State of equity: childhood immunization in the World Health Organization African region

Casey, Rebecca M.; Hampton, Lee M.; Anya, Blanche-Philomene Melanga; Gacic-Dobo, Marta; Diallo, Mamadou Saliou; Wallace, Aaron S.

doi:10.11604/pamj.supp.2017.27.3.12114

Cited by 14 publications

(12 citation statements)

References 12 publications

(14 reference statements)

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“…This remains even more critical with some Gavi eligible countries scheduled for graduation from Gavi support in the coming years. Lastly, the stagnant subregional DTP3 coverage since 2009 highlights the point that efforts at improving coverage may yield more obvious immediate results at low coverage levels and as coverage increases, more significant high-level commitment and in-country ownership will be needed to reach the last child 41…”

Section: Discussionmentioning

confidence: 99%

Tracking coverage, dropout and multidimensional equity gaps in immunisation systems in West Africa, 2000–2017

et al. 2019

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BackgroundSeveral West African countries are unlikely to achieve the recommended Global Vaccine Action Plan (GVAP) immunisation coverage and dropout targets in a landscape beset with entrenched intra-country equity gaps in immunisation. Our aim was to assess and compare the immunisation coverage, dropout and equity gaps across 15 West African countries between 2000 and 2017.MethodsWe compared Bacille Calmette Guerin (BCG) and the third dose of diphtheria–tetanus–pertussis (DTP3) containing vaccine coverage between 2000 and 2017 using the WHO and Unicef Estimates of National Immunisation Coverage for 15 West African countries. Estimated subregional median and weighted average coverages, and dropout (DTP1–DTP3) were tracked against the GVAP targets of ≥90% coverage (BCG and DTP3), and ≤10% dropouts. Equity gaps in immunisation were assessed using the latest disaggregated national health survey immunisation data.ResultsThe weighted average subregional BCG coverage was 60.7% in 2000, peaked at 83.2% in 2009 and was 65.7% in 2017. The weighted average DTP3 coverage was 42.3% in 2000, peaked at 70.3% in 2009 and was 61.5% in 2017. As of 2017, 46.7% of countries (7/15) had met the GVAP targets on DTP3 coverage. Average weighted subregional immunisation dropouts consistently reduced from 16.4% in 2000 to 7.4% in 2017, meeting the GVAP target in 2008. In most countries, inequalities in BCG, and DTP3 coverage and dropouts were mainly related to equity gaps of more than 20% points between the wealthiest and the poorest, high coverage regions and low coverage regions, and between children of mothers with at least secondary education and those with no formal education. A child’s sex and place of residence (urban or rural) minimally determined equity gaps.ConclusionsThe West African subregion made progress between 2000 and 2017 in ensuring that its children utilised immunisation services, however, wide equity gaps persist.

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Section: Discussionmentioning

confidence: 99%

Tracking coverage, dropout and multidimensional equity gaps in immunisation systems in West Africa, 2000–2017

et al. 2019

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“…Love-Koh et al (2020) categorize methods used to define equity measures into five: 1) gap measures, regression-based measures, Lorenz and concentration curves, measures incorporating inequality aversion, and health-related social welfare. The equity measures defined by absolute and relative gaps are commonly used by international agencies, such as the WHO, to distribute resources, such as vaccines and medical treatment, between population groups in low- and middle-income countries (Casey et al, 2017).…”

Section: Problem Formulationmentioning

confidence: 99%

A Multi-Stage Stochastic Programming Approach to Epidemic Resource Allocation with Equity Considerations

Yin

Büyüktahtakın

2021

Preprint

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Existing compartmental models in epidemiology are limited in terms of optimizing the resource allocation to control an epidemic outbreak under disease growth uncertainty. In this study, we address this core limitation by presenting a multi-stage stochastic programming compartmental model, which integrates the uncertain disease progression and resource allocation to control an infectious disease outbreak. The proposed multi-stage stochastic program involves various disease growth scenarios and optimizes the distribution of treatment centers and resources while minimizing the total expected number of new infections and funerals. We define two new equity metrics, namely infection and capacity equity, and explicitly consider equity for allocating treatment funds and facilities over multiple time stages. We also study the multistage value of the stochastic solution (VSS), which demonstrates the superiority of the proposed stochastic programming model over its deterministic counterpart. We apply the proposed formulation to control the Ebola Virus Disease (EVD) in Guinea, Sierra Leone, and Liberia of West Africa to determine the optimal and fair resource-allocation strategies. Our model balances the proportion of infections over all regions, even without including the infection equity or prevalence equity constraints. Model results also show that allocating treatment resources proportional to population is sub-optimal, and enforcing such a resource allocation policy might adversely impact the total number of infections and deaths, and thus resulting in a high cost that we have to pay for the fairness. Our multi-stage stochastic epidemic-logistics model is practical and can be adapted to control other infectious diseases in meta-populations and dynamically evolving situations.

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“…The lowest vaccination coverage rates are in the WHO African Region and, taking into account the whole population of incompletely vaccinated children, more than half of them (60%) live in only 10 countries (Nigeria, India, Pakistan, Indonesia, Ethiopia, Philippines, Democratic Republic of Congo, Brazil, Angola, Vietnam). 19 In poorer regions of the world immunization services are often carried out in unconventional places that gather a large number of people (schools, religious facilities). Educational methods and incentives are effective strategies to support vaccination systems.…”

Section: Dovepressmentioning

confidence: 99%

<p>A Review of Recommendations for Routine Immunization Services During COVID-19 Pandemic That are Relevant for Nursing Personnel Involved in the Implementation of Immunoprophylaxis</p>

Bednarek¹,

Klepacz²

2020

JMDH

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Immunization programmes are of key importance for maintaining good health and protecting life. Disruption to routine immunization may increase the incidence of diseases that can be prevented by vaccinations. The aim of this review is to present the current recommendations on immunization services during the COVID-19 pandemic that are relevant for the nursing practice. It contains an overview of recommended guidelines published in March and April 2020, and of scientific publications on immunizations for children and adults, taking into account recommendations related to the new epidemiological risk caused by SARS-CoV-2 infections. The ongoing global pandemic of COVID-19 calls for changes in the organization of health care and puts an additional burden on all resources forming the healthcare system. The COVID-19 pandemic poses a particular challenge to public health, as active immunoprophylaxis should make it possible to control other infectious diseases. Protection against the spread of SARS-CoV-2 may hamper routine immunization services, which must be administered with particular regard to epidemiological safety. Nurses have always had an important role to play in the implementation and promotion of vaccinations and in emphasizing their importance for public health. Therefore, it is crucial that they have up-to-date information on vaccinological interventions that reduce the risk of transmission of SARS-CoV-2 infections.

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State of equity: childhood immunization in the World Health Organization African region

Cited by 14 publications

References 12 publications

Tracking coverage, dropout and multidimensional equity gaps in immunisation systems in West Africa, 2000–2017

Tracking coverage, dropout and multidimensional equity gaps in immunisation systems in West Africa, 2000–2017

A Multi-Stage Stochastic Programming Approach to Epidemic Resource Allocation with Equity Considerations

<p>A Review of Recommendations for Routine Immunization Services During COVID-19 Pandemic That are Relevant for Nursing Personnel Involved in the Implementation of Immunoprophylaxis</p>

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