低收入和中等收入国家免疫运动的激励措施:一个范围审查,对有效性和意外后果的证据进行映射
Matthew J Saunders1,2, Monique Pereboom3, Jose Luis Alvarez4
1Médecins Sans Frontières, London, UK msaunder@sgul.ac.uk.
BMJ global health
|June 30, 2025
概括
激励措施可以提高低收入和中等收入国家 (LMIC) 的短期免疫率,但可能会降低内在动机和信任. 谨慎的计划设计对于减轻负面影响和确保可持续性至关重要.
科学领域:
- 全球健康 全球健康
- 公共卫生政策 公共卫生政策
- 卫生经济学 卫生经济学
背景情况:
- 低收入和中等收入国家 (LMIC) 的疫苗接种计划经常利用激励计划.
- 了解这些激励措施的有效性和潜在的负面影响是有限的.
- 进行了范围审查,以综合LMIC疫苗接种激励措施的证据.
研究的目的:
- 绘制和综合有关在LMIC中使用免疫激励措施的证据.
- 为了比较不同地区和激励类型的经验.
- 识别与这些计划相关的意想不到的后果和实施挑战.
主要方法:
- 对于2000-2024年的研究,对奥维德MEDLINE和灰色文献进行了全面的搜索.
- 包括关于在LMIC中接种免疫的货币和非货币激励措施的定量和定性研究.
- 数据进行了叙事合成,以评估有效性,感知和意外后果.
主要成果:
- 包括来自19个LMIC的40项研究,主要评估儿童免疫的货币激励措施.
- 大多数研究都显示了对免疫接种的适度,短期的积极影响,没有证据表明免疫接种减少.
- 显著的意外后果包括内在动机的减少,支付期望和对医疗服务的信任的侵蚀.
结论:
- 在LMIC的免疫激励措施可以改善短期的吸收,但根据背景有很大差异.
- 负面的意想不到的后果,如减少的内在动机和信任,必须在程序设计中考虑.
- 未来的计划应该涉及社区共同设计,探索非货币替代方案,并专注于可持续融入卫生系统.
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