Childhood vaccine uptake in Africa: threats, challenges, and opportunities

Mbonigaba, Edward; Nderu, David; Chen, Simiao; Denkinger, Claudia M.; Geldsetzer, Pascal; McMahon, Shannon A.; Bärnighausen, Till

doi:10.29392/001c.26312

Cited by 6 publications

(8 citation statements)

References 30 publications

(28 reference statements)

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“…Reasons highlighted included narrow doorways, delayed support and communication. This nding is supported by the nding that the major blockades of access to services among the physically disabled are the step staircases, steep ramps, and narrow doors (30). Participants who believed COVID-19 existed were more likely than those who thought it was not there to be vaccinated.…”

Section: Discussionmentioning

confidence: 94%

An evaluation of physical access barriers to Covid-19 vaccines uptake among persons with physical disabilities in western Kenya

Odongo,

Osir,

Awandu

2023

Preprint

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Background Physically disabled persons continue to face discrimination, exclusion and neglect which hamper equitable access to services and disproportionately affect them during a pandemic. This study aimed to evaluate the physical access barriers to COVID-19 vaccines among persons with physical disabilities during the COVID-19 pandemic, (March, 2020 to March, 2022) in Ugenya Subcounty, Siaya County in western Kenya. Methods The study design was cross sectional involving physically disabled persons. A simple random sampling technique was used to recruit participants 108 participants. Structured questionnaires were used to collect data needed. Results Marital status, (χ2 = 13.310, p = 0.004), mobility impairment, (χ2 = 16.168, p = 0.001), source of information, (χ2 = 4.022, p = 0.002), vaccination site, (χ2 = 95.480, p =0.001), motivation, (χ2 = 95.457, p = 0.045), decision time, (χ2 = 95.501, p = 0.001) and access to room, (χ2 = 84.098, p = 0.001), all had statistically significant associations with access to and uptake of COVID-19 vaccines. Multinomial logistic regression analysis showed that fare used and age, (0.001), alongside transport means and age, (p = 0.004), had statistically significant associations with COVID-19 vaccine access and uptake. Those who had difficulty both in movement and speaking found it hard to access and receive COVID-19 vaccines, (p = 0.001). Conclusion Marital status, information from reliable sources, belief in existence of COVID-19 were associated with access to and uptake of COVID-19 vaccines. Additionally, nonpayment of transport fare increased the odds of being vaccinated. Therefore, programs such as mobile health teams or reimbursement of fare should be adopted to increase access to healthcare by the physically disabled.

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Section: Discussionmentioning

confidence: 94%

An evaluation of physical access barriers to Covid-19 vaccines uptake among persons with physical disabilities in western Kenya

Odongo,

Osir,

Awandu

2023

Preprint

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“…Demand side variables like maternal education, religious beliefs and myths [9][10][11], poverty [11] and vaccine hesitancy [12] were omitted. However, the variables included are sufficient to explain efficiency based on healthcare system characteristics.…”

Section: Limitationsmentioning

confidence: 99%

Fiscal space for the immunisation program in Zambia– an efficiency analysis approach

Chompolola,

Chama-Chiliba,

Simuyemba

et al. 2024

BMC Res Notes

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Objective The immunisation programme in Zambia remains one of the most effective public health programmes. Its financial sustainability is, however, uncertain. Using administrative data on immunisation coverage rate, vaccine utilisation, the number of health facilities and human resources, expenditure on health promotion, and the provision of outreach services from 24 districts, we used Data Envelopment Analysis to determine the level of technical efficiency in the provision of immunisation services. Based on our calculated levels of technical efficiency, we determined the available fiscal space for immunisation. Results Out of the 24 districts in our sample, 9 (38%) were technically inefficient in the provision of immunisation services. The average efficiency score, however, was quite high, at 0.92 (CRS technology) and 0.95 (VRS technology). Based on the calculated level of technical efficiency, we estimated that an improvement in technical efficiency can save enough vaccine doses to supply between 5 and 14 additional districts. The challenge, however, lies in identifying and correcting for the sources of technical inefficiency.

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“…For instance, maternal education of any level [primary, secondary, or tertiary] [21], and political instability through civil war [24]. Dependency on unsustainable multinational foreign aid, which usually leads to unprecedented financial restraints [25], low uptake of vaccination in Muslim families, which represent a significant part of African populations [26], and lack of transportation to health centers in rural areas are some of the challenges in addition to economic factors and false beliefs regarding vaccines safety [27][28][29].…”

Section: Introductionmentioning

confidence: 99%

The effect of mHealth on childhood vaccination in Africa: A systematic review and meta-analysis

Gilano,

Sako,

Molla

et al. 2024

PLoS ONE

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Introduction Vaccine-preventable diseases are the public health problems in Africa, although vaccination is an available, safe, simple, and effective method prevention. Technologies such as mHealth may provide maternal access to health information and support decisions on childhood vaccination. Many studies on the role of mHealth in vaccination decisions have been conducted in Africa, but the evidence needs to provide conclusive information to support mHealth introduction. This study provides essential information to assist planning and policy decisions regarding the use of mHealth for childhood vaccination. Methods We conducted a systematic review and meta-analysis for studies applying mHealth in Africa for vaccination decisions following the Preferred Reporting Items for Systematic and Meta-Analysis [PRISMA] guideline. Databases such as CINAHL, EMBASE, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, Global Health, HINARI, and Cochrane Library were included. We screened studies in Endnote X20 and performed the analysis using Revman 5.4.1. Results The database search yielded 1,365 articles [14 RCTs and 4 quasi-experiments] with 21,070 participants satisfied all eligibility criteria. The meta-analysis showed that mHealth has an OR of 2.15 [95% CI: 1.70–2.72; P<0.001; I2 = 90%] on vaccination rates. The subgroup analysis showed that regional differences cause heterogeneity. Funnel plots and Harbord tests showed the absence of publication bias, while the GRADE scale showed a moderate-quality body of evidence. Conclusion Although heterogeneous, this systematic review and meta-analysis showed that the application of mHealth could potentially improve childhood vaccination in Africa. It increased childhood vaccination by more than double [2.15 times] among children whose mothers are motivated by mHealth services. MHealth is more effective in less developed regions and when an additional incentive party with the messaging system. However, it can be provided at a comparably low cost based on the development level of regions and can be established as a routine service in Africa. Registration PROSPERO: CRD42023415956.

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Childhood vaccine uptake in Africa: threats, challenges, and opportunities

Cited by 6 publications

References 30 publications

An evaluation of physical access barriers to Covid-19 vaccines uptake among persons with physical disabilities in western Kenya

An evaluation of physical access barriers to Covid-19 vaccines uptake among persons with physical disabilities in western Kenya

Fiscal space for the immunisation program in Zambia– an efficiency analysis approach

The effect of mHealth on childhood vaccination in Africa: A systematic review and meta-analysis

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