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Dudeja N, Khan T, Varughese DT, Abraham SG, Ninan MM, Prasad CL, Sarkar R, Kang G. Technologies for strengthening immunization coverage in India: a systematic review. Lancet Reg Health Southeast Asia 2024; 23:100251. [PMID: 38404512 PMCID: PMC10884965 DOI: 10.1016/j.lansea.2023.100251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 02/27/2024]
Abstract
Background Immunization coverage varies across India in different settings, geographic areas and populations. Technologies for improving immunization access can reduce disparities in coverage. This systematic review, which follows PRISMA guidelines, aims to examine the technologies for strengthening immunization coverage in India. Methods Studies published between January 1, 2011 and July 31, 2021 were searched in Medline (through PubMed), Cochrane Library and Google Scholar. All observational and experimental studies, except qualitative studies, were included. Studies published in the English language and related to technologies for strengthening immunization, conducted on children, pregnant women, adults, elderly, healthcare personnel, caregivers and vulnerable populations across all Indian settings were included. Non-English articles, protocols, commentaries, letters, abstracts, correspondence, opinion articles, modelling, narrative and systematic reviews were excluded. Two reviewers screened studies independently, extracted data in a standardized sheet and appraised the study quality using the Mixed Methods Appraisal Tool. The primary outcome was technologies that improved immunization coverage. The protocol is registered with OSF (https://osf.io/r42gm). Findings 6592 titles and abstracts were screened, and data extracted from 23 India-specific studies. Quality of 22/23 studies was average or above. Technologies identified included reminder systems, capacity building, community engagement and wearable technologies. Automated incentivised mobile phone reminders, immunization due-list, computerized data tracking, community mobilization and campaigns improved vaccine coverage, although effectiveness of some varied viz., reminder systems, and across states. Newer technologies included the Jyotigram Yojana, Digital Near-field Communication Pendants, "Reaching Every District" Programme and the "My Village My Home" tool. Interpretation Technologies for improving immunization systems, capacity building and community engagement were effective. Newer technologies on vaccine delivery, mapping and cold chain logistics were not evaluated in India or were ineffective. There were limited studies in populations other than children and pregnant women. Future work is needed to evaluate the effectiveness of identified technologies across diverse settings. Funding No funding was received for preparing this manuscript.
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Affiliation(s)
- Nonita Dudeja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Tila Khan
- School of Medical Science & Technology, Indian Institute of Technology Kharagpur, West Bengal, India
| | - Deepak Thomas Varughese
- Department of Community Medicine, Believers Church Medical College, Thiruvalla, Kerala, India
| | - Sebin George Abraham
- Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India
| | - Marilyn Mary Ninan
- Department of Clinical Microbiology, Christian Medical College, Vellore, Tamil Nadu, India
| | | | - Rajiv Sarkar
- Indian Institute of Public Health Shillong, Shillong, Meghalaya, India
| | - Gagandeep Kang
- Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
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Dudeja N, Sharma D, Maria A, Pawar P, Mukherjee R, Nargotra S, Mohapatra A. Implementing recommended breastfeeding practices in healthcare facilities in India during the COVID-19 pandemic: a scoping review of health system bottlenecks and potential solutions. Front Nutr 2023; 10:1142089. [PMID: 37583462 PMCID: PMC10423995 DOI: 10.3389/fnut.2023.1142089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/14/2023] [Indexed: 08/17/2023] Open
Abstract
Background Breastfeeding practices in institutional settings got disrupted during the COVID-19 pandemic. We reviewed the challenges faced and the "work-around" solutions identified for implementing recommended breastfeeding practices in institutionalized mother-newborn dyads in resource constrained settings during the pandemic with the aim to identify learnings that could be potentially adapted to the Indian and relatable contexts, for building resilient health systems. Methods We conducted a scoping review of literature using the PRISMA ScR Extension guidelines. We searched the Medline via PubMed and Web of Science databases for literature published between 1st December 2019 and 15th April 2022. We included original research, reviews, and policy recommendations published in English language and on India while others were excluded. Further, we searched for relevant gray literature on Google (free word search), websites of government and major professional bodies in India. Three reviewers independently conducted screening and data extraction and the results were displayed in tabular form. Challenges and potential solutions for breastfeeding were identified and were categorized under one or more suitable headings based on the WHO building blocks for health systems. Results We extracted data from 28 papers that were deemed eligible. Challenges were identified across all the six building blocks. Lack of standard guidelines for crisis management, separation of the newborn from the mother immediately after birth, inadequate logistics and resources for infection prevention and control, limited health workforce, extensive use of formula and alternative foods, inconsistent quality of care and breastfeeding support, poor awareness among beneficiaries about breastfeeding practices (and especially, about its safety during the pandemic) were some of the challenges identified. The solutions primarily focused on the development of standard guidelines and operating procedures, restricted use of formula, use of telemedicine services for counseling and awareness and improving resource availability for risk mitigation through strategic mobilization. Conclusion The COVID-19 pandemic has provided rich learning opportunities for health system strengthening in India. Countries must strengthen learning mechanisms to identify and adapt best practices from within their health systems and from other relatable settings.
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Affiliation(s)
- Nonita Dudeja
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
| | - Divita Sharma
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
| | - Arti Maria
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Priyanka Pawar
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
| | - Ritika Mukherjee
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
| | - Shikha Nargotra
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
| | - Archisman Mohapatra
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
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Mungmunpuntipantip R, Wiwanitkit V, Lahariya C, Thakur A, Dudeja N. Monkeypox Disease Outbreak (2022): Correspondence. Indian Pediatr 2022; 59:730. [PMID: 36101959 PMCID: PMC9518952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Affiliation(s)
| | - Viroj Wiwanitkit
- grid.440681.f0000 0004 1764 9922Dr DY Patil University, Pune, India
| | | | - Archana Thakur
- Foundation for People-Centric Health Systems, New Delhi, India
| | - Nonita Dudeja
- Foundation for People-Centric Health Systems, New Delhi, India
- Human Capital Lighthouse (Consulting) Pvt Ltd, New Delhi, India
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Lahariya C, Thakur A, Dudeja N. Monkeypox Disease Outbreak (2022): Correspondence: Authors' Reply. Indian Pediatr 2022; 59:730-731. [PMID: 36101960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Affiliation(s)
| | | | - Nonita Dudeja
- Foundation for People-Centric Health Systems and Human Capital Lighthouse (Consulting) Pvt Ltd, New Delhi
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Lahariya C, Thakur A, Dudeja N. Monkeypox Disease Outbreak (2022): Epidemiology, Challenges, and the Way Forward. Indian Pediatr 2022; 59:636-642. [PMID: 35762024 PMCID: PMC9419123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
The biggest-ever outbreak of monkeypox disease in non-endemic countries started in May, 2022. Though no monkeypox case has been reported from India, till mid-June, 2022, yet, considering the rate of spread to the non-endemic countries, there is an urgent need of better understanding of the monkeypox virus and disease epidemiology to help clinicians, public health specialists, and policymakers to be prepared for any eventuality. This review summarises the monkeypox disease epidemiology, clinical features, therapies, vaccines and outlines the measures for preparedness and response for a possible outbreak. The disease is known to cause severe outcome in children, pregnant women, and immunocompromised hosts and this group need to be given special attention. The monkeypox disease outbreak (2022) in non-endemic countries should be used as an opportunity by India and other low and middle income countries to strengthen public health surveillance and health system capacity for outbreak and epidemic preparedness and response.
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Affiliation(s)
- Chandrakant Lahariya
- Foundation for People-Centric Health Systems, New Delhi. Correspondence to: Dr Chandrakant Lahariya, B-2/173, First Floor, Safdarjung Enclave, New Delhi 110 029, India.
| | | | - Nonita Dudeja
- Human Capital Lighthouse (Consulting) Pvt. Ltd., New Delhi
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Abstract
The biggest-ever outbreak of monkeypox disease in non-endemic countries started in May, 2022. Though no monkeypox case has been reported from India, till mid-June, 2022, yet, considering the rate of spread to the non-endemic countries, there is an urgent need of better understanding of the monkeypox virus and disease epidemiology to help clinicians, public health specialists, and policymakers to be prepared for any eventuality. This review summarises the monkeypox disease epidemiology, clinical features, therapies, vaccines and outlines the measures for preparedness and response for a possible outbreak. The disease is known to cause severe outcome in children, pregnant women, and immunocompromised hosts and this group need to be given special attention. The monkeypox disease outbreak (2022) in non-endemic countries should be used as an opportunity by India and other low and middle income countries to strengthen public health surveillance and health system capacity for outbreak and epidemic preparedness and response.
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Affiliation(s)
- Chandrakant Lahariya
- Foundation for People-Centric Health Systems, New Delhi. Correspondence to: Dr Chandrakant Lahariya, B-2/173, First Floor, Safdarjung Enclave, New Delhi 110 029, India.
| | | | - Nonita Dudeja
- Human Capital Lighthouse (Consulting) Pvt. Ltd., New Delhi
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Sinha B, Dudeja N, Chowdhury R, Choudhary TS, Upadhyay RP, Rongsen-Chandola T, Mazumder S, Taneja S, Bhandari N. Enteral Zinc Supplementation in Preterm or Low Birth Weight Infants: A Systematic Review and Meta-analysis. Pediatrics 2022; 150:188644. [PMID: 35921675 DOI: 10.1542/peds.2022-057092j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Evidence on the effect of zinc supplementation on health outcomes in preterm or low birth weight (LBW) infants is unclear. We estimated the effect of enteral zinc versus no zinc supplementation in human milk fed preterm or LBW infants on mortality, growth, morbidities, and neurodevelopment. METHODS Data sources include PubMed, Cochrane Central and Embase databases through March 24, 2021. Study selection was randomized or quazi-experimental trials. Two reviewers independently screened, extracted data, and assessed quality. We reported pooled relative risks (RR) for categorical outcomes, and mean differences (MD) for continuous outcomes. RESULTS Fourteen trials with 9940 preterm or LBW infants were included. Moderate to low certainty evidence showed that enteral zinc supplementation had little or no effect on mortality (risk ratio 0.73, 95% confidence interval [CI] 0.46 to 1.16), but increased weight (MD 378.57, 95% CI 275.26 to 481.88), length (MD 2.92, 95% CI 1.53 to 4.31), head growth (MD 0.56, 95% CI 0.23 to 0.90), and decreased diarrhea (RR 0.81; 95% CI 0.68 to 0.97). There was no effect on acute respiratory infections, bacterial sepsis, and psychomotor development scores. The effect of zinc supplementation on mental development scores is inconclusive. There was no evidence of serious adverse events. Eight trials had some concerns or high risk of bias, small-sized studies, and high heterogeneity between trials led to moderate to very low certainty of evidence. CONCLUSIONS Zinc supplementation in preterm or LBW infants have benefits on growth and diarrhea prevention. Further research is needed to generate better quality evidence.
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Affiliation(s)
- Bireshwar Sinha
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.,DBT and Wellcome India Alliance Clinical and Public health Fellow, Hyderabad, India
| | - Nonita Dudeja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Ranadip Chowdhury
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.,DBT and Wellcome India Alliance Clinical and Public health Fellow, Hyderabad, India
| | - Tarun Shankar Choudhary
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Ravi Prakash Upadhyay
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.,DBT and Wellcome India Alliance Clinical and Public health Fellow, Hyderabad, India
| | | | - Sarmila Mazumder
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
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Dudeja N, Sinha B, Goyal N, Arya A, Revi A, Dutta A, More D, Chakravarty A, Kumar CM, Rongsen-Chandola T. Association of water, sanitation, hygiene and food practices with enteric fever in a paediatric cohort in North India. BMJ Paediatr Open 2022; 6:10.1136/bmjpo-2021-001352. [PMID: 36053585 PMCID: PMC9045109 DOI: 10.1136/bmjpo-2021-001352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/05/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Our aim was to assess the association of water, sanitation and hygiene (WASH) and food practices with culture-confirmed enteric fever in children <15 years of age. METHODS We followed a cohort of 6000 children from an urban low socioeconomic neighbourhood in South Delhi for 2 years to estimate burden of culture-confirmed enteric fever. Risk ratios (RRs) were estimated to study the association between WASH practices and enteric fever. We assessed the microbiological quality of drinking water and conducted geospatial analysis to evaluate the distribution of enteric fever cases around households with contaminated drinking water. RESULTS A total of 5916 children in 3123 households completed survey. Piped water (82%) was the major source of household drinking water. One-third (32%) of the households treated water before consumption. Almost all households had sanitary toilets (99.9%) and 16% used shared toilets. Consumption of food from street vendors and unnamed ice creams more than once a week was observed in children from 12.7% and 38.4% households, respectively. Eighty culture-confirmed enteric fever cases were reported. The risk of enteric fever was 71% higher in children belonging to households having food from outside once a week or more (RR 1.71, 95% CI 1.00 to 2.94). The RR for enteric fever in children living in households with availability of safe drinking water was 0.75 (95% CI 0.45 to 1.26). We found that 14.8% of the households had presence of coliforms or Escherichia coli in their household drinking water. The odds of having a case of enteric fever within a 5 and 25 m buffer zone around households with contaminated drinking water were 4.07 (95% CI 0.81 to 20.5) and 1.44 (95% CI 0.69 to 3.00), respectively. CONCLUSION In addition to WASH practices, optimal food hygiene may have a role in urban low socioeconomic population to control enteric fever. TRIAL REGISTRATION NUMBER CTRI/2017/09/009719.
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Affiliation(s)
- Nonita Dudeja
- Division of Infectious Diseases, Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Bireshwar Sinha
- Division of Infectious Diseases, Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nidhi Goyal
- Division of Infectious Diseases, Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Alok Arya
- Division of Infectious Diseases, Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Anitha Revi
- Division of Infectious Diseases, Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Ankita Dutta
- Clinical and Research Laboratories, Society for Applied Studies, New Delhi, India
| | - Deepak More
- Clinical and Research Laboratories, Society for Applied Studies, New Delhi, India
| | - Aparna Chakravarty
- Department of Paediatrics, Hakeem Abdul Hameed Centenary Hospital, Hamdard Institute of Medical Sciences and Research, New Delhi, Delhi, India
| | - Chandra Mohan Kumar
- Department of Paediatrics, Hakeem Abdul Hameed Centenary Hospital, Hamdard Institute of Medical Sciences and Research, New Delhi, Delhi, India
| | - Temsunaro Rongsen-Chandola
- Division of Infectious Diseases, Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
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Sinha B, Dudeja N, Mazumder S, Kumar T, Adhikary P, Roy N, Rongsen Chandola T, Mehta R, Raina N, Bhandari N. Estimating the Impact of COVID-19 Pandemic Related Lockdown on Utilization of Maternal and Perinatal Health Services in an Urban Neighborhood in Delhi, India. Front Glob Womens Health 2022; 3:816969. [PMID: 35425937 PMCID: PMC9002136 DOI: 10.3389/fgwh.2022.816969] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To estimate utilization of maternal, perinatal healthcare services after the lockdown was implemented in response to the COVID-19 pandemic compared to the period before. Methods This study conducted in Dakshinpuri, an urban neighborhood in Delhi, reports data over a 13-month period which includes the period “before lockdown” i.e., October 1, 2019 to March 21, 2020 and “after lockdown” i.e., March 22 to November 5, 2020. The period “after lockdown” included the lockdown phase (March 22 to May 31, 2020) and unlock phase (June 1 to November 5, 2020). Mothers delivered during this period in the study area were interviewed using semi-structured questionnaires. In-depth interviews (IDIs) were conducted in a subsample to understand the experiences, challenges, and factors for underutilization of healthcare services. Findings The survey covered a total population of 21,025 in 4,762 households; 199 eligible mothers (mean age 27.4 years) were interviewed. In women who delivered after lockdown against before lockdown, adjusted odds of having >2 antenatal care visits in the third trimester was 80% lower (aOR 0.2, 95% CI 0.1–0.5); proportion of institutional deliveries was lower (93 vs. 97%); exclusive breastfeeding during first 6 months of birth (64.5 vs. 75.7%) and health worker home visitation within 6 weeks of birth (median, 1 vs. 3 visits) were substantially lower. Fear of contracting COVID-19, poor quality of services, lack of transportation and financial constraints were key issues faced by mothers in accessing health care. More than three-fourth (81%) of the mothers reported feeling down, depressed or hopeless after lockdown. The major factors for stress during lockdown was financial reasons (70%), followed by health-related concerns. Conclusion COVID-19 pandemic-related lockdown substantially affected maternal and perinatal healthcare utilization and service delivery.
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Affiliation(s)
- Bireshwar Sinha
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
- Department of Biotechnology (DBT)/Wellcome India Alliance, Hyderabad, India
| | - Nonita Dudeja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sarmila Mazumder
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
- *Correspondence: Sarmila Mazumder
| | - Tivendra Kumar
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Priyanka Adhikary
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nivedita Roy
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | | | - Rajesh Mehta
- Regional Office for South-East Asia, World Health Organization, New Delhi, India
| | - Neena Raina
- Regional Office for South-East Asia, World Health Organization, New Delhi, India
| | - Nita Bhandari
- Knowledge Integration and Translational Platform at Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
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Raut S, Apte A, Srinivasan M, Dudeja N, Dayma G, Sinha B, Bavdekar A. Determinants of maternal influenza vaccination in the context of low- and middle-income countries: A systematic review. PLoS One 2022; 17:e0262871. [PMID: 35081138 PMCID: PMC8791521 DOI: 10.1371/journal.pone.0262871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 01/06/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Pregnancy and early infancy are considered to be the vulnerable phases for severe influenza infection causing morbidity and mortality. Despite WHO recommendations, influenza is not included in the immunization programs of many low- and middle-income countries. This systematic review is aimed at identifying barriers and facilitators for maternal influenza vaccination amongst the perinatal women and their health care providers in low- and middle-income countries. METHODS We selected 11 studies from the 1669 records identified from PubMed, CABI, EMBASE and Global Health databases. Studies related to both pandemic and routine influenza vaccination and studies conducted amongst women in the antenatal as well as postnatal period were included. Both qualitative, quantitative, cross-sectional and interventional studies were included. RESULTS Knowledge about influenza disease, perception of the disease severity during pregnancy and risk to the foetus/newborn and perceived benefits of influenza vaccination during pregnancy were associated with increased uptake of influenza vaccination during pregnancy. Recommendation by health care provider, vaccination in previous pregnancy and availability of vaccine in public health system facilitated vaccine uptake. High parity, higher education, vaccination in the later months of pregnancy, less than 4 antenatal visits, concerns about vaccine safety and negative publicity in media were identified as barriers for influenza vaccination. Lack of government recommendation, concerns about safety and effectiveness and distrust in manufacturer were the barriers for the healthcare providers to recommend vaccination. CONCLUSION While availability of influenza vaccine in public health system can be a key to the success of vaccine implementation program, increasing the awareness about need and benefits of maternal influenza vaccination amongst pregnant women as well as their health care providers is crucial to improve the acceptance of maternal influenza vaccination in low and middle-income countries.
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Affiliation(s)
- Shrish Raut
- PRERNA Young Investigator, KEM Hospital Research Centre, Pune, India
| | - Aditi Apte
- PRERNA Young Scientist, KEM Hospital Research Centre, Pune, India
| | | | - Nonita Dudeja
- PRERNA Young Investigator, Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Girish Dayma
- PRERNA Young Investigator, KEM Hospital Research Centre, Pune, India
| | - Bireshwar Sinha
- PRERNA Young Scientist, Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Ashish Bavdekar
- Associate Professor, Department of Pediatrics; Consultant, Pediatric Research & Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
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