治理问题:探索治理对54个非洲国家的常规免疫绩效的影响:使用线性混合模型进行10年 (2012-2021) 的分析
Raoul Kamadjeu1, Katarzyna Wyka1, Elizabeth A Kelvin2
1Department of Epidemiology and Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York City, USA.
Vaccine
|September 12, 2024
概括
非洲免疫覆盖率下降与治理有关. 改善治理可以显著提高对DTP和麻疹等疾病的疫苗接种率,保护更多的儿童.
科学领域:
- 公共卫生 公共卫生
- 全球健康 全球健康
- 免疫接种计划 免疫接种计划
背景情况:
- 在过去的十年里,许多非洲国家的免疫覆盖率停滞或下降.
- 这使得数百万儿童易患疫苗可以预防的疾病.
- 有效的免疫接种与国家治理及其提供综合服务的能力密切相关.
研究的目的:
- 在54个非洲国家调查治理与免疫覆盖率趋势之间的关系.
- 评估治理对关键儿童疫苗疫苗接种率轨迹的影响.
主要方法:
- 使用世卫组织/联合国儿童基金会和伊布拉希姆非洲治理指数 (IIAG) 的公开数据进行的生态研究.
- 从2012年到2021年对DTPCV1,DTPCV3和MCV1的常规免疫性能进行分析.
- 使用线性混合模型来评估治理对免疫覆盖率的影响.
主要成果:
- 在54个非洲国家中,大多数国家 (59.3%) 总体免疫覆盖率下降.
- 整体IIAG得分显示,随着时间的推移,免疫覆盖率与免疫覆盖率有积极关联.
- 一个单位的IIAG得分增加与疫苗覆盖率 (DTPCV1,DTPCV3,MCV1) 的年平均增加0.64%至0.74%相关.
结论:
- 国家治理似乎是免疫计划绩效的关键决定因素.
- 免疫率的停滞或下降可能由治理因素解释,增加对外部冲击的脆弱性.
- 利益相关者应该考虑治理和服务交付之间的联系,在设定对免疫计划结果的期望时.
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