Dataset Information

Healthcare provider perspectives on delivering next generation rotavirus vaccines in five low-to-middle-income countries.

ABSTRACT:

Background

Live oral rotavirus vaccines (LORVs) have significantly reduced rotavirus hospitalizations and deaths worldwide. However, LORVs are less effective in low- and middle-income countries (LMICs). Next-generation rotavirus vaccines (NGRVs) may be more effective but require administration by injection or a neonatal oral dose, adding operational complexity. Healthcare providers (HPs) were interviewed to assess rotavirus vaccine preferences and identify delivery issues as part of an NGRV value proposition.

Objective

Determine HP vaccine preferences about delivering LORVs compared to injectable (iNGRV) and neonatal oral (oNGRV) NGRVs.

Methods

64 HPs from Ghana, Kenya, Malawi, Peru, and Senegal were interviewed following a mixed-method guide centered on three vaccine comparisons: LORV vs. iNGRV; LORV vs. oNGRV; oNGRV vs. iNGRV. HPs reviewed attributes for each vaccine in the comparisons, then indicated and explained their preference. Additional questions elicited views about co-administering iNGRV+LORV for greater public health impact, a possible iNGRV-DTP-containing combination vaccine, and delivering neonatal doses.

Results

Almost all HPs preferred oral vaccine options over iNGRV, with many emphasizing an aversion to additional injections. Despite this strong preference, HPs described challenges delivering oral doses. Preferences for LORV vs. oNGRV were split, marked by disparate views on rotavirus disease epidemiology and the safety, need, and feasibility of delivering neonatal vaccines. Although overwhelmingly enthusiastic about an iNGRV-DTP-containing combination option, several HPs had concerns. HP views were divided on the feasibility of co-administering iNGRV+LORV, citing challenges around logistics and caregiver sensitization.

Conclusion

Our findings provide valuable insights on delivering NGRVs in routine immunization. Despite opposition to injectables, openness to co-administering LORV+iNGRV to improve efficacy suggests future HP support of iNGRV if adequately informed of its advantages. Rationales for LORV vs. oNGRV underscore needs for training on rotavirus epidemiology and stronger service integration. Expressed challenges delivering existing LORVs merit further examination and indicate need for improved delivery.

SUBMITTER: Mooney J

PROVIDER: S-EPMC9223340 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Healthcare provider perspectives on delivering next generation rotavirus vaccines in five low-to-middle-income countries.

Mooney Jessica J Price Jessica J Bain Carolyn C Bawa John Tanko JT Gurley Nikki N Kumar Amresh A Liyanage Guwani G Mkisi Rouden Esau RE Odero Chris C Seck Karim K Simpson Evan E Hausdorff William P WP

PloS one 20220623 6

<h4>Background</h4>Live oral rotavirus vaccines (LORVs) have significantly reduced rotavirus hospitalizations and deaths worldwide. However, LORVs are less effective in low- and middle-income countries (LMICs). Next-generation rotavirus vaccines (NGRVs) may be more effective but require administration by injection or a neonatal oral dose, adding operational complexity. Healthcare providers (HPs) were interviewed to assess rotavirus vaccine preferences and identify delivery issues as part of an N ...[more]

PMID: 35737718

Similar Datasets

Project description:IntroductionInformation on immunization delivery costs (IDCs) is essential for better planning and budgeting for the sustainability and performance of national programs. However, delivery cost evidence is fragmented and of variable quality, making it difficult for policymakers, planners, and other stakeholders to understand and use. This study aimed to consolidate and summarize the evidence on delivery costs, answering the question: What are the unit costs of vaccine delivery across low- and middle-income countries (LMICs) and through a variety of delivery strategies?MethodsWe conducted a systematic review of over 15,000 published and unpublished resources from 2005 to 2018 that included IDCs in LMICs. We quality-rated and extracted data from 61 resources that contained 410 immunization delivery unit costs (e.g., cost per dose, cost per fully immunized child). We converted cost findings to a common year (2016) and currency (U.S. dollars) to ensure comparability across studies and settings. We performed a descriptive and gap analysis and developed immunization delivery cost ranges using comparable unit costs for single vaccines and schedules of vaccines.ResultsThe majority of IDC evidence comes from low-income countries and Sub-Saharan Africa. Most unit costs are presented as cost per dose and represent health facility-based delivery.DiscussionThe cost ranges may be higher than current estimates used in many LMICs for budgeting: $0.16-$2.54 incremental cost per dose (including economic, financial, and fiscal costs) for single, newly introduced vaccines, and $0.75-$9.45 full cost per dose (economic costs) for schedules of four to eight vaccines delivered to children under one.ConclusionsDespite increased attention on improving coverage and strengthening immunization delivery, evidence on the cost of delivery is nascent but growing. The cost ranges can inform planning and policymaking, but should be used with caution given their width and the few unit costs used in their development.

Project description:BackgroundNew vaccines for pregnant women have recently been introduced in some high-income countries to protect infants in early life. Implementing maternal immunisation (MI) successfully in low- and middle-income countries will require planning and adaptations to immunisation and maternal health programs. To inform cost of MI delivery studies, we gathered perspectives from key stakeholders in five countries (Bangladesh, Ghana, Kenya, Mozambique, and Nepal) regarding health system requirements, opportunities, and challenges to introducing new maternal vaccines into routine health programs.MethodsWe convened national stakeholders for country workshops to deliberate potential delivery strategies, opportunities, and constraints for implementing new MI interventions. Divided into thematic areas, participants discussed health system adaptations needed to establish or strengthen an MI platform.FindingsStakeholders felt that existing programs that administer vaccines to pregnant women, primarily tetanus-containing vaccines, provide a proven path for the delivery of additional maternal vaccines. Maternal health and immunisation program integration was perceived strongest at the health care provision level and weakest at the national level. Concerted coordination at the national level was identified as critical to the success of introducing new interventions. Stakeholders perceived that most health workforce providing immunisation and antenatal care services undergo similar training and have transferrable skills, however developing operational guidelines with clear roles and responsibilities was deemed critical for ownership and accountability. Human resource constraints were cited as a challenge for some countries. The importance of raising awareness of disease burden and new MI interventions was also highlighted across countries. Sustainable financing was a recurring challenge cited, especially with transitions from Gavi support.ConclusionsThe workshops enabled country stakeholders to deliberate needs to support the introduction of new maternal vaccines. While circumstances and needs differed, stakeholders across countries were optimistic about the capability of their health systems to integrate new maternal vaccines.

Project description:ObjectivesTo assess the competence of primary healthcare (PHC) providers in delivering maternal and child nutrition services at the PHC level and patients' experience in receiving the recommended components of care.DesignObservational cross-sectional analysis.SettingHealthcare facilities in low/middle-income countries (LMICs) with available service provision assessment surveys (Afghanistan (2018), Democratic Republic of Congo (2018), Haiti (2017), Kenya (2010), Malawi (2013-2014), Namibia (2009), Nepal (2015), Rwanda (2007), Senegal (2018), Tanzania (2015) and Uganda (2007).Participants18 644 antenatal visits and 23 262 sick child visits in 8458 facilities across 130 subnational areas in 11 LMICs from 2007 to 2019.Outcomes(1) Provider competence assessed as the direct observations of actions performed during antenatal care (ANC) and sick child visits; and (2) patients' experience defined as the self-reported awareness of the nutrition services received during ANC and sick child visits and provider effectiveness in delivering these services.ResultsExcept for DRC, all countries scored below 50% on patients' experience and provider competence. More than 70% of clients were advised on taking iron supplements during pregnancy; however, less than 32% of patients were advised on iron side effects in all the studied countries. Across all countries, providers commonly took anthropometric measurements of expectant mothers and children; however, such assessments were rarely followed up with advice or counselling about growth patterns. In addition, less than 20% of observed providers advised on early/immediate breast feeding in all countries with available data.ConclusionThe 11 assessed countries demonstrated the delivery of limited nutrition services; nonetheless, the apparent deficiency in the extent and depth of questions asked for the majority of tracer activities revealed significant opportunities for improving the quality of nutrition service delivery at the PHC level.

Project description:BackgroundThe term "end-of-life" care refers to the physical, social, spiritual, and emotional assistance provided to people near the end of their lives. Throughout history, gender has profoundly impacted many of the decisions people make. Studies have shown an increased demand for palliative care worldwide, which varies significantly among low-and middle-income countries. Achieving universal health coverage requires everyone to have access to health care where and when they need it, irrespective of gender. This scoping review aims to map the evidence available on the gender disparities in end-of-life care in low-and middle-income countries, considering the perspectives of patients, caregivers, and care providers.MethodologyA comprehensive search was done for the review in the following databases: PubMed, Embase, Scopus, Web of Science, ProQuest, and Cumulative Index to Nursing and Allied Health Literature. The World Health Organization's definition of gender was the inclusion standard. Studies conducted in low-and middle-income countries were included. Only articles published between 2005 and 2024 were retained. Articles on sexual minorities were excluded.ResultsEight articles were selected for the review and the descriptive analysis was done, followed by a thematic analysis to synthesize the available data into themes. The themes identified based on the patient's perspectives were end-of-life preferences, challenges, and perceptions towards caregiving. Care provider perspectives included attitude toward euthanasia and perception towards care provision, while caregiver perspectives involved perceptions of caregiving and challenges. Gender disparities were evident across all perspectives, with women being disproportionately affected.ConclusionThe review identified significant gender disparities in different aspects of end-of-life care. Women often experience a greater caregiving burden and higher risks of emotional, physical, and sexual violence, while men encounter societal stigma in caregiving roles. Addressing these disparities is required to ensure equitable and inclusive EOL care. Further research should be done in this direction to identify the influence of gender on end-of-life care and how it interacts with other factors like culture, religion, socio-economic status, and education to inform policies that promote gender-sensitive end-of-life care.

Dataset Information

Healthcare provider perspectives on delivering next generation rotavirus vaccines in five low-to-middle-income countries.

Background

Objective

Methods

Results

Conclusion

Publications

Healthcare provider perspectives on delivering next generation rotavirus vaccines in five low-to-middle-income countries.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets