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4.
BMC Public Health ; 20(Suppl 4): 1807, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33339529

RESUMO

BACKGROUND: Since its inception in 1988, the Global Polio Eradication Initiative (GPEI) has partnered with 200 countries to vaccinate over 2.5 billion children against poliomyelitis. The polio eradication approach has adapted to emerging challenges and diverse contexts. Knowledge assets gained from these experiences can inform implementation of future health programs, but only if efforts are made to systematically map barriers, identify strategies to overcome them, identify unintended consequences, and compare experiences across country contexts. METHODS: A sequential explanatory mixed methods design, including an online survey followed by key informant interviews (KIIs), was utilized to map tacit knowledge derived from the polio eradication experience from 1988 to 2019. The survey and KIIs were conducted between September 2018 and March 2019. A cross-case comparison was conducted of two study countries, the Democratic Republic of Congo (DRC) and Ethiopia, which fit similar epidemiological profiles for polio. The variables of interest (implementation barriers, strategies, unintended consequences) were compared for consistencies and inconsistencies within and across the two country cases. RESULTS: Surveys were conducted with 499 and 101 respondents, followed by 23 and 30 KIIs in the DRC and Ethiopia, respectively. Common implementation barriers included accessibility issues caused by political insecurity, population movement, and geography; gaps in human resources, supply chain, finance and governance; and community hesitancy. Strategies for addressing these barriers included adapting service delivery approaches, investing in health systems capacity, establishing mechanisms for planning and accountability, and social mobilization. These investments improved system infrastructure and service delivery; however, resources were often focused on the polio program rather than strengthening routine services, causing community mistrust and limiting sustainability. CONCLUSIONS: The polio program investments in the DRC and Ethiopia facilitated program implementation despite environmental, system, and community-level barriers. There were, however, missed opportunities for integration. Remaining pockets of low immunization coverage and gaps in surveillance must be addressed in order to prevent importation of wild poliovirus and minimize circulating vaccine-derived poliovirus. Studying these implementation processes is critical for informing future health programs, including identifying implementation tools, strategies, and principles which can be adopted from polio eradication to ensure health service delivery among hard-to-reach populations. Future disease control or eradication programs should also consider strategies which reduce parallel structures and define a clear transition strategy to limit long-term external dependency.


Assuntos
Erradicação de Doenças/organização & administração , Poliomielite/prevenção & controle , Criança , República Democrática do Congo/epidemiologia , Etiópia/epidemiologia , Recursos em Saúde , Humanos , Programas de Imunização/organização & administração , Vacinas contra Poliovirus/administração & dosagem , Política , Cobertura Vacinal/organização & administração
5.
Med Sci (Paris) ; 36(11): 1034-1037, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33151866

RESUMO

Coronavirus disease (COVID)-19 is an emerging pandemic infection whose significant ability to spread in a naïve population is well established. The first response of states to the COVID-19 outbreak was to impose lock-down and social barrier measures, such as wearing a surgical mask or social distancing. One of the consequences of this pandemic in terms of public health was the suspension or slowdown of infant vaccination campaigns, in almost all countries. The indirect effects of COVID-19 may therefore weigh on mortality from measles and polio in developing countries. In this pandemic chaos, the only hope lies in the rapid development of an effective vaccine against severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). However, acceptance of this vaccine has not yet been won, as beyond the many unknowns that will inevitably weigh around such rapid development, skepticism among vaccine hesitants is growing.


Assuntos
Infecções por Coronavirus/epidemiologia , Programas de Imunização/estatística & dados numéricos , Pandemias , Pneumonia Viral/epidemiologia , Saúde Pública/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Betacoronavirus/fisiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças/prevenção & controle , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Programas de Imunização/organização & administração , Programas de Imunização/normas , Programas de Imunização/tendências , Sarampo/epidemiologia , Sarampo/prevenção & controle , Pandemias/prevenção & controle , Participação do Paciente/estatística & dados numéricos , Participação do Paciente/tendências , Pneumonia Viral/imunologia , Pneumonia Viral/prevenção & controle , Poliomielite/epidemiologia , Poliomielite/prevenção & controle , Saúde Pública/normas , Saúde Pública/tendências , Cobertura Vacinal/organização & administração , Cobertura Vacinal/estatística & dados numéricos , Vacinas Virais/uso terapêutico
6.
Washington; Organización Panamericana de la Salud; nov. 11, 2020. 64 p.
Não convencional em Inglês, Espanhol, Português | LILACS | ID: biblio-1151159

RESUMO

Todos os anos as vacinas salvam entre 2 e 3 milhões de vidas e protegem toda a população contra mais de uma dezena de doenças potencialmente letais. Graças à vacinação, em 1980 foi possível erradicar a varíola­e agora estamos em vias de erradicar a poliomielite. Apesar das vacinas terem proporcionado tamanha melhoria na qualidade de vida, há anos que o número de casos de sarampo­uma das doenças mais contagiosas que se conhece­vem aumentando. Para reverter essa situação, é preciso que a taxa de cobertura vacinal alcance o índice de no mínimo 95%. Para os profissionais da saúde, esse tem sido um grande desafio técnico e de comunicação. Estudos mostram que informar sobre a qualidade, a segurança, a eficácia e a disponibilidade de vacinas não tem sido suficiente para mudar a conduta do público perante a vacinação, e que, de maneira geral, transferir essas informações pura e simplesmente não aumenta a cobertura vacinal. Por isso, é necessário compreender as razões que levam as pessoas a não vacinarem a si mesmas e aos seus filhos. Essa compreensão permitirá que se inicie um diálogo bidirecional com base no respeito, o que permitirá que os comunicadores elaborem mensagens melhores e mais eficazes. Nesse contexto, as orientações deste documento visam, principalmente, equipar o pessoal da saúde com ferramentas que lhes permitam aumentar a eficiência da comunicação com a população geral e aumentar, manter ou recuperar a confiança do público nas vacinas e nos programa de imunização na Região das Américas.


Vaccines save between 2 million and 3 million lives each year and protect the entire population from more than a dozen life-threatening diseases. Thanks to vaccination, smallpox was eradicated in 1980, and we are on track to eradicate polio. However, despite great strides in the control of measles, one of the most contagious diseases known, the last few years have unfortunately seen an increase in cases. This is why high vaccination coverage­95% or more­is needed, posing a major technical and communication challenge for health workers. Studies show that telling people about the quality, safety, effectiveness and availability of vaccines is not enough to influence behavior change related to immunization, and in general, doesn´t increase coverage. For this reason, it´s necessary to understand the reasons why people choose not to get vaccinated or not get their children vaccinated, in order to begin a two-way respectful dialogue using the best, most effective messages. Given this context, the main objective of these guidelines is to provide tools for staff working in the field of immunization to support effective communication between health personnel and the general population, with the aim of strengthening, maintaining or recovering trust in vaccines and the immunization programs in the Region of the Americas.


Las vacunas salvan entre 2 y 3 millones de vidas cada año y protegen a toda la población contra más de una docena de enfermedades potencialmente mortales. Gracias a la vacunación se erradicó la viruela en el año 1980 y estamos en vías de erradicar la poliomielitis. No obstante, en los últimos años ha habido un aumento en los casos de sarampión, una de las enfermedades conocidas más contagiosas. Por esta razón es necesario alcanzar una cobertura de vacunación de 95% o más, lo que constituye un gran desafío técnico y de comunicación para el personal de salud. Los estudios demuestran que informar sobre la calidad, la seguridad, la eficacia y la oferta de las vacunas no es suficiente para lograr cambios de conducta frente a la vacunación y que, en general, no aumenta su cobertura. Por este motivo, es necesario comprender las razones que llevan a las personas a no vacunarse o a no vacunar a sus hijos, con vistas a iniciar un diálogo bidireccional basado en el respeto que redunde en mensajes mejores y más eficaces. En este contexto, las presentes orientaciones tienen como objetivo principal facilitar a los equipos de salud herramientas que sirvan de apoyo para la comunicación efectiva entre el personal de salud y la población general, con miras a lograr el objetivo de fortalecer, mantener o recuperar la confianza en las vacunas y en los programas de inmunización en la Región de las Américas.


Assuntos
Humanos , Vacinas/efeitos adversos , Vacinas/imunologia , Programas de Imunização/organização & administração , Cobertura Vacinal/organização & administração , Comunicação em Saúde , Pandemias/prevenção & controle
8.
Am J Public Health ; 110(7): 1092-1097, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32437281

RESUMO

Objectives. To describe the ongoing collaboration of the Centers for Disease Control and Prevention's (CDC's) school vaccination assessment with state, local, and territorial immunization programs to provide data to monitor school entry vaccination.Methods. Departments of health and education partner to collect data from public school, private school, and homeschooled kindergartners in the 50 US states, the District of Columbia, 2 cities, and the US territories. Immunization programs submit vaccination coverage and exemption data to the CDC, and the CDC reports these data annually via multiple sources.Results. Among the 50 states and the District of Columbia, the number of programs using a census for vaccination coverage data increased from 39 to 41 during the school years 2012-2013 to 2017-2018 (which for most states was August or September through May or June), and the number using a census to collect exemption data increased from 40 to 46. The number of states that reported sharing their local-level vaccination coverage data online increased from 11 in 2012-2013 to 31 in 2017-2018.Conclusions. Coverage data can be used to address undervaccination among kindergartners to work with communities and schools that are susceptible to vaccine-preventable diseases. As more states publish local-level data online, access to improved data provides the public more valuable information.


Assuntos
Centers for Disease Control and Prevention, U.S./organização & administração , Programas de Imunização/organização & administração , Cobertura Vacinal/organização & administração , Vacinação/estatística & dados numéricos , Pré-Escolar , Coleta de Dados , Humanos , Programas de Imunização/estatística & dados numéricos , Instituições Acadêmicas , Estados Unidos
9.
Pan Afr Med J ; 35(Suppl 1): 4, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373255

RESUMO

Introduction: Immunization program monitoring includes numerous activities, some of which include monitoring of vaccination coverage, surveillance performance and epidemiological patterns. The provision of timely, high quality and actionable feedback is an essential component of strengthening health systems. Within the African region of the WHO, various bulletins are produced and disseminated regularly to provide feedback on the performance of immunization programs and vaccine preventable disease control initiatives. Methods: The 2019 annual national immunization program managers' meeting for countries in the eastern and southern African subregion was held in Asmara from 18 - 20 March 2019. A survey questionnaire was administered to the participants representing the national programs and in-country partners across the 20 countries. Results: On average, the 75 respondents receive 1.8 e-mailed feedback bulletins monthly. Twenty-three (31%) respondents receive 3 or more written feedback bulletins per month, and 72% receive the bulletins regularly. On a scale of 1 - 5 (from lowest to highest), 87% participants rated the relevance of the bulletins they receive at 4 - 5. Only 19% of the respondents responded that the results are discussed within the national immunization program, and 14% stated that action points are generated based on the feedback received. Fifty-nine (79%) respondents want to receive more frequent feedback on routine immunization performance. Among the EPI program managers and the EPI program data managers, the access to these feedback bulletins was quite limited. Even though the primary objective of the bulletins is to initiate discussions and action based on the provided feedback, such discussions do not happen regularly at country level. The programmatic use and advocacy value of the bulletins is not optimal. Conclusion: We recommend integrating program feedback, regularly updating the distribution lists, the additional use of instant messaging platforms for distribution, as well as online posting of the bulletins for wider availability.


Assuntos
Retroalimentação , Programas de Imunização/organização & administração , Avaliação de Programas e Projetos de Saúde/métodos , Inquéritos e Questionários , Cobertura Vacinal , África Oriental/epidemiologia , África Austral/epidemiologia , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Assistência à Saúde/estatística & dados numéricos , Países em Desenvolvimento , Humanos , Programas de Imunização/normas , Disseminação de Informação/métodos , Vigilância da População/métodos , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/normas , Atenção Primária à Saúde/estatística & dados numéricos , Inquéritos e Questionários/normas , Nações Unidas , Vacinação/estatística & dados numéricos , Cobertura Vacinal/métodos , Cobertura Vacinal/organização & administração , Cobertura Vacinal/estatística & dados numéricos , Organização Mundial da Saúde
10.
Pan Afr Med J ; 35(Suppl 1): 5, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373256

RESUMO

Introduction: Malawi's National Immunization Program introduced a second routine dose of measles containing vaccine (MCV2) in 2015 but found coverage lagging. We assessed data quality and gaps in service delivery. Methods: Investigators used a modified data quality audit in 6 low performing districts accompanied by questionnaires for health facilities (HF) and households with children with >1 vaccination. Results: MCV2 doses administered according to source were: 733 in registers, 2364 in reports, 1655 in district reports, 2761 in the electronic database. There was 77% agreement regarding status for MCV2 between the register and the home-based record (HBR). Drop-out differences were found between HF according to the practice of waiting for a minimum number of children to open an MCV vial, canceling sessions due to stock-out and requesting payment for a home-based record. Eighty one percent (81%) of children whose caregivers knew 2 doses were needed had received MCV2 vs fifty eight (58%) of children whose caregivers didn't know. Sixty two (62%) of children who were charged for HBR received MCV2 vs 78% reporting no charge. Conclusion: The drop-out between the first and second doses of MCV was high and inconsistent with elimination goals. The quality of administrative data in these 6 districts was found to be poor. This investigation found that session cancelation, charging for HBR and lack of caregiver knowledge affected completion of the vaccination series. The authors recommend program improvements in these areas to increase uptake of MCV2 and improved reporting practices at all levels of the system.


Assuntos
Barreiras de Comunicação , Vacina contra Sarampo/administração & dosagem , Sarampo/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Participação do Paciente/estatística & dados numéricos , Cobertura Vacinal/estatística & dados numéricos , Criança , Pré-Escolar , Confiabilidade dos Dados , Erradicação de Doenças/métodos , Erradicação de Doenças/organização & administração , Erradicação de Doenças/normas , Erradicação de Doenças/estatística & dados numéricos , Relação Dose-Resposta Imunológica , Humanos , Programas de Imunização/métodos , Programas de Imunização/organização & administração , Programas de Imunização/normas , Programas de Imunização/estatística & dados numéricos , Esquemas de Imunização , Lactente , Recém-Nascido , Malaui/epidemiologia , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Vigilância da População/métodos , Melhoria de Qualidade/organização & administração , Melhoria de Qualidade/normas , Projetos de Pesquisa , Inquéritos e Questionários/normas , Inquéritos e Questionários/estatística & dados numéricos , Vacinação/estatística & dados numéricos , Cobertura Vacinal/métodos , Cobertura Vacinal/organização & administração
11.
Pan Afr Med J ; 35(Suppl 1): 6, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373257

RESUMO

Introduction: Cross Rivers State, in southern Nigeria, conducted measles Supplemental Immunization Activities (SIAs) in 2 phases from 2 -15 March, 2018. The SIAs coordination was led by the State technical coordination committee. A total of 90 supervisors from the national and subnational levels, including consultants were deployed to support the SIAs. The instant messaging service - WhatsApp was utilized to help in the communication and coordination among the State and field teams. Methods: We reviewed the chat logs from the WhatsApp group exchanges made between 28 February 2018 and 31 March 2018. Thematic content analysis was done. Results: A total of 653 WhatsApp messages were posted among the 55 group members during the study period, including text messages and media content. Eleven percent of the posts related to monitoring processes and data sharing, while posts related to vaccine logistics and waste management made up about 6% of the total. Overall coordination and deployment was covered in 6% of the posts. Forty percent of the media content showed vaccination service delivery and SIAs launching events or monitoring meetings in various areas. The coordination team used WhatsApp to send reminders to the field staff about data sharing, vaccine and waste management, as well as feedback on coverage and completeness of data sharing. The WhatsApp group discussions did not include most of the logistical and hesitancy challenges documented in the State SIAs technical report. Conclusion: We recommend focusing group discussions on instant messaging platforms so that they can be used for problem solving and sharing best practices, integrating it with other supervisory processes and tools, as well as providing feedback based on processed data from the field.


Assuntos
Programas de Imunização/organização & administração , Vacina contra Sarampo/administração & dosagem , Sarampo/prevenção & controle , Aplicativos Móveis , Envio de Mensagens de Texto , Cobertura Vacinal/organização & administração , Criança , Pré-Escolar , Comunicação , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Assistência à Saúde/estatística & dados numéricos , Erradicação de Doenças/métodos , Erradicação de Doenças/organização & administração , Humanos , Programas de Imunização/métodos , Programas de Imunização/estatística & dados numéricos , Esquemas de Imunização , Ciência da Implementação , Aplicativos Móveis/estatística & dados numéricos , Nigéria/epidemiologia , Sistemas de Alerta/estatística & dados numéricos , Inquéritos e Questionários , Envio de Mensagens de Texto/estatística & dados numéricos , Vacinação , Cobertura Vacinal/métodos , Cobertura Vacinal/estatística & dados numéricos
12.
Pan Afr Med J ; 35(Suppl 1): 8, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373259

RESUMO

Introduction: Guinea, Sierra Leone and Liberia have attained significant reduction in measles incidence between 2004 and 2013. The Ebola outbreak in 2014-2015 in West Africa caused significant disruption of the health service delivery in the three worst affected countries. The magnitude of the impact on the immunization program has not been well documented. Methods: We reviewed national routine immunization administrative coverage data as well as measles surveillance performance and measles epidemiology in the years before, during and after the EVD outbreak in Guinea, Liberia, Sierra Leone. Results: Both Liberia and Guinea experienced a sharp decline of more than 25% in the monthly number of children vaccinated against measles in 2014 and 2015 as compared to the previous years, while there was no reported decline in Sierra Leone. Guinea and Liberia experienced a decline in measles surveillance activity and performance indicators in 2014 and 2015. During this period, there was an increase in measles incidence and a decline in the mean age of measles cases reported in Liberia and Sierra Leone. Guinea started reporting high measles incidence in 2016. All three countries organized measles supplemental immunization activities by June 2015. Liberia achieved 99% administrative coverage, while Guinea and Sierra Leone attained 90.6% and 97.2% coverage respectively. There were no severe adverse events reported during these mass vaccination activities. The disruptive effect of the Ebola outbreak on immunization services was especially evident in Guinea and Liberia. Our review of the reported administrative vaccination coverage at national level does not show significant decline in measles first dose vaccination coverage in Sierra Leone as compared to other reports. This may be due to inaccuracies in coverage monitoring and data quality problems. The increases in measles transmission and incidence in these three countries can be explained by the rapid accumulation of susceptible children. Despite the organization of mass vaccination activities, measles incidence through 2017 has remained higher than the pre-Ebola period in all three countries. Conclusion: The Ebola outbreak in West Africa significantly affected measles vaccination coverage rates in two of the three worst affected countries, and led to persistent gaps in coverage, along with high measles incidence that was documented until two years after the end of the Ebola outbreak. Liberia and Sierra Leone have demonstrated coverage improvements after the end of the Ebola outbreak.


Assuntos
Erradicação de Doenças/organização & administração , Surtos de Doenças , Doença pelo Vírus Ebola/epidemiologia , Programas de Imunização/organização & administração , Sarampo/prevenção & controle , Cobertura Vacinal/estatística & dados numéricos , Criança , Pré-Escolar , Assistência à Saúde/métodos , Assistência à Saúde/organização & administração , Assistência à Saúde/normas , Erradicação de Doenças/métodos , Erradicação de Doenças/normas , Guiné/epidemiologia , Humanos , Programas de Imunização/normas , Programas de Imunização/estatística & dados numéricos , Lactente , Libéria/epidemiologia , Vacinação em Massa/organização & administração , Vacinação em Massa/normas , Vacinação em Massa/estatística & dados numéricos , Sarampo/epidemiologia , Vigilância da População , Estudos Retrospectivos , Serra Leoa/epidemiologia , Cobertura Vacinal/organização & administração , Cobertura Vacinal/normas
13.
Pan Afr Med J ; 35(Suppl 1): 11, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373262

RESUMO

Introduction: Poor data quality and use have been identified as key challenges that negatively impact immunization programs in low- and middle-income countries (LMICs). In addition, many LMICs have a shortage of health personnel, and staff available have demanding workloads across several health programs. In order to address these challenges, the Better Immunization Data (BID) Initiative introduced a comprehensive suite of interventions, including an electronic immunization registry aimed at improving the quality, reliability, and use of immunization data in Arusha Region, Tanzania, and Southern Province of Zambia. The objective of this study was to assess the incremental costs of implementing the BID interventions in immunization programs in these two countries. Methods: We conducted a micro-costing study to estimate the economic costs of service delivery and logistics for the immunization programs with and without the BID interventions in a sample of health facilities and district program offices in each country. Structured questionnaires were used to interview immunization program staff at baseline and post-intervention to assess annual resource utilization and costs. Cost outcomes were reported as annual cost per facility, cost per district and changes in resource costs due to the BID interventions (i.e., costs associated with health worker time, start-up costs, etc.). Sub-group analyses were conducted by health facility to assess variation in costs by volume served and location (rural versus urban). One-way sensitivity analyses were conducted to identify influential parameters. Costs were reported in 2017 US dollars. Results: In Tanzania, the average annual reduction in resource costs was estimated at US$10,236 (95% confidence interval: $7,606-$14,123) per health facility, while the average annual reduction in resource costs per district was estimated at $6,542. In Zambia, reductions in resource costs were modest at an estimated annual average of $628 (95% confidence interval: $209-$1,467) per health facility and $236 per district. Resource cost reductions were mainly attributable to reductions in time required for immunization service delivery and reporting. One-way sensitivity analyses identified key cost drivers, all related to reductions in health worker time. Conclusion: The introduction of electronic immunization registries and stock management systems through the BID Initiative was estimated to result in potential time savings in both countries. Health worker time was the area most impacted by the interventions, suggesting that time savings gained could be utilized for patient care. Information generated through this work provides evidence to inform stakeholder decision-making for scale-up of the BID interventions in Tanzania and Zambia and to inform other Low-to-Middle-Income Countries (LMICs) interested in similar interventions.


Assuntos
Registros Eletrônicos de Saúde , Vacinação em Massa/economia , Vacinação em Massa/organização & administração , Sistema de Registros , Estoque Estratégico/economia , Estoque Estratégico/organização & administração , Vacinas , Criança , Redução de Custos/métodos , Análise Custo-Benefício , Confiabilidade dos Dados , Assistência à Saúde/economia , Assistência à Saúde/organização & administração , Assistência à Saúde/estatística & dados numéricos , Registros Eletrônicos de Saúde/economia , Registros Eletrônicos de Saúde/organização & administração , Custos de Cuidados de Saúde , Humanos , Programas de Imunização/economia , Programas de Imunização/métodos , Programas de Imunização/organização & administração , Programas de Imunização/estatística & dados numéricos , Vacinação em Massa/métodos , Vacinação em Massa/estatística & dados numéricos , Vigilância da População/métodos , Estoque Estratégico/estatística & dados numéricos , Tanzânia/epidemiologia , Cobertura Vacinal/economia , Cobertura Vacinal/organização & administração , Cobertura Vacinal/estatística & dados numéricos , Vacinas/economia , Vacinas/provisão & distribução , Zâmbia/epidemiologia
14.
Pan Afr Med J ; 35(Suppl 1): 15, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373266

RESUMO

The recent setbacks in efforts to achieve measles elimination goals are alarming. To reverse the current trends, it is imperative that the global health community urgently intensify efforts and make resource commitments to implement evidence-based elimination strategies fully, including supporting research and innovations. The Immunization Agenda 2030: A Global Strategy to Leave No One Behind (IA2030) is the new global guidance document that builds on lessons learned and progress made toward the GVAP goals, includes research and innovation as a core strategic priority, and identifies measles as a "tracer" for improving immunisation services and strengthening primary health care systems. To achieve vaccination coverage and equity targets that leave no one behind, and accelerate progress toward disease eradication and elimination goals, sustained and predictable investments are needed for the identified research and innovations priorities for the new decade.


Assuntos
Surtos de Doenças/estatística & dados numéricos , Imunização/economia , Invenções/economia , Investimentos em Saúde , Sarampo/epidemiologia , Sarampo/prevenção & controle , Erradicação de Doenças/economia , Erradicação de Doenças/organização & administração , Erradicação de Doenças/normas , Surtos de Doenças/economia , Surtos de Doenças/prevenção & controle , Obtenção de Fundos/métodos , Obtenção de Fundos/tendências , Saúde Global/economia , Saúde Global/normas , Saúde Global/estatística & dados numéricos , Humanos , Imunização/métodos , Programas de Imunização/economia , Programas de Imunização/métodos , Programas de Imunização/organização & administração , Incidência , Invenções/tendências , Investimentos em Saúde/economia , Investimentos em Saúde/organização & administração , Investimentos em Saúde/tendências , Sarampo/economia , Vacina contra Sarampo/economia , Vacina contra Sarampo/uso terapêutico , Cobertura Vacinal/economia , Cobertura Vacinal/organização & administração , Cobertura Vacinal/normas
15.
PLoS One ; 15(3): e0230359, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32203527

RESUMO

INTRODUCTION: The clinical and economic impact of cervical cancer consistently become a serious burden for all countries, including Indonesia. The implementation of HPV vaccination policy for a big country such as Indonesia requires a strong commitment from several decision-makers. The aim of this study was to provide a comprehensive description on cost-effectiveness and the budget-impact of HPV vaccination policy in Indonesia. METHOD: A cohort Markov model was used to evaluate the cost and the clinical impact of HPV vaccination for 10 years old girls in Indonesia. The researchers consider two doses of all three available HPV vaccines adjusted with the HPV infection profilewith 95% vaccination coverage to estimate the national cervical cancer incidence and mortality. The Budget impact analysis explores three different scenarios covering (1) Two districts per year expansion, (2) oneprovince per year expansion and (3) achieving the National Immunization Program in 2024. RESULTS: Upon fully vaccinating almost 2.3 million 10-year-old girls, 34,723; 43,414; and 51,522 cervical cancer cases were prevented by Quadrivalent, Bivalent and Nonavalent vaccines, consecutively. Furthermore, the highest (591 cases) and lowest (399 cases) mortality were prevented by Nonavalent and Quadrivalent vaccines, respectively. Most of the vaccines were considerably cost-effective and only the Bivalent vaccine with the GAVI/UNICEF price which will be considered a cost-saving strategy.To provide national coverage of HPV vaccination in Indonesia, the government has to provide an annual budget of about US$49 million and US$22 million using the government contract price and GAVI/UNICEF price, respectively. CONCLUSION: HPV vaccination shows a cost-effective strategy and the budget required to provide this policy is considerably affordable for Indonesia.


Assuntos
Análise Custo-Benefício , Vacinação em Massa/economia , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Neoplasias do Colo do Útero/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Orçamentos/estatística & dados numéricos , Criança , Simulação por Computador , Redução de Custos/estatística & dados numéricos , Feminino , Humanos , Incidência , Indonésia/epidemiologia , Cadeias de Markov , Vacinação em Massa/organização & administração , Vacinação em Massa/estatística & dados numéricos , Pessoa de Meia-Idade , Modelos Econômicos , Mortalidade , Infecções por Papillomavirus/economia , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/virologia , Vacinas contra Papillomavirus/economia , Políticas , Dinâmica Populacional , Anos de Vida Ajustados por Qualidade de Vida , Neoplasias do Colo do Útero/economia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia , Cobertura Vacinal/economia , Cobertura Vacinal/organização & administração , Cobertura Vacinal/estatística & dados numéricos , Adulto Jovem
16.
J Infect Chemother ; 26(3): 225-230, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31607433

RESUMO

BACKGROUND: The human papilloma virus (HPV) vaccination coverage rate in Japan has dropped dramatically from more than 70% to less than 1% since 2013. With conflicting information and a lack of quantification of the benefits and risks of the HPV vaccine, parents have been hindered in making their decision. We quantified the benefits and risks of the HPV vaccine in terms of quality-adjusted life-years (QALYs), to help their informed decision. METHOD: A literature search was performed to determine the incidence and burden of each outcome in a decision tree model. The benefits and the risks of the HPV vaccination were determined in QALY change with a sensitivity analysis. RESULT: The benefits of the HPV vaccine in terms of QALYs gained were 703.72, 14.45, and 30.83/100,000 persons for cervical cancer, cervical intraepithelial neoplasm 3 (CIN 3), and genital warts, respectively. The QALY loss due to acute adverse reactions, chronic adverse reactions without assistance needs, and chronic adverse reactions with assistance needs were 0.07, 5.83, and 5.82/100,000 persons, respectively. The risk/benefit ratio in QALY change in the base case was 0.0156. In all scenarios, the benefit of the HPV vaccine was significantly greater than the risk. CONCLUSION: The benefits are much greater than the risks, even if it is assumed that all reported adverse events were due to the vaccination. The Japanese government and health care providers should immediately recommend the HPV vaccine to all adolescent girls irrespective of any causal links between the vaccine and reported adverse events.


Assuntos
Vacinação em Massa/organização & administração , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus/administração & dosagem , Neoplasias do Colo do Útero/prevenção & controle , Cobertura Vacinal/organização & administração , Adolescente , Adulto , Movimento contra Vacinação/tendências , Criança , Análise Custo-Benefício , Tomada de Decisões , Feminino , Humanos , Japão/epidemiologia , Vacinação em Massa/efeitos adversos , Vacinação em Massa/economia , Vacinação em Massa/estatística & dados numéricos , Pessoa de Meia-Idade , Modelos Teóricos , Infecções por Papillomavirus/economia , Infecções por Papillomavirus/epidemiologia , Infecções por Papillomavirus/patologia , Vacinas contra Papillomavirus/efeitos adversos , Vacinas contra Papillomavirus/economia , Pais/psicologia , Anos de Vida Ajustados por Qualidade de Vida , Medição de Risco , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/virologia , Cobertura Vacinal/economia , Cobertura Vacinal/estatística & dados numéricos , Cobertura Vacinal/tendências , Adulto Jovem
17.
Rev. esp. salud pública ; 94: 0-0, 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-193568

RESUMO

La Ponencia de Programa y Registro de Vacunaciones se creó en 1991 para asesorar al Consejo Interterritorial del Sistema Nacional de Salud en el conocimiento de las enfermedades inmunoprevenibles y el establecimiento y evaluación de medidas para su prevención y control. Entre otras funciones, la Ponencia evalúa los programas de vacunación teniendo en cuenta la evidencia científica y la situación epidemiológica. De esta manera, asesora en la toma de decisiones que se realiza en la Comisión de Salud Pública del Consejo Interterritorial. Desde su creación, la Ponencia ha realizado recomendaciones desde el punto de vista técnico y científico en las modificaciones que se han realizado en el calendario de vacunación, incluyendo la incorporación de vacunas y el cambio de pautas de vacunación, desde el primer calendario del Consejo Interterritorial de 1996 hasta el actual calendario común de vacunación a lo largo de toda la vida. La Ponencia es considerada el Comité Técnico Asesor de Vacunaciones de España, tanto por las funciones que desarrolla como por la metodología utilizada para la elaboración de propuestas. En este artículo se revisan las funciones que desarrolla la Ponencia de Programa y Registro de Vacunaciones, las modificaciones que se han realizado en el calendario con su asesoramiento y los retos en el momento actual


The Committee for Immunization Programme and Registry (Ponencia de Programa y Registro de Vacunaciones) was created in 1991 to advise the Interterritorial Council of the National Health System on the situation of vaccine preventable diseases and the establishment and evaluation of measures for their prevention and control. Among other functions, this Committee evaluates the immunization programmes taking into account the scientific evidence and the epidemiological situation. In this way the Committee advises decision makers on the Public Health Commission of the Interterritorial Council. Any change in the National Immunization Programme, since the first one published in 1996 by the Interterritorial Council to the current Immunization Programme throughout life, has been advised from the technical and scientific point of view by this Committee. Taking into account both the work developed and the methodology used for developing the technical advice, the Committee for Immunization Programme and Registry is considered the National Immunization Technical Advisory Group for Spain. This paper reviews the functions and work developed by the Committee for Immunization Programme and Registry, the changes conducted in the National Immunization Programme under its advice and the current challenges


Assuntos
Humanos , Vacinação/tendências , Programas de Imunização/organização & administração , Cobertura Vacinal/organização & administração , Controle de Doenças Transmissíveis/organização & administração , Vacinação Obrigatória , Políticas Públicas de Saúde , Monitoramento Epidemiológico , Comitês Consultivos/organização & administração
18.
Expert Rev Vaccines ; 18(11): 1167-1185, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31791159

RESUMO

Introduction: Low levels of adult vaccination have been documented in the United States and globally. Research has been conducted to identify reasons for low immunization rates; however, the most useful studies are those that implemented interventions for identified barriers to evaluate their impact on rates of immunization. Identifying successful interventions provides immunization providers with evidence-based methods that can be utilized to increase the uptake of recommended vaccines.Areas covered: This review focuses on known barriers to adult immunizations and the interventions available in the literature to overcome these barriers. It outlines interventions that may increase vaccine uptake in the adult population through addressing barriers related to lack of vaccine knowledge, cost, access, provider and practice-based challenges, and racial and ethnic disparities.Expert opinion: Improving adult immunization rates is critical to protecting a population against vaccine-preventable diseases. Those interventions that appeared to increase immunization rates in the adult population included education and reminders about vaccination using text and telephone calls, low-cost or subsidized vaccines, easy access to immunization services, and understanding the cultural and social needs of different racial and ethnic populations. It is likely that an evidence-based multimodal approach using different categories of interventions is necessary to significantly improve adult immunization rates.


Assuntos
Acesso aos Serviços de Saúde , Aceitação pelo Paciente de Cuidados de Saúde , Cobertura Vacinal/organização & administração , Doenças Preveníveis por Vacina/prevenção & controle , Vacinas/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Gravidez , Estados Unidos , Adulto Jovem
19.
Am J Trop Med Hyg ; 101(4_Suppl): 85-90, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31760969

RESUMO

Seventy-five percent of children aged 12-23 months in Malawi have received all eight basic vaccinations-still leaving many children at risk. The Malawi Expanded Program on Immunization comprehensive Multi-Year Plan 2016-2020 reveals several challenges impeding immunization and disease surveillance efforts, such as the fact that non-governmental health organizations (NGHOs) and communities are minimally included in the planning, implementation, and monitoring of these activities. This article examines the extent to which NGHOs are promoting the use of social mobilization (SM) and community mobilizers (CMs) for sharing health information related to the eradication of polio, the importance of routine immunization, and the control of measles and neonatal tetanus. Data collection involved document analysis and interviews with 11 organizations in Malawi whose work contributes to the eradication of polio and control of measles and neonatal tetanus. Content analysis was used to analyze the qualitative data, whereas descriptive statistics were used to analyze the quantitative data. Non-governmental health organizations use a variety of approaches for SM, including mass media campaigns (radio and printed booklets), local skits and dramas, and home visits. Most NGHOs use training workshops and opinion leaders to impart knowledge and skills to CMs on immunization to eradicate polio and to control measles and neonatal tetanus. Major challenges faced by the NGHOs include negative attitudes toward campaigns and demotivation of CMs due to lack of financial incentives. The article concludes with a discussion of approaches to strengthen SM and the role of CMs by NGHOs.


Assuntos
Participação da Comunidade/estatística & dados numéricos , Erradicação de Doenças/organização & administração , Sarampo/prevenção & controle , Organizações , Poliomielite/prevenção & controle , Tétano/prevenção & controle , Cobertura Vacinal/organização & administração , Erradicação de Doenças/estatística & dados numéricos , Feminino , Humanos , Lactente , Recém-Nascido , Malaui , Cobertura Vacinal/estatística & dados numéricos
20.
J Comp Eff Res ; 8(13): 1055-1065, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31580161

RESUMO

Aim: Our objective was to systematically review the use of the positive deviance approach to identify strategies to improve vaccination coverage rates. Materials & methods: We searched English language articles in Medline, Embase, Cochrane Library, CINAHL and PsycINFO without any date restrictions on 4 October 2017. We compiled a list of all strategies and evaluated the quality of these studies using the QATSDD tool. Results: After a review of 241 citations, we included eight studies. These studies focused on a wide variety of vaccines and settings. Core strategies that support vaccine uptake include the importance of tailoring and targeting in both messaging and delivery of vaccines and tracking delivery of vaccines. Patient and provider education, reminders, feedback loops, community collaborations, immunization registries and use of a medical home were also identified as other strategies. Conclusion: Our findings highlight several useful core strategies, which can be used to promote vaccination coverage. PROSPERO: CRD42017078221.


Assuntos
Assistência à Saúde/organização & administração , Cobertura Vacinal/organização & administração , Cobertura Vacinal/estatística & dados numéricos , Comunicação , Comportamento Cooperativo , Assistência à Saúde/normas , Educação em Saúde/organização & administração , Humanos , Assistência Centrada no Paciente/organização & administração , Sistema de Registros , Sistemas de Alerta
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