New vaccine adoption

Qualitative study of national decision-making processes in seven low- and middle-income countries

Datos Bibliográficos

ID11490076
AutoresH E D Burchett, Helen Burchett (0000-0002-8380-2476, University of London), Sandra Mounier-Jack (0000-0002-2801-379X, University of London), Ulla Kou Griffiths (0000-0001-6822-6493, University of London), Robin Biellik (University of London), Pierre Ongolo-Zogo (0000-0001-5941-1048, University of London), Enrique Chavez (University of London), Haribondhu Sarma (0000-0003-1553-8498, University of London), Jasim Uddin (0009-0008-2207-4197, University of London), M Konate (0000-0002-0986-5399, University of London), Y Kitaw (University of London), M Molla (University of London), Sabina Wakasiaka (0000-0002-4417-7786, University of London), Lucy Gilson (0000-0002-2775-7703, University of London), Antonia Mills (0000-0001-9863-9950, University of London)
Año2012
Volumen27
Númerosuppl 2
Páginasii5-ii16
Fecha de publicación2012-05-01
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth Policy and Planning (JOURNAL)
Identificadores de la revistaISSN: 0268-1080 • E-ISSN: 1460-2237
EditorialOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czs035
PMID22513732
OpenAlexW2132917695
IdiomaEN
Citas recibidas16
Referencias citadas23

As more new and improved vaccines become available, decisions on which to adopt into routine programmes become more frequent and complex. This qualitative study aimed to explore processes of national decision-making around new vaccine adoption and to understand the factors affecting these decisions. Ninety-five key informant interviews were conducted in seven low- and middle-income countries: Bangladesh, Cameroon, Ethiopia, Guatemala, Kenya, Mali and South Africa. Framework analysis was used to explore issues both within and between countries. The underlying driver for adoption decisions in GAVI-eligible countries was the desire to seize GAVI windows of opportunity for funding. By contrast, in South Africa and Guatemala, non-GAVI-eligible countries, the decision-making process was more rooted in internal and political dynamics. Decisions to adopt new vaccines are, by nature, political. The main drivers influencing decisions were the availability of funding, political prioritization of vaccination or the vaccine-preventable disease and the burden of disease. Other factors, such as financial sustainability and feasibility of introduction, were not as influential. Although GAVI procedures have established more formality in decision-making, they did not always result in consideration of all relevant factors. As familiarity with GAVI procedures increased, questioning by decision-makers about whether a country should apply for funding appeared to have diminished. This is one of the first studies to empirically investigate national processes of new vaccine adoption decision-making using rigorous methods. Our findings show that previous decision-making frameworks (developed to guide or study national decision-making) bore little resemblance to real-life decisions, which were dominated by domestic politics. Understanding the realities of vaccine policy decision-making is critical for developing strategies to encourage improved evidence-informed decision-making about new vaccine adoptions. The potential for international initiatives to encourage evidence-informed decision-making should be realised, not assumed.

Business · Developing country · Economic growth · Economics · Formality · Political science · Politics · Qualitative research · Sociology · Sustainability · Vaccine Coverage and Hesitancy · Vibrio bacteria research studies · Viral gastroenteritis research and epidemiology