Portnoy, Allison; Jit, Mark; Helleringer, Stéphane; Verguet, Stéphane; (2020) Comparative Distributional Impact of Routine Immunization and Supplementary Immunization Activities in Delivery of Measles Vaccine in Low- and Middle-Income Countries. Value in Health, 23 (7). pp. 891-897. ISSN 1098-3015 DOI: https://doi.org/10.1016/j.jval.2020.03.012
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
Abstract
OBJECTIVES: In many countries, measles disproportionately affects poorer households. To achieve equitable delivery, national immunization programs can use 2 main delivery platforms: routine immunization and supplementary immunization activities (SIAs). The objective of this article is to use data concerning measles vaccination coverage delivered via routine and SIA strategies to make inferences about the associated equity impact. METHODS: We relied on Demographic and Health Survey and Multiple Indicator Cluster Surveys multi-country survey data to conduct a comparative analysis of routine and SIA measles vaccination status of children by wealth quintile. We estimated the value of the angle, θ, for the ratio of the difference between coverage levels of adjacent wealth quintiles by using the arc-tangent formula. For each country/year observation, we averaged the θ estimates into one summary measurement, defined as the "equity impact number." RESULTS: Across 20 countries, the equity impact number summarized across wealth quintiles was greater (and hence less equitable) for routine delivery than for SIAs in the survey rounds (years) during, before, and after an SIA about 65% of the time. The equity impact numbers for routine measles vaccination averaged across wealth quintiles were usually greater than for SIA measles vaccination across country-year observations. CONCLUSIONS: This analysis examined how different measles vaccine delivery platforms can affect equity. It can serve to elucidate the impact of immunization and public health programs in terms of comparing horizontal to vertical delivery efforts and in reducing health inequalities in global and country-level decision-making.
Item Type | Article |
---|---|
Faculty and Department | Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology & Dynamics (2023-) |
Research Centre |
Centre for the Mathematical Modelling of Infectious Diseases Vaccine Centre |
PubMed ID | 32762991 |
Elements ID | 148576 |
Official URL | http://dx.doi.org/10.1016/j.jval.2020.03.012 |
Download
Filename: Portnoy-etal-2020-Comparative-Distributional-Impact-of-Routine-Immunization-and-Supplementary-Immunization-Activities-in-Delivery-of-Measles-Vaccine-in-Low-and-Middle-Income-Countries.pdf
Licence: Creative Commons: Attribution 4.0
Download