An evaluation of immunization services, using the reaching every district criteria, in two districts of Gujarat, India.
An evaluation of immunization services, using the reaching every district criteria, in two districts of Gujarat, India.
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DOI：
10.1186/s41256-018-0060-4
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发表时间：
2018
影响因子：
8.7
通讯作者：
Boulton ML
中科院分区：
文献类型：
--
作者：
Montgomery JP;Ganguly P;Carlson BF;Shrivastwa N;Boulton ML
免疫接种被认为是当今采用的最成功和最具成本效益的公共卫生干预措施。虽然印度的免疫覆盖率在过去十年中大大提高，但覆盖率极低的地区仍然存在。密歇根大学公共卫生学院和印度甘地纳加尔公共卫生研究所合作，记录了印度两个地区提供免疫服务的优势和劣势。本报告描述了对位于印度古吉拉特邦两个地区的10个初级卫生中心（PHCs）诊所级免疫服务提供情况的定性评估。评估标准来源于“覆盖每个地区”战略，该战略旨在为提供儿童免疫接种提供框架。2013年4月，各初级保健院的工作人员接受了采访。访谈揭示了免疫服务提供的若干障碍，包括：1)疫苗和供应短缺；2)难以到达社区；3)互联网接入不可靠；4)冷链设备故障；5)免疫记录和登记的维护和使用不一致。免疫服务的提供是一个复杂的过程，在许多阶段可能遇到障碍。对印度古吉拉特邦的疫苗提供系统进行的基于red的评估确定了该系统运行不理想的几个点，以及成功应对这些挑战的可能解决方案。
Immunizations are considered the most successful and cost-effective public health interventions employed today. While immunization coverage in India has improved dramatically in the last decade, areas of very low coverage persist. The University of Michigan School of Public Health and the Indian Institute of Public Health Gandhinagar collaborated to document strengths and weaknesses of immunization service delivery in two districts in India. This report describes a qualitative assessment of clinic level immunization service delivery in ten primary health centers (PHCs) located in two districts of Gujarat, India. Assessment criteria were derived from the Reaching Every District (RED) strategy that is intended to provide a framework for delivering childhood immunizations. Staff from the PHCs were interviewed in April 2013. Interviews revealed several barriers to immunization service delivery including: 1) Vaccine and supply stockouts; 2) Hard to reach communities; 3) Unreliable Internet access; 4) Cold chain equipment malfunctions; 5) Inconsistently maintained and utilized immunization records and registries. Immunization service delivery is a complex process that can encounter barriers at many stages. A RED-based evaluation of the vaccine delivery system in Gujarat, India identified several points where the system was performing sub-optimally and possible solutions to successfully address these challenges.