Cargando…

Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review

Introduction: As the world continues to urbanize, particularly in low- and middle-income countries, understanding the barriers and effective interventions to improve urban immunization equity is critical to achieving both Immunization Agenda 2030 targets and the Sustainable Development Goals. Approx...

Descripción completa

Detalles Bibliográficos
Autores principales: Belt, Rachel Victoria, Abdullah, Shakil, Mounier-Jack, Sandra, Sodha, Samir V., Danielson, Niklas, Dadari, Ibrahim, Olayinka, Folake, Ray, Arindam, Crocker-Buque, Tim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386579/
https://www.ncbi.nlm.nih.gov/pubmed/37515016
http://dx.doi.org/10.3390/vaccines11071200
_version_ 1785081702359498752
author Belt, Rachel Victoria
Abdullah, Shakil
Mounier-Jack, Sandra
Sodha, Samir V.
Danielson, Niklas
Dadari, Ibrahim
Olayinka, Folake
Ray, Arindam
Crocker-Buque, Tim
author_facet Belt, Rachel Victoria
Abdullah, Shakil
Mounier-Jack, Sandra
Sodha, Samir V.
Danielson, Niklas
Dadari, Ibrahim
Olayinka, Folake
Ray, Arindam
Crocker-Buque, Tim
author_sort Belt, Rachel Victoria
collection PubMed
description Introduction: As the world continues to urbanize, particularly in low- and middle-income countries, understanding the barriers and effective interventions to improve urban immunization equity is critical to achieving both Immunization Agenda 2030 targets and the Sustainable Development Goals. Approximately 25 million children missed one or more doses of the diphtheria, tetanus and pertussis (DTP3) vaccine in 2021 and it is estimated that close to 30% of the world’s children missing the first dose of DTP, known as zero-dose, live in urban and peri-urban settings. Methods: The aim of this research is to improve understanding of urban immunization equity through a qualitative review of mixed method studies, urban immunization strategies and funding proposals across more than 70 urban areas developed between 2016 and 2020, supported by Gavi, the Vaccine Alliance. These research studies and strategies created a body of evidence regarding the barriers to vaccination in urban settings and potential interventions relevant to low- and middle-income countries (LMICs) with a focus on the vaccination of urban poor, populations of concern and residents of informal settlements. Through the document review we identified common challenges to achieving equitable coverage in urban areas and mapped proposed interventions. Results: We identified 70 documents as part of the review and categorized results across (1) social determinants of health, (2) immunization service-delivery barriers and (3) quality of services. Barriers and solutions identified in the documents were categorized in these thematic areas, drawing information from results in more than 21 countries. Conclusion: Populations of concern such as migrants, refugees, residents of informal settlements and the urban poor face barriers to accessing care which include poor availability and quality of service. Example solutions proposed to these challenges include tailored delivery strategies, improved use of digital data collection and child-friendly services. More research is required on the efficacy of the proposed interventions identified and on gender-specific dynamics in urban poor areas affecting equitable immunization coverage.
format Online
Article
Text
id pubmed-10386579
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-103865792023-07-30 Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review Belt, Rachel Victoria Abdullah, Shakil Mounier-Jack, Sandra Sodha, Samir V. Danielson, Niklas Dadari, Ibrahim Olayinka, Folake Ray, Arindam Crocker-Buque, Tim Vaccines (Basel) Review Introduction: As the world continues to urbanize, particularly in low- and middle-income countries, understanding the barriers and effective interventions to improve urban immunization equity is critical to achieving both Immunization Agenda 2030 targets and the Sustainable Development Goals. Approximately 25 million children missed one or more doses of the diphtheria, tetanus and pertussis (DTP3) vaccine in 2021 and it is estimated that close to 30% of the world’s children missing the first dose of DTP, known as zero-dose, live in urban and peri-urban settings. Methods: The aim of this research is to improve understanding of urban immunization equity through a qualitative review of mixed method studies, urban immunization strategies and funding proposals across more than 70 urban areas developed between 2016 and 2020, supported by Gavi, the Vaccine Alliance. These research studies and strategies created a body of evidence regarding the barriers to vaccination in urban settings and potential interventions relevant to low- and middle-income countries (LMICs) with a focus on the vaccination of urban poor, populations of concern and residents of informal settlements. Through the document review we identified common challenges to achieving equitable coverage in urban areas and mapped proposed interventions. Results: We identified 70 documents as part of the review and categorized results across (1) social determinants of health, (2) immunization service-delivery barriers and (3) quality of services. Barriers and solutions identified in the documents were categorized in these thematic areas, drawing information from results in more than 21 countries. Conclusion: Populations of concern such as migrants, refugees, residents of informal settlements and the urban poor face barriers to accessing care which include poor availability and quality of service. Example solutions proposed to these challenges include tailored delivery strategies, improved use of digital data collection and child-friendly services. More research is required on the efficacy of the proposed interventions identified and on gender-specific dynamics in urban poor areas affecting equitable immunization coverage. MDPI 2023-07-04 /pmc/articles/PMC10386579/ /pubmed/37515016 http://dx.doi.org/10.3390/vaccines11071200 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Belt, Rachel Victoria
Abdullah, Shakil
Mounier-Jack, Sandra
Sodha, Samir V.
Danielson, Niklas
Dadari, Ibrahim
Olayinka, Folake
Ray, Arindam
Crocker-Buque, Tim
Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review
title Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review
title_full Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review
title_fullStr Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review
title_full_unstemmed Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review
title_short Improving Equity in Urban Immunization in Low- and Middle-Income Countries: A Qualitative Document Review
title_sort improving equity in urban immunization in low- and middle-income countries: a qualitative document review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386579/
https://www.ncbi.nlm.nih.gov/pubmed/37515016
http://dx.doi.org/10.3390/vaccines11071200
work_keys_str_mv AT beltrachelvictoria improvingequityinurbanimmunizationinlowandmiddleincomecountriesaqualitativedocumentreview
AT abdullahshakil improvingequityinurbanimmunizationinlowandmiddleincomecountriesaqualitativedocumentreview
AT mounierjacksandra improvingequityinurbanimmunizationinlowandmiddleincomecountriesaqualitativedocumentreview
AT sodhasamirv improvingequityinurbanimmunizationinlowandmiddleincomecountriesaqualitativedocumentreview
AT danielsonniklas improvingequityinurbanimmunizationinlowandmiddleincomecountriesaqualitativedocumentreview
AT dadariibrahim improvingequityinurbanimmunizationinlowandmiddleincomecountriesaqualitativedocumentreview
AT olayinkafolake improvingequityinurbanimmunizationinlowandmiddleincomecountriesaqualitativedocumentreview
AT rayarindam improvingequityinurbanimmunizationinlowandmiddleincomecountriesaqualitativedocumentreview
AT crockerbuquetim improvingequityinurbanimmunizationinlowandmiddleincomecountriesaqualitativedocumentreview