Socioeconomic characteristics associated with the introduction of new vaccines and full childhood vaccination in Ghana, 2014

  • Vaccine, Volume 38, No. 14, Year 2020

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Study Justification:
The study aimed to assess the impact of newly introduced vaccines on childhood vaccination coverage in Ghana. This is important because understanding the coverage rates of different vaccines can help identify any gaps or disparities in vaccination among children. By examining the sociodemographic factors associated with full vaccination, the study aimed to provide insights into the barriers and challenges that may exist in ensuring equitable access to vaccines for all children in Ghana.
Highlights:
– Full vaccination coverage in Ghana was found to be 70.8% among children aged 12-24 months.
– Vaccination coverage varied depending on the age at which the vaccines were administered, with higher coverage for vaccines given at younger ages.
– Newly introduced vaccines had lower coverage compared to those that have been available for a longer time.
– Factors associated with decreased odds of full vaccination included living outside of Greater Accra, home delivery, younger maternal age, urban residence, and having more than one child under five in the home.
– Factors such as sex of the child, wealth, religion, and maternal education were not found to be associated with full vaccination status.
Recommendations:
– Ensure equitable access to vaccination for all children regardless of demographic and socioeconomic background.
– Focus on improving vaccination coverage for newly introduced vaccines.
– Target interventions towards areas with lower vaccination coverage, such as regions outside of Greater Accra and urban areas.
– Address barriers to vaccination, such as home delivery and younger maternal age, through targeted outreach and education programs.
Key Role Players:
– Ministry of Health: Responsible for implementing vaccination programs and policies.
– Ghana Health Service: Oversees the delivery of healthcare services, including vaccination programs.
– District Health Offices: Responsible for implementing vaccination programs at the local level.
– Community Health Workers: Involved in vaccine delivery and education at the community level.
– Non-Governmental Organizations (NGOs): Can provide support in implementing vaccination programs and addressing barriers to access.
Cost Items for Planning Recommendations:
– Vaccine procurement and distribution: Budget for purchasing and distributing vaccines, including newly introduced vaccines.
– Outreach and education programs: Funding for community-based initiatives to raise awareness about vaccination and address barriers to access.
– Training and capacity building: Budget for training healthcare workers and community health workers on vaccination delivery and education.
– Monitoring and evaluation: Allocation of resources for monitoring vaccination coverage and evaluating the impact of interventions.
– Infrastructure and logistics: Investment in healthcare facilities, cold chain storage, and transportation systems to support vaccination programs.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is moderately strong. The study uses data from the 2014 Ghana Demographic and Health Survey to calculate vaccine coverage and describe associations between sociodemographic indicators and full vaccination. The sample size is relatively small, with 1107 children aged 12-24 months. The study uses logistic regression to estimate odds ratios for socioeconomic factors’ association with full vaccination. However, the abstract does not provide information on the representativeness of the sample or the statistical significance of the associations found. To improve the strength of the evidence, future studies could consider using a larger sample size, providing information on the representativeness of the sample, and reporting statistical significance.

Background: Childhood vaccination in Ghana has historically been high, but the impact of recently introduced vaccines on coverage is unknown. We calculate vaccine coverage of Ghanaian children– contrasting newly introduced vaccines and those long available – and describe associations between sociodemographic indicators and full vaccination. Methods: Data from the 2014 Ghana Demographic and Health Survey was used to calculate full vaccination, defined as receipt of one dose bacillus Calmette-Guérin (BCG); two doses of rotavirus vaccine; 3 doses of pentavalent vaccine, oral polio vaccine (OPV), and pneumococcal conjugate vaccine (PCV); and one dose of measles-rubella vaccine and yellow fever vaccine, among children age 12–24 months. Logistic regression with survey procedures was used to estimate odds ratios for socioeconomic factors’ association with full vaccination. Results: The sample comprised a total of 1107 children 12–24 months. Full vaccination coverage was 70.8%. Vaccination coverage was higher for vaccines administered at younger ages (e.g., birth dose of BCG was 97.0%) than at older ages (e.g., yellow fever at 9 months was 88.2%). Newly introduced vaccines had lower coverage: at 10 weeks, pentavalent 2 was 95.4%, versus 91.2% for PCV 2 and 88.8% for rotavirus 2. Living outside of Greater Accra, home delivery, younger maternal age, urban residence, and more than one child under five in the home were all associated with decreased odds of full vaccination in the adjusted analysis whereas sex of the child, wealth, religion, and maternal education were not associated with full vaccination status. Conclusion: Ghana has high overall vaccination rates although disparities in full vaccination by sociodemographic status exist. As vaccine recommendations are revised, it will be important to insure equitable access to vaccination for all children regardless of demographic and socioeconomic background.

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Based on the provided description, it seems that the focus is on analyzing the associations between socioeconomic characteristics and full childhood vaccination in Ghana. While the description does not explicitly mention innovations, there are potential recommendations that can be derived from the findings to improve access to maternal health. These recommendations could include:

1. Targeted Outreach Programs: Develop and implement targeted outreach programs to reach populations living outside of Greater Accra, as they were associated with decreased odds of full vaccination. These programs could involve community health workers, mobile clinics, or awareness campaigns to ensure equitable access to vaccination across different regions.

2. Maternal Education: Although maternal education was not associated with full vaccination status in the analysis, promoting maternal education can have long-term benefits for improving access to maternal health. Education can empower women to make informed decisions about vaccination and seek appropriate healthcare services for themselves and their children.

3. Addressing Barriers to Urban Residence: Urban residence was associated with decreased odds of full vaccination. It is important to identify and address the specific barriers faced by urban populations, such as limited access to healthcare facilities or lack of awareness about vaccination services. This could involve expanding healthcare infrastructure in urban areas or implementing targeted awareness campaigns.

4. Strengthening Health Systems: To ensure equitable access to vaccination, it is crucial to strengthen health systems at all levels. This includes improving vaccine supply chains, training healthcare providers, and enhancing data collection and monitoring systems. By strengthening health systems, the overall delivery of maternal health services can be improved.

5. Collaboration and Partnerships: Collaboration between government agencies, non-governmental organizations, and international partners is essential for improving access to maternal health. By working together, resources can be pooled, expertise can be shared, and innovative approaches can be developed to address the barriers faced by different populations.

These recommendations are based on the information provided and aim to improve access to maternal health by addressing the disparities identified in the analysis.
AI Innovations Description
Based on the provided description, the recommendation to improve access to maternal health is to ensure equitable access to vaccination for all children regardless of demographic and socioeconomic background. This can be achieved by implementing the following strategies:

1. Strengthening healthcare infrastructure: Improve the availability and accessibility of healthcare facilities, particularly in rural areas, to ensure that all children have access to vaccination services.

2. Enhancing community outreach programs: Implement community-based initiatives to raise awareness about the importance of vaccination and provide information on the availability and location of vaccination services.

3. Addressing barriers to vaccination: Identify and address barriers that prevent certain groups from accessing vaccination services, such as transportation issues, cultural beliefs, or language barriers.

4. Targeted interventions: Develop targeted interventions to reach vulnerable populations, such as those living in remote areas or with lower socioeconomic status, to ensure they have equal access to vaccination services.

5. Collaboration and partnerships: Foster collaboration between healthcare providers, community organizations, and government agencies to coordinate efforts and resources to improve vaccination coverage.

6. Continuous monitoring and evaluation: Regularly monitor vaccination coverage rates and identify areas with low coverage to implement targeted interventions and evaluate their effectiveness.

By implementing these recommendations, it is possible to improve access to maternal health and ensure that all children have equal opportunities to receive the necessary vaccinations for their well-being.
AI Innovations Methodology
Based on the provided description, it seems that you are looking for innovations to improve access to maternal health. Here are some potential recommendations:

1. Mobile Health (mHealth) Solutions: Develop mobile applications or text messaging services to provide pregnant women with information on prenatal care, nutrition, and vaccination schedules. These tools can also be used to send reminders for appointments and medication adherence.

2. Telemedicine: Implement telemedicine services to provide remote consultations and monitoring for pregnant women in rural or underserved areas. This can help overcome geographical barriers and improve access to healthcare professionals.

3. Community Health Workers: Train and deploy community health workers to provide maternal health education, antenatal care, and postnatal support in remote or marginalized communities. These workers can bridge the gap between healthcare facilities and the community, ensuring that pregnant women receive the necessary care.

4. Maternal Health Vouchers: Introduce voucher programs that provide financial assistance to pregnant women, especially those from low-income backgrounds, to access maternal health services. These vouchers can cover costs for prenatal care, delivery, and postnatal care.

To simulate the impact of these recommendations on improving access to maternal health, you can follow this methodology:

1. Define the parameters: Identify the specific indicators that will be used to measure access to maternal health, such as the number of prenatal visits, institutional delivery rates, or vaccination coverage.

2. Collect baseline data: Gather data on the current state of access to maternal health services in the target population. This can be done through surveys, interviews, or existing health records.

3. Introduce the innovations: Implement the recommended innovations, such as mHealth solutions, telemedicine services, community health worker programs, or maternal health voucher systems.

4. Monitor and collect data: Continuously monitor the implementation of the innovations and collect data on the selected indicators. This can be done through surveys, interviews, or health facility records.

5. Analyze the data: Compare the baseline data with the data collected after the implementation of the innovations. Analyze the changes in the selected indicators to assess the impact of the recommendations on improving access to maternal health.

6. Evaluate and adjust: Evaluate the results and identify any gaps or areas for improvement. Use this information to refine the innovations and make necessary adjustments to further enhance access to maternal health.

By following this methodology, you can simulate the impact of the recommended innovations on improving access to maternal health and make informed decisions for future interventions.


Statistics:
Citations: 6
Identifiers:
DOI: 10.1016/j.vaccine.2020.02.065
ISSN: 0264410X
Research Areas:
Disparities, Health System and Policy, Infectious Diseases, Maternal Access, Maternal and Child Health, Quality of Care
Study Countries:
Ghana
Study Design:
Cross Sectional Study
Study Approach:
Quantitative
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