidence and deaths due to HPV types 16/18 by age in each country. We estimated labor force participation and fertility effects from improvements in health, and converted these into inputs consistent with those used to calculate the United Nations Gender Inequality Index to assess gender equity. Results: In our case study, we found that HPV vaccination among girls could help narrow socioeconomic gender disparities by quantifying the main pathways by which HPV vaccination improves health, which enables improvement in gender equity indicators such as labor force participation and maternal mortality ratios. While these improvements are small when averaged over the entire population, the components measuredlabor force participation and maternal mortality ratioaccount for 50% of the index scores. Conclusions: This proof of concept model is a starting point to inform future health and economic analyses that might incorporate the impact of gender equity as an additional impact of vaccination in improving the health and well-being of the population.

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“…SIAs are usually implemented by national governments with the assistance of international organizations such as the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) [3]. The types of SIAs vary—they are carried out country-wide during national immunization days (NIDs), in regions with a high risk of polio transmission during sub-national immunization days (SNIDs), as part of child health days (CHDs) that provide maternal and child healthcare, or through mop-up rounds that aim to stem any chains of polio transmission that remain in a region [4,5].…”

Section: Introductionmentioning

confidence: 99%

The impact of supplementary immunization activities on routine vaccination coverage: An instrumental variable analysis in five low-income countries

2019

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Background Countries deliver vaccines either through routine health services or supplementary immunization activities (SIAs), usually community-based or door-to-door immunization campaigns. While SIAs have been successful at increasing coverage of vaccines in low- and middle-income countries, they may disrupt the delivery of routine health services. We examine the impact of SIAs on routine vaccine coverage in five low-income countries. Methods Data on the number and timing of SIAs conducted in various countries was compiled by WHO and obtained through UNICEF. Information on the coverage of vaccines not targeted by SIAs (e.g., DPT) was extracted from the Demographic and Health Surveys. We focus on SIAs that took place between 1996 and 2013 in Bangladesh, Senegal, Togo, Gambia, and Cote d’Ivoire, and examine outcomes for children aged 12–59 months. To avoid biases resulting from non-random placement and timing of SIAs, we use age of a child at her first SIA as an instrumental variable for total exposure to SIAs. Results We find that SIA exposure reduced the likelihood of receiving routine vaccines in all the countries included in the study; the coefficients of interest are however statistically insignificant for Gambia and Cote d’Ivoire. In countries that witnessed statistically significant SIA-induced declines in the likelihood of obtaining DPT 3, measles as well as BCG, reductions ranged from 1.3 percentage points (Senegal) to 5.5 percentage points (Bangladesh). Conclusion SIA exposure reduced routine vaccination rates in study countries. Efforts should be made to limit the detrimental impact of SIAs on the services provided by routine health systems.

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Polio Supplementary Immunization Activities and Equity in Access to Vaccination: Evidence From the Demographic and Health Surveys

Cited by 28 publications

References 32 publications

Introducing new vaccines in low- and middle-income countries: challenges and approaches

Introducing new vaccines in low- and middle-income countries: challenges and approaches

The impact of vaccination on gender equity: conceptual framework and human papillomavirus (HPV) vaccine case study

The impact of supplementary immunization activities on routine vaccination coverage: An instrumental variable analysis in five low-income countries

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