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Olayinka F, Sauer M, Menning L, Summers D, Wonodi C, Mackay S, MacDonald NE, Peter Figueroa J, Andriamitantsoa B, Bonsu G, Haldar P, Lindstrand A, Shimp L. Building and sustaining public and political commitment to the value of vaccination: Recommendations for the Immunization Agenda 2030 (Strategic Priority Area 2). Vaccine 2024; 42 Suppl 1:S43-S53. [PMID: 36528448 DOI: 10.1016/j.vaccine.2022.11.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/11/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022]
Abstract
Vaccines have contributed to substantial improvements in health and social development outcomes for millions in recent decades. However, equitable access to immunization remains a critical challenge that has stalled progress toward improving several health indicators around the world. The COVID-19 pandemic has also negatively impacted routine immunization services around the world further threatening universal access to the benefits of lifesaving vaccines. To overcome these challenges, the Immunization Agenda 2030 (IA2030) focuses on increasing both commitment and demand for vaccines. There are three broad barriers that will need to be addressed in order to achieve national and subnational immunization targets: (1) shifting leadership priorities and resource constraints, (2) visibility of disease burden, and (3) social and behavioral drivers. IA2030 proposes a set of interventions to address these barriers. First, efforts to ensure government engagement on immunization financing, regulatory, and legislative frameworks. Next, those in subnational leadership positions and local community members need to be further engaged to ensure local commitment and demand. Governance structures and health agencies must accept responsibility and be held accountable for delivering inclusive, quality, and accessible services and for achieving national targets. Further, the availability of quality immunization services and commitment to adequate financing and resourcing must go hand-in-hand with public health programs to increase access to and demand for vaccination. Last, strengthening trust in immunization systems and improving individual and program resilience can help mitigate the risk of vaccine confidence crises. These interventions together can help ensure a world where everyone, everywhere has access to and uses vaccines for lifesaving vaccination.
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Affiliation(s)
| | - Molly Sauer
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Lisa Menning
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | | | - Chizoba Wonodi
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA; International Vaccine Access Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | | | | | | | | | - George Bonsu
- Expanded Program on Immunization, Government of Ghana, Accra, Ghana
| | - Pradeep Haldar
- Ministry of Health and Family Welfare, Government of India, New Delhi, India
| | - Ann Lindstrand
- Department of Immunization, Vaccines and Biologicals, World Health Organization, Geneva, Switzerland
| | - Lora Shimp
- JSI Research & Training Institute, Inc, Arlington, USA.
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Luies SK, Sultana T, Budden A, Asaduzzaman M, Hossain MB, Kelly M, Gray D, Uddin MJ, Sarma H. Partnerships in the introduction of new routine vaccines in Bangladesh: evidence from a prospective process evaluation. BMJ Open 2022; 12:e061742. [PMID: 36167397 PMCID: PMC9516160 DOI: 10.1136/bmjopen-2022-061742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the contribution of partners in the introduction of two new vaccines concurrently: pneumococcal 10-valent conjugate vaccine (PCV-10) and inactivated polio vaccine (IPV) into the routine Expanded Programme on Immunization (EPI) in Bangladesh. DESIGN We conducted a prospective process evaluation that included the theory of change development, root cause analysis and in-depth investigation. As part of process tracking, we reviewed relevant documents, observed trainers' and vaccinators' training and key stakeholder meetings. We analysed the data thematically. SETTING We purposively selected eight Upazila (subdistrict) and one city corporation covering nine districts and seven administrative divisions of Bangladesh. PARTICIPANTS Nineteen national key informants were interviewed and 16 frontline health workers were invited to the group discussions considering their involvement in the vaccine introduction process. RESULTS The EPI experienced several challenges during the joint introduction of PCV-10 and IPV, such as frequent changes in the vaccine introduction schedule, delays in budget allocation, vaccine supply shortage and higher wastage rates of IPV. EPI addressed these challenges in collaboration with its partners, that is, the World Health Organization (WHO) and United Nations Children's Fund (UNICEF), who provided technical assistance to develop a training curriculum and communication materials and enhanced demand generation at the community level. In addition, the WHO conducted a country readiness assessment for PCV-10, and UNICEF supported vaccine shipment. Other government ministries, City Corporations and municipalities also supported the EPI. CONCLUSIONS The partnership among the EPI stakeholders effectively addressed various operational challenges during the joint introduction of PCV-10 and IPV helped strengthen Bangladesh's immunisation systems. These accomplishments are attributed to several factors that should be supported and strengthened for future vaccine introductions in Bangladesh and other low and-middle countries.
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Affiliation(s)
- Sharmin Khan Luies
- Infectious Diseases Division, icddr,b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
| | - Tahmina Sultana
- Research Program, Bangladesh Institute of Governance and Management, Dhaka, Bangladesh
| | - Ashwin Budden
- D'EVA Consulting, Washington, District of Columbia, USA
| | - Mohammad Asaduzzaman
- SanMarkS at iDE (International Development Enterprises), iDE Bangladesh, Dhaka, Bangladesh
| | - Md Billal Hossain
- Department of Sociology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Darren Gray
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Md Jasim Uddin
- Health Systems and Population Studies Division, icddr,b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhal, Dhaka 1212, Bangladesh
| | - Haribondhu Sarma
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
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Political economy analysis of universal health coverage and health financing reforms in low- and middle-income countries: the role of stakeholder engagement in the research process. Health Res Policy Syst 2021; 19:143. [PMID: 34895251 PMCID: PMC8665578 DOI: 10.1186/s12961-021-00788-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 10/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Progress towards universal health coverage (UHC) is an inherently political process. Political economy analysis (PEA) is gaining momentum as a tool to better understand the role of the political and economic dimensions in shaping and achieving UHC in different contexts. Despite the acknowledged importance of actors and stakeholders in political economy considerations, their role in the PEA research process beyond “study subjects” as potential cocreators of knowledge and knowledge users has been overlooked so far. We therefore aimed to review the approaches with reference to stakeholder engagement during the research process adopted in the current published research on the political economy of UHC and health financing reforms, and the factors favouring (or hindering) uptake and usability of PEA work. Methods We reviewed the literature to describe whether, when and how stakeholders were involved in the research process of studies looking at the political economy of UHC and health financing reforms, and to identify challenges and lessons learned on effective stakeholder engagement and research uptake. We used a standardized search strategy with key terms across several databases; we screened and included articles that focused on PEA and UHC. Additionally, we conducted a short survey of the authors of the included studies to complement the information retrieved. Results Fifty articles met the inclusion criteria and were included in the analysis. We found overall little evidence of systematic engagement of stakeholders in the research process, which focused mostly on the data collection phase of the research (i.e., key informant interviews). Our study identifies some reasons for the varying stakeholder engagement. Challenges include PEA requiring specific skills, a focus on sensitive issues, and the blurriness in researchers’ and stakeholders’ roles and the multiple roles of stakeholders as research participants, study subjects and research users. Among the approaches that might favour usability of PEA work, we identified early engagement, coproduction of research questions, local partners and personal contact, political willingness, and trust and use of prospective analysis. Conclusions Stakeholder engagement and research uptake are multifaceted concepts and complex processes, particularly when applied to PEA. As such, stakeholder engagement in the research process of PEA of UHC and health financing reforms is limited and underreported. Despite the challenges, however, stakeholder engagement remains key to ensuring relevance, usability and research uptake of PEA studies. More efforts are required to ensure engagement at different stages of the research process and better reporting in published articles.
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Muthathi IS, Kawonga M, Rispel LC. Using social network analysis to examine inter-governmental relations in the implementation of the Ideal Clinic Realisation and Maintenance programme in two South African provinces. PLoS One 2021; 16:e0251472. [PMID: 33979415 PMCID: PMC8115818 DOI: 10.1371/journal.pone.0251472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 04/27/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Within the context of universal health coverage (UHC), South Africa has embarked on a series of health sector reforms. The implementation of the Ideal Clinic Realisation and Maintenance (ICRM) programme is a major UHC reform. Cooperative governance is enshrined in South Africa's Constitution, with health a concurrent competency of national and provincial government. Hence, effective inter-governmental relations (IGR) are essential for the ICRM programme implementation. AIM The aim of the study was to measure the cohesion of IGR, specifically consultation, support and information sharing, across national, provincial and local government health departments in the ICRM programme implementation. MATERIALS AND METHODS Using Provan and Milward's theory on network effectiveness, this study was a whole network design social network analysis (SNA). The study was conducted in two districts in Gauteng (GP) and Mpumalanga (MP) provinces of South Africa. Following informed consent, we used both an interview schedule and a network matrix to collect the social network data from health policy actors in national, provincial and local government. We used UCINET version 6.619 to analyse the SNA data for the overall network cohesion and cohesion within and between the government spheres. RESULTS The social network analysis revealed non-cohesive relationships between the different spheres of government. In both provinces, there was poor consultation in the ICRM programme implementation, illustrated by the low densities of seeking advice (GP = 15.6%; MP = 24.4%) and providing advice (GP = 14.1%; MP = 25.1%). The most cohesive relationships existed within the National Department of Health (density = 66.7%), suggesting that national policy actors sought advice from one another, rather than from the provincial health departments. A density of 2.1% in GP, and 12.5% in MP illustrated the latter. CONCLUSION The non-cohesive relationships amongst policy actors across government spheres should be addressed in order to realise the benefits of cooperative governance in implementing the ICRM programme.
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Affiliation(s)
- Immaculate Sabelile Muthathi
- School of Public Health, Faculty of Health Sciences of the University of the Witwatersrand, Johannesburg, South Africa
| | - Mary Kawonga
- Department of Community Health, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Laetitia Charmaine Rispel
- Centre for Health Policy and South African Research Chairs Initiative, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Donadel M, Panero MS, Ametewee L, Shefer AM. National decision-making for the introduction of new vaccines: A systematic review, 2010-2020. Vaccine 2021; 39:1897-1909. [PMID: 33750592 PMCID: PMC10370349 DOI: 10.1016/j.vaccine.2021.02.059] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Competing priorities make using a transparent and evidence-based approach important when deciding to recommend new vaccines. We conducted a literature review to document the processes and frameworks for national decision-making on new vaccine introductions and explored which key features have evolved since 2010. METHODS We searched literature published on policymaking related to vaccine introduction from March 2010 to August 2020 in six databases. We screened articles for eligibility with the following exclusion criteria: non-human or hypothetical vaccines, the sole focus on economic evaluation or decision to adopt rather than policy decision-making. We employed nine broad categories of criteria from the 2012 review for categorization and abstracted data on the country, income level, vaccine, and other relevant criteria. RESULTS Of the 3808 unique references screened, 116 met eligibility criteria and were classified as: a) framework of vaccine adoption decision-making (27), b) studies that analyse empirical data on or examples of vaccine adoption decision-making (45), c) theoretical and empirical articles that provide insights into the vaccine policymaking process (44 + 17 already included in the previous categories). Commonly reported criteria for decision-making were the burden of disease; vaccine efficacy/effectiveness, safety; impact on health and non-health outcomes; economic evaluation and cost-effectiveness of alternative interventions. Programmatic and acceptability aspects were not as often considered. Most (50; 82%) of the 61 articles describing the process of vaccine introduction policymaking highlighted the role of country, regional, or global evidence-informed recommendations and a robust national governance as enabling factors for vaccine adoption. CONCLUSIONS The literature on vaccine adoption decision-making has expanded since 2010. We found that policymakers and expert advisory committee members (e.g., National Immunization Technical Advisory Group [NITAG]) increasingly value the interventions based on economic evaluations. The results of this review could guide discussions on evidence-informed immunization decision-making among country, sub-regional, and regional stakeholders.
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Affiliation(s)
- Morgane Donadel
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Maria Susana Panero
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lynnette Ametewee
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA; Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Abigail M Shefer
- Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Shelley KD, Kamya C, Mpanya G, Mulongo S, Nagasha SN, Beylerian E, Duber HC, Hernandez B, Osterman A, Phillips DE, Shearer JC. Partnership and Participation-A Social Network Analysis of the 2017 Global Fund Application Process in the Democratic Republic of the Congo and Uganda. Ann Glob Health 2020; 86:140. [PMID: 33200071 PMCID: PMC7646284 DOI: 10.5334/aogh.2961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background The Global Fund to Fight AIDS, Tuberculosis and Malaria was founded in 2002 as a public-private partnership between governments, the private sector, civil society, and populations affected by the three diseases. A key principle of the Global Fund is country ownership in accessing funding through "engagement of in-country stakeholders, including key and vulnerable populations, communities, and civil society." Research documenting whether diverse stakeholders are actually engaged and on how stakeholder engagement affects processes and outcomes of grant applications is limited. Objective To examine representation during the 2017 Global Fund application process in the Democratic Republic of the Congo (DRC) and Uganda and the benefits and drawbacks of partnership to the process. Methods We developed a mixed-methods social network survey to measure network structure and assess perceptions of how working together in partnership with other individuals/organizations affected perceived effectiveness, efficiency, and country ownership of the application process. Surveys were administered from December 2017-May 2018, initially to a set of central actors, followed by any individuals named during the surveys (up to 10) as collaborators. Network analyses were conducted using R. Findings Collaborators spanning many organizations and expertise areas contributed to the 2017 applications (DRC: 152 nodes, 237 ties; Uganda: 118 nodes, 241 ties). Participation from NGOs and civil society representatives was relatively strong, with most of their ties being to different organization types, Uganda (63%), and DRC (67%), highlighting their collaborative efforts across the network. Overall, the perceived benefits of partnership were high, including very strong ratings for effectiveness in both countries. Perceived drawbacks of partnership were minimal; however, less than half of respondents thought partnership helped reduce transaction costs or financial costs, suggesting an inclusive and participatory process may come with short-term efficiency tradeoffs. Conclusions Social network analysis can be useful for identifying who is included and excluded from the process, which can support efforts to ensure stronger, more meaningful engagement in future Global Fund application processes.
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Affiliation(s)
| | - Carol Kamya
- Infectious Diseases Research Collaboration (IDRC), Kampala, UG
| | | | | | | | | | - Herbert C. Duber
- Department of Emergency Medicine, University of Washington, Seattle, US
- Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, US
| | - Bernardo Hernandez
- Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, US
| | | | - David E. Phillips
- Department of Health Metrics Sciences, Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, US
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Assegaai T, Schneider H. The supervisory relationships of community health workers in primary health care: social network analysis of ward-based outreach teams in Ngaka Modiri Molema District, South Africa. BMJ Glob Health 2019; 4:e001839. [PMID: 31908861 PMCID: PMC6936529 DOI: 10.1136/bmjgh-2019-001839] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 11/13/2019] [Accepted: 11/19/2019] [Indexed: 11/21/2022] Open
Abstract
Introduction Supportive supervision remains a key challenge to the sustainability of community health worker (CHW) programmes globally. The aim of the study was to identify critical actors and patterns of relationships in the supervision of ward-based outreach teams (WBOT) in a rural South African district. Methods A cross-sectional study of social and professional relationships of WBOTs with other primary health care (PHC) system actors was conducted using a social network analysis (SNA) approach. A structured questionnaire was distributed to CHWs (37), WBOT team leaders (3), PHC facility managers (5) and PHC local area managers (2) (total n=47) assessing interaction patterns of supportive supervision, namely management, development and support. Results The supportive supervision system pivoted around team leaders, who were nurse cadres and who ensured internal cohesion and support among WBOT members. The network patterns also showed the extent of peer support between CHWs in WBOTs. PHC facility staff and middle managers in the subdistrict did not appear to play active roles in the supervision of CHWs and their team leaders. However, there were exceptions, with WBOTs drawing on sympathetic cadres identified among the PHC facility staff for support. Conclusion Supportive supervision of CHWs can be thought of as a system of horizontal and vertical relationships that go beyond just one supervisor–supervisee interaction. In this study, supervisory relationships within teams functioned better than those between teams and the rest of the PHC system. Understanding these relationships is key to designing effective supportive supervision in CHW programmes. SNA can be a valuable approach in identifying the relationships to be strengthened.
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Affiliation(s)
- Tumelo Assegaai
- School of Public Health, University of the Western Cape Faculty of Community and Health Sciences, Cape Town, South Africa
| | - Helen Schneider
- School of Public Health, University of the Western Cape, Cape Town, South Africa
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Innovation diffusion: how homogenous networks influence the uptake of community-based injectable contraceptives. BMC Public Health 2019; 19:1520. [PMID: 31727032 PMCID: PMC6857216 DOI: 10.1186/s12889-019-7819-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 10/21/2019] [Indexed: 11/10/2022] Open
Abstract
Background Studies have shown that social networks influence health behaviors, including the adoption of health innovations. This study explored the potential for early adopters of community health worker-delivered injectable contraceptives (CHWDIC) to influence the uptake of this innovation by women in their social networks. Methods This Social Network Analysis (SNA) study was conducted in Gombe, Nigeria. Twenty women who were early adopters of the CHWDIC were recruited. Each participant (ego) listed ten women of reproductive age (alters) with whom they related. An interviewer-administered questionnaire was used to collect from each ego, data about the nature of her relationship with each alter (ego-alter relationship), whether she talked about CHWDIC with each alter, and whether her listed alters talked to each other about CHWDIC (alter-alter relationship). Data were also collected on age, marital status and education level for each ego and alter. Data were analyzed with UCINET social network analysis software. Variables of interest include homophilia (similarity), density (number of ties as a proportion of possible ties), degree (popularity) and betweeness (frequency of connecting actor pairs who otherwise might not communicate). Results There were 20 egos and 200 alters. Between two thirds (alters) and three quarters (egos) of the women were 30 years or older. All of the egos and 196 (98%) of alters were married. Most of the networks had similar (homophilic) actors according to certain sociodemographic characteristics - ethnicity, age, education and type of marriage. More than 90% of the networks had density greater than 50%, suggesting high cohesion in most networks. The majority of actors in these networks used injectable contraceptives. In some of the networks, few actors with the highest prominence (betweeness centrality) were not users of injectable contraceptives. Conclusion The study illustrates the application and feasibility of ego SNA in identifying champions and opinion leaders among women of reproductive age group. It also shows the influence of social networks on the diffusion of community-based injectable contraceptives, and how homophilic and dense networks may have positive health externality. The interrelatedness of network members’ decision to adopt a health innovation was also demonstrated by the findings of this study.
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Padmawati RS, Heywood A, Sitaresmi MN, Atthobari J, MacIntyre CR, Soenarto Y, Seale H. Religious and community leaders' acceptance of rotavirus vaccine introduction in Yogyakarta, Indonesia: a qualitative study. BMC Public Health 2019; 19:368. [PMID: 30943929 PMCID: PMC6446267 DOI: 10.1186/s12889-019-6706-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 03/27/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Indonesia, oral rotavirus vaccines are available but not funded on the National Immunization Program (NIP). New immunization program introduction requires an assessment of community acceptance. For religiously observant Muslims in Indonesia, vaccine acceptance is further complicated by the use of porcine trypsin during manufacturing and the absence of halal labeling. In Indonesia, religious and community leaders and the Majelis Ulama Indonesia (MUI) are important resources for many religiously observant Muslims in decisions regarding the use of medicines, including vaccines. This study aimed to explore the views of religious and community leaders regarding the rotavirus vaccine to inform future communication strategies. METHODS Twenty semi-structured in-depth interviews were undertaken with religious leaders and community representatives from two districts of Yogyakarta Province, Indonesia. Thematic analysis was undertaken. RESULTS Although there was recognition childhood diarrhoea can be severe and a vaccine was needed, few were aware of the vaccine. Participants believed a halal label was required for community acceptance, and maintenance of trust in their government and leaders. Participants considered themselves to be key players in promoting the vaccine to the community post-labeling. CONCLUSIONS This study highlights the need for better stakeholder engagement prior to vaccine availability and the potentially important role of religious and community leaders in rotavirus vaccine acceptability in the majority Muslim community of Yogyakarta, Indonesia. These findings will assist with the development of strategies for new vaccine introduction in Indonesia.
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Affiliation(s)
| | - Anita Heywood
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia.
| | - Mei Neni Sitaresmi
- Faculty of Medicine, Universitas Gadjah Mada (UGM), Yogyakarta, Indonesia
| | - Jarir Atthobari
- Faculty of Medicine, Universitas Gadjah Mada (UGM), Yogyakarta, Indonesia
| | - C Raina MacIntyre
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Yati Soenarto
- Faculty of Medicine, Universitas Gadjah Mada (UGM), Yogyakarta, Indonesia
| | - Holly Seale
- School of Public Health and Community Medicine, UNSW Medicine, University of New South Wales, Sydney, Australia
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Witter S, Anderson I, Annear P, Awosusi A, Bhandari NN, Brikci N, Binachon B, Chanturidze T, Gilbert K, Jensen C, Lievens T, McPake B, Raichowdhury S, Jones A. What, why and how do health systems learn from one another? Insights from eight low- and middle-income country case studies. Health Res Policy Syst 2019; 17:9. [PMID: 30665412 PMCID: PMC6341535 DOI: 10.1186/s12961-018-0410-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 12/26/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND All health systems struggle to meet health needs within constrained resources. This is especially true for low-income countries. It is critical that they can learn from wider contexts in order to improve their performance. This article examines policy transfer and evidence use linked to it in low- and middle-income settings. The objective was to inform international investments in improved learning across health systems. METHODS The article uses a comparative case study design, drawing on case studies conducted in Bangladesh, Burkina Faso, Cambodia, Ethiopia, Georgia, Nepal, Rwanda and Solomon Islands. One or two recent health system reforms were selected in each case and 148 key informants were interviewed in total, using a semi-structured tool focused on different stages of the policy cycle. Interviewees were selected for their engagement in the policy process and represented political, technical, development partner, non-governmental, academic and civil society constituencies. Data analysis used a framework approach, allowing for new themes to be developed inductively, focusing initially on each case and then on patterns across cases. RESULTS The selected policies demonstrated a range of influences of externally imposed, co-produced and home-grown solutions on the development of initial policy ideas. Eventual uptake of policy was strongly driven in most settings by local political economic considerations. Policy development post-adoption demonstrated some strong internal review, monitoring and sharing processes but there is a more contested view of the role of evaluation. In many cases, learning was facilitated by direct personal relationships with local development partner staff. While barriers and facilitators to evidence use included supply and demand factors, the most influential facilitators were incentives and capacity to use evidence. CONCLUSIONS These findings emphasise the agency of local actors and the importance of developing national and sub-national institutions for gathering, filtering and sharing evidence. Developing demand for and capacity to use evidence appears more important than augmenting supply of evidence, although specific gaps in supply were identified. The findings also highlight the importance of the local political economy in setting parameters within which evidence is considered and the need for a conceptual framework for health system learning.
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Affiliation(s)
- Sophie Witter
- ReBUILD and Institute for Global Health and Development, Queen Margaret University Edinburgh, Musselburgh, EH21 2UU United Kingdom
| | - Ian Anderson
- Crawford School of Public Policy, Australian National University, Canberra, Australia
| | - Peter Annear
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | | | | | - Nouria Brikci
- Oxford Policy Management (OPM), Oxford, United Kingdom
| | | | | | - Katherine Gilbert
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | | | - Tomas Lievens
- Oxford Policy Management (OPM), Oxford, United Kingdom
| | - Barbara McPake
- Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia
| | | | - Alex Jones
- Oxford Policy Management (OPM), Oxford, United Kingdom
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Who Are the Key Players Involved with Shaping Public Opinion and Policies on Obesity and Diabetes in New Zealand? Nutrients 2018; 10:nu10111592. [PMID: 30380721 PMCID: PMC6267561 DOI: 10.3390/nu10111592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 10/20/2018] [Accepted: 10/24/2018] [Indexed: 11/26/2022] Open
Abstract
There is an urgent need for strategic approaches to address the high prevalence of obesity and diabetes in New Zealand. Such approaches rely strongly on input from multiple actors in the diabetes and obesity policy space. We conducted a social network analysis to identify influential actors involved with shaping public opinion and/or policy regarding obesity and diabetes in New Zealand. Our analysis revealed a diverse network of 272 individuals deemed influential by their peers. These individuals represented nine professional categories, particularly academics (34%), health service providers (22%), and government representatives (17%). The network included a total of 17 identified decision-makers. Relative capacity of professional categories to access these decision-makers was highest for representatives of the food and beverage industry (25%), compared with nongovernment organisations (9%) or academics (7%). We identified six distinct brokers, in academic (n = 4), government (n = 1), and nongovernmental (n = 1) positions, who could play a key role in improving communication and networking activities among all interest groups. Such actions should ultimately establish effective networks to foster evidence-based policy development to prevent and reduce the burden of diabetes and obesity.
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McIntyre L, Jessiman-Perreault G, Mah CL, Godley J. A social network analysis of Canadian food insecurity policy actors. CAN J DIET PRACT RES 2018; 79:60-66. [DOI: 10.3148/cjdpr-2017-034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: This paper aims to: (i) visualize the networks of food insecurity policy actors in Canada, (ii) identify potential food insecurity policy entrepreneurs (i.e., individuals with voice, connections, and persistence) within these networks, and (iii) examine the political landscape for action on food insecurity as revealed by social network analysis. Methods: A survey was administered to 93 Canadian food insecurity policy actors. They were each asked to nominate 3 individuals whom they believed to be policy entrepreneurs. Ego-centred social network maps (sociograms) were generated based on data on nominees and nominators. Results: Seventy-two percent of the actors completed the survey; 117 unique nominations ensued. Eleven actors obtained 3 or more nominations and thus were considered policy entrepreneurs. The majority of actors nominated actors from the same province (71.5%) and with a similar approach to theirs to addressing food insecurity (54.8%). Most nominees worked in research, charitable, and other nongovernmental organizations. Conclusions: Networks of Canadian food insecurity policy actors exist but are limited in scope and reach, with a paucity of policy entrepreneurs from political, private, or governmental jurisdictions. The networks are divided between food-based solution actors and income-based solution actors, which might impede collaboration among those with differing approaches to addressing food insecurity.
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Affiliation(s)
- Lynn McIntyre
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB
| | | | - Catherine L. Mah
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John’s, NL
| | - Jenny Godley
- Department of Sociology, University of Calgary and O’Brien Institute for Public Health, University of Calgary, Calgary, AB
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Social Networks, Engagement and Resilience in University Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14121488. [PMID: 29194361 PMCID: PMC5750906 DOI: 10.3390/ijerph14121488] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Revised: 11/24/2017] [Accepted: 11/27/2017] [Indexed: 11/16/2022]
Abstract
Analysis of social networks may be a useful tool for understanding the relationship between resilience and engagement, and this could be applied to educational methodologies, not only to improve academic performance, but also to create emotionally sustainable networks. This descriptive study was carried out on 134 university students. We collected the network structural variables, degree of resilience (CD-RISC 10), and engagement (UWES-S). The computer programs used were excel, UCINET for network analysis, and SPSS for statistical analysis. The analysis revealed results of means of 28.61 for resilience, 2.98 for absorption, 4.82 for dedication, and 3.13 for vigour. The students had two preferred places for sharing information: the classroom and WhatsApp. The greater the value for engagement, the greater the degree of centrality in the friendship network among students who are beginning their university studies. This relationship becomes reversed as the students move to later academic years. In terms of resilience, the highest values correspond to greater centrality in the friendship networks. The variables of engagement and resilience influenced the university students' support networks.
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Kamya C, Shearer J, Asiimwe G, Carnahan E, Salisbury N, Waiswa P, Brinkerhoff J, Hozumi D. Evaluating Global Health Partnerships: A Case Study of a Gavi HPV Vaccine Application Process in Uganda. Int J Health Policy Manag 2017; 6:327-338. [PMID: 28812825 PMCID: PMC5458794 DOI: 10.15171/ijhpm.2016.137] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 10/08/2016] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Global health partnerships have grown rapidly in number and scope, yet there has been less emphasis on their evaluation. Gavi, the Vaccine Alliance, is one such public-private partnership; in Gavi-eligible countries partnerships are dynamic networks of immunization actors who work together to support all stages and aspects of Gavi support. This paper describes a conceptual framework - the partnership framework - and analytic approach for evaluating the perceptions of partnerships' added value as well as the results from an application to one case in Uganda. METHODS We used a mixed-methods case study design embedded in the Gavi Full Country Evaluations (FCE) to test the partnership framework on Uganda's human papillomavirus (HPV) vaccine application partnership. Data from document review, interviews, and social network surveys enabled the testing of the relationships between partnership framework domains (context, structure, practices, performance, and outcomes). Topic guides were based on the framework domains and network surveys identified working together relationships, professional trust, and perceptions of the effectiveness, efficiency, and legitimacy of the partnership's role in this process. RESULTS Data from seven in-depth interviews, 11 network surveys and document review were analyzed according to the partnership framework, confirming relationships between the framework domains. Trust was an important contributor to the perceived effectiveness of the process. The network was structured around the EPI program, who was considered the leader of this process. While the structure and composition of the network was largely viewed as supporting an effective and legitimate process, the absence of the Ministry of Education (MoE) may have had downstream consequences if this study's results had not been shared with the Ministry of Health (MoH) and acted upon. The partnership was not perceived to have increased the efficiency of the process, perhaps as a result of unclear or absent guidelines around roles and responsibilities. CONCLUSION The health and functioning of global health partnerships can be evaluated using the framework and approach presented here. Network theory and methods added value to the conceptual and analytic processes and we recommend applying this approach to other global health partnerships to ensure that they are meeting the complex challenges they were designed to address.
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Affiliation(s)
- Carol Kamya
- Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
| | | | - Gilbert Asiimwe
- Infectious Diseases Research Collaboration (IDRC), Kampala, Uganda
| | | | | | - Peter Waiswa
- Makerere University School of Public Health, Kampala, Uganda.,Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden.,The INDEPTH Network, Maternal, Newborn and Child Health Working Group, Accra, Ghana
| | | | - Dai Hozumi
- Management Sciences for Health, Arlington, VA, USA
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15
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Jessani N, Kennedy C, Bennett S. The Human Capital of Knowledge Brokers: An analysis of attributes, capacities and skills of academic teaching and research faculty at Kenyan schools of public health. Health Res Policy Syst 2016; 14:58. [PMID: 27484172 PMCID: PMC4971650 DOI: 10.1186/s12961-016-0133-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 07/13/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Academic faculty involved in public health teaching and research serve as the link and catalyst for knowledge synthesis and exchange, enabling the flow of information resources, and nurturing relations between 'two distinct communities' - researchers and policymakers - who would not otherwise have the opportunity to interact. Their role and their characteristics are of particular interest, therefore, in the health research, policy and practice arena, particularly in low- and middle-income countries. We investigated the individual attributes, capacities and skills of academic faculty identified as knowledge brokers (KBs) in schools of public health (SPH) in Kenya with a view to informing organisational policies around the recruitment, retention and development of faculty KBs. METHODS During April 2013, we interviewed 12 academics and faculty leadership (including those who had previously been identified as KBs) from six SPHs in Kenya, and 11 national health policymakers with whom they interact. Data were qualitatively analyzed using inductive thematic analysis to unveil key characteristics. RESULTS Key characteristics of KBs fell into five categories: sociodemographics, professional competence, experiential knowledge, interactive skills and personal disposition. KBs' reputations benefitted from their professional qualifications and content expertise. Practical knowledge in policy-relevant situations, and the related professional networks, allowed KB's to navigate both the academic and policy arenas and also to leverage the necessary connections required for policy influence. Attributes, such as respect and a social conscience, were also important KB characteristics. CONCLUSION Several changes in Kenya are likely to compel academics to engage increasingly with policymakers at an enhanced level of debate, deliberation and discussion in the future. By recognising existing KBs, supporting the emergence of potential KBs, and systematically hiring faculty with KB-specific characteristics, SPHs can enhance their collective human capital and influence on public health policy and practice. Capacity strengthening of tangible skills and recognition of less tangible personality characteristics could contribute to enhanced academic-policymaker networks. These, in turn, could contribute to the relevance of SPH research and teaching programs as well as evidence-informed public health policies.
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Affiliation(s)
- Nasreen Jessani
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205 United States of America
| | - Caitlin Kennedy
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205 United States of America
| | - Sara Bennett
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, 615 N. Wolfe St, Baltimore, MD 21205 United States of America
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16
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Shearer JC, Abelson J, Kouyaté B, Lavis JN, Walt G. Why do policies change? Institutions, interests, ideas and networks in three cases of policy reform. Health Policy Plan 2016; 31:1200-11. [PMID: 27233927 DOI: 10.1093/heapol/czw052] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2016] [Indexed: 11/15/2022] Open
Abstract
Policy researchers have used various categories of variables to explain why policies change, including those related to institutions, interests and ideas. Recent research has paid growing attention to the role of policy networks-the actors involved in policy-making, their relationships with each other, and the structure formed by those relationships-in policy reform across settings and issues; however, this literature has largely ignored the theoretical integration of networks with other policy theories, including the '3Is' of institutions, interests and ideas. This article proposes a conceptual framework integrating these variables and tests it on three cases of policy change in Burkina Faso, addressing the need for theoretical integration with networks as well as the broader aim of theory-driven health policy analysis research in low- and middle-income countries. We use historical process tracing, a type of comparative case study, to interpret and compare documents and in-depth interview data within and between cases. We found that while network changes were indeed associated with policy reform, this relationship was mediated by one or more of institutions, interests and ideas. In a context of high donor dependency, new donor rules affected the composition and structure of actors in the networks, which enabled the entry and dissemination of new ideas and shifts in the overall balance of interest power ultimately leading to policy change. The case of strategic networking occurred in only one case, by civil society actors, suggesting that network change is rarely the spark that initiates the process towards policy change. This analysis highlights the important role of changes in institutions and ideas to drive policymaking, but hints that network change is a necessary intermediate step in these processes.
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Affiliation(s)
- Jessica C Shearer
- Health Systems Innovation and Delivery, PATH, Seattle Washington, USA
| | - Julia Abelson
- Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | | | - John N Lavis
- Center for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - Gill Walt
- London School of Hygiene and Tropical Medicine, London, UK
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17
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Hadisoemarto PF, Reich MR, Castro MC. Introduction of pentavalent vaccine in Indonesia: a policy analysis. Health Policy Plan 2016; 31:1079-88. [PMID: 27107293 PMCID: PMC5013783 DOI: 10.1093/heapol/czw038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2016] [Indexed: 11/13/2022] Open
Abstract
The introduction of pentavalent vaccine containing Haemophilus influenzae type b antigen in Indonesia's National Immunization Program occurred nearly three decades after the vaccine was first available in the United States and 16 years after Indonesia added hepatitis B vaccine into the program. In this study, we analyzed the process that led to the decision to introduce pentavalent vaccine in Indonesia. Using process tracing and case comparison, we used qualitative data gathered through interviews with key informants and data extracted from written sources to identify four distinct but interrelated processes that were involved in the decision making: (a) pentavalent vaccine use policy process, (b) financing process, (c) domestic vaccine development process and (d) political process. We hypothesized that each process is associated with four necessary conditions that are jointly sufficient for the successful introduction of pentavalent vaccine in Indonesia, namely (a) an evidence-based vaccine use recommendation, (b) sufficient domestic financing capacity, (c) sufficient domestic vaccine manufacturing capacity and (d) political support for introduction. This analysis of four processes that led to the decision to introduce a new vaccine in Indonesia may help policy makers and other stakeholders understand and manage activities that can accelerate vaccine introduction in the future.
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Affiliation(s)
- Panji F Hadisoemarto
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Boston, MA 02115, USA Faculty of Medicine, Department of Public Health, Padjadjaran University, Jl. Eyckman 38, West Java, Bandung 40161 Indonesia
| | - Michael R Reich
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Boston, MA 02115, USA
| | - Marcia C Castro
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Boston, MA 02115, USA
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18
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Jessani NS, Boulay MG, Bennett SC. Do academic knowledge brokers exist? Using social network analysis to explore academic research-to-policy networks from six schools of public health in Kenya. Health Policy Plan 2015; 31:600-11. [PMID: 26537610 PMCID: PMC4857485 DOI: 10.1093/heapol/czv107] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2015] [Indexed: 12/22/2022] Open
Abstract
The potential for academic research institutions to facilitate knowledge exchange and influence evidence-informed decision-making has been gaining ground. Schools of public health (SPHs) may play a key knowledge brokering role—serving as agencies of and for development. Understanding academic-policymaker networks can facilitate the enhancement of links between policymakers and academic faculty at SPHs, as well as assist in identifying academic knowledge brokers (KBs). Using a census approach, we administered a sociometric survey to academic faculty across six SPHs in Kenya to construct academic-policymaker networks. We identified academic KBs using social network analysis (SNA) in a two-step approach: First, we ranked individuals based on (1) number of policymakers in their network; (2) number of academic peers who report seeking them out for advice on knowledge translation and (3) their network position as ‘inter-group connectors’. Second, we triangulated the three scores and re-ranked individuals. Academic faculty scoring within the top decile across all three measures were classified as KBs. Results indicate that each SPH commands a variety of unique as well as overlapping relationships with national ministries in Kenya. Of 124 full-time faculty, we identified 7 KBs in 4 of the 6 SPHs. Those scoring high on the first measure were not necessarily the same individuals scoring high on the second. KBs were also situated in a wide range along the ‘connector/betweenness’ measure. We propose that a composite score rather than traditional ‘betweenness centrality’, provides an alternative means of identifying KBs within these networks. In conclusion, SNA is a valuable tool for identifying academic-policymaker networks in Kenya. More efforts to conduct similar network studies would permit SPH leadership to identify existing linkages between faculty and policymakers, shared linkages with other SPHs and gaps so as to contribute to evidence-informed health policies.
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Affiliation(s)
- Nasreen S Jessani
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Marc G Boulay
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Sara C Bennett
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Romore I, Ali AM, Semali I, Mshinda H, Tanner M, Abdulla S. Assessment of parental perception of malaria vaccine in Tanzania. Malar J 2015; 14:355. [PMID: 26383545 PMCID: PMC4573291 DOI: 10.1186/s12936-015-0889-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 09/02/2015] [Indexed: 11/13/2022] Open
Abstract
Background Clinical trials of the RTS,S malaria vaccine have completed Phase III and the vaccine is on track for registration. Before making decisions about implementation, it is essential to prepare the ground for introducing the vaccine by assessing awareness and willingness to use malaria vaccines and to provide policy makers with evidence-based information on the best strategies to engage communities to manage the introduction of malaria vaccine in Tanzania. Methods In November 2011, as part of a large cross-sectional study of all 23 regions of Tanzania (mainland Tanzania and Zanzibar) was conducted during Tanzanian Integrated Measles Campaign (IMC) survey. In this study, the variables of interests were awareness and willingness to use a malaria vaccine. The main outcome measure was willingness to use a malaria vaccine. Logistic regression was used to examine the influence of predictive factors. Results A representative sample of 5502 (out of 6210) women, aged 18 years or older and with children under 11 months old, was selected to participate, using random sampling probability. Awareness of the forthcoming malaria vaccine, 11.8 % of participants in mainland Tanzania responded affirmatively, compared to 3.4 % in Zanzibar (p value <0.0001). 94.5 % of all respondents were willing to vaccinate their children against malaria, with a slight difference between mainland Tanzania (94.3 %) and Zanzibar (96.8 %) (p value = 0.0167). Conclusions Although mothers had low awareness and high willingness to use malaria vaccine, still availability of malaria vaccine RTS,S will compliment other existing malaria interventions and it will be implemented through the Immunization, Vaccines and Biologicals (IVB) programme (formerly EPI). The information generated from this study can aid policy makers in planning and setting priorities for introducing and implementing the malaria vaccine. Electronic supplementary material The online version of this article (doi:10.1186/s12936-015-0889-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Idda Romore
- Swiss Tropical and Public health Institute, Socinstrasse 57, Postfach, 4002, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Ifakara Health Institute (IHI), P.O. Box 78373, Dar Es Salaam, Tanzania.
| | - Ali Mohamed Ali
- Swiss Tropical and Public health Institute, Socinstrasse 57, Postfach, 4002, Basel, Switzerland. .,University of Basel, Basel, Switzerland. .,Ifakara Health Institute (IHI), P.O. Box 78373, Dar Es Salaam, Tanzania.
| | - Innocent Semali
- Muhimbili University of Health and Allied Science (MUHAS), P.O. Box 65015, Dar Es Salaam, Tanzania.
| | - Hassan Mshinda
- Commision for Science and Technology (COSTEC), P.O. Box 4302, Dar Es Salaam, Tanzania.
| | - Marcel Tanner
- Swiss Tropical and Public health Institute, Socinstrasse 57, Postfach, 4002, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | - Salim Abdulla
- Ifakara Health Institute (IHI), P.O. Box 78373, Dar Es Salaam, Tanzania.
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Uwizihiwe JP. 40th Anniversary of Introduction of Expanded Immunization Program (EPI): A Literature Review of Introduction of New Vaccines for Routine Childhood Immunization in Sub-Saharan Africa. ACTA ACUST UNITED AC 2015. [DOI: 10.15406/ijvv.2015.01.00004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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21
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Exploring the use of social network analysis to measure communication between disease programme and district managers at sub-national level in South Africa. Soc Sci Med 2015; 135:1-14. [PMID: 25931377 DOI: 10.1016/j.socscimed.2015.04.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
With increasing interest in maximising synergies between disease control programmes (DCP) and general health services (GHS), methods are needed to measure interactions between DCP and GHS actors. In South Africa, administrative integration reforms make GHS managers at decentralised level (district managers) responsible for the oversight of DCP operations within districts, with DCP managers (programme managers) providing specialist support. The reforms necessitate interdependence, but these actors work together ineffectively. Communication is crucial for joint working, but no research to assess communication between these actors has been done. This study explores the use of social network analysis (SNA) to measure the extent to which programme and district managers in South Africa communicate, using HIV monitoring and evaluation (M&E) as an exemplar. Data were collected from fifty one managers in two provinces during 2010-2011, to measure: a) one-on-one task-related communication - talking about the collation (verification, reporting) and use of HIV data for monitoring HIV interventions; and b) group communication through co-participating in management committees where HIV data are used for monitoring HIV interventions in districts. SNA measures were computed to describe actor centrality, network density (cohesion), and communication within and between respective manager groups. Block modelling was applied to identify management committees that connect respective manager groups. Results show HIV programme managers located at higher level communicated largely amongst themselves as a group (homophily), seldom talked to the district managers to whom they are supposed to provide specialist HIV M&E support, and rarely participated with them in management committees. This research demonstrates the utility of SNA as a tool for measuring the extent of communication between DCP and GHS actors at sub-national level. Actions are needed to bridge observed communication gaps in order to promote collaborative monitoring of HIV programme interventions within districts.
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Mohammadhassanzadeh H, Shokraneh F. Social networking in health system for knowledge translation. J Cardiovasc Thorac Res 2014; 6:71-3. [PMID: 24753838 PMCID: PMC3992738 DOI: 10.5681/jcvtr.2014.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2014] [Accepted: 03/01/2014] [Indexed: 11/17/2022] Open
Affiliation(s)
- Hafez Mohammadhassanzadeh
- Research Center for Pharmaceutical Nanotechnology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farhad Shokraneh
- Cochrane Schizophrenia Group, the Institute of Mental Health, a partnership between the University of Nottingham and Nottinghamshire Healthcare NHS Trust, UK
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Kochhar S, Rath B, Seeber LD, Rundblad G, Khamesipour A, Ali M. Introducing new vaccines in developing countries. Expert Rev Vaccines 2014; 12:1465-78. [DOI: 10.1586/14760584.2013.855612] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Blanchet K. How to facilitate social contagion? Int J Health Policy Manag 2013; 1:189-92. [PMID: 24596863 PMCID: PMC3937890 DOI: 10.15171/ijhpm.2013.35] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 08/15/2013] [Indexed: 11/09/2022] Open
Abstract
Achieving the Millennium Development Goals has proven to be a real challenge. Providing evidence on cost-effective interventions did not prove to be sufficient to secure the trust of national authorities, health care providers and patients. Introducing change in a health system requires a good understanding of the relationships between the actors of the system. Social network analysis can provide a new avenue to analyse the diffusion of innovations within a health system or a health organisation and analyse the structure and the properties of a health system. Evidence has been generated on the necessity of not only identifying the actors of a system but also qualifying the relationships between these actors.
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Affiliation(s)
- Karl Blanchet
- Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
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25
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Paterson P, Larson HJ. The role of publics in the introduction of new vaccines. Health Policy Plan 2012; 27 Suppl 2:ii77-9. [PMID: 22513734 PMCID: PMC3328759 DOI: 10.1093/heapol/czs038] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mantel C, Wang SA. The privilege and responsibility of having choices: decision-making for new vaccines in developing countries. Health Policy Plan 2012; 27 Suppl 2:ii1-4. [PMID: 22513728 DOI: 10.1093/heapol/czs041] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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