在低收入和中等收入国家改善常规儿童免疫的有效干预措施:系统审查的系统审查的系统审查
Monica Jain1, Maren Duvendack2, Shannon Shisler3
1International Initiative for Impact Evaluation, New Delhi, Delhi, India mjain@3ieimpact.org.
BMJ open
|February 16, 2024
概括
在低收入和中等收入国家,护理人员和社区干预显著提高了儿童免疫率. 需要对卫生系统干预措施进行更多的研究,以加强常规免疫计划.
科学领域:
- 公共卫生 公共卫生
- 全球健康 全球健康
- 卫生系统研究 卫生系统研究
背景情况:
- 常规儿童免疫接种对于降低低收入和中等收入国家 (L&MICs) 的儿童死亡率至关重要.
- 各种干预措施对L&MICs免疫结果的有效性需要全面的综合.
- 关于干预措施的现有证据是零碎的,需要一个综合性审查方法.
研究的目的:
- 综合关于有效干预措施的证据,以改善L&MICs的常规儿童免疫结果.
- 发现L&MICs儿童免疫干预的证据基础上的差距.
- 为未来的研究和政策提供建议.
主要方法:
- 进行了总体审查,系统审查的系统审查.
- 搜索了11个学术数据库和23个灰色文学来源,在2021年10月进行了更新的搜索.
- 包括系统性审查,评估L&MIC中常规儿童免疫接种结果的干预有效性;采用混合方法合成.
主要成果:
- 面向护理人员的干预措施 (教育,敏感化,书面信息) 对免疫结果产生了大而显著的积极影响.
- 医疗系统干预的证据有限;家庭访问是有效的,按绩效支付具有混合效应,外包是不确定的.
- 面向社区的干预措施显示出微小的积极效果;整体证据是异质的,发现了显著的差距.
结论:
- 针对护理人员和社区的干预措施是有效的改善日常儿童免疫.
- 面向卫生系统的干预措施的证据基础很少,这限制了家庭访问以外的坚定的结论.
- 对于特定干预和理解干预互补性,存在显著的证据差距,需要进一步进行高质量的研究.
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