Is the intention to vaccinate enough? Systematic variation in the value of timely vaccinations and preferences for monetary vs non-monetary incentives among pregnant women in southern Tanzania.
Is the intention to vaccinate enough? Systematic variation in the value of timely vaccinations and preferences for monetary vs non-monetary incentives among pregnant women in southern Tanzania.
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DOI：
10.1016/j.jvacx.2023.100266
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发表时间：
2023-04
期刊：
影响因子：
3.8
通讯作者：
Vasudevan, Lavanya
中科院分区：
文献类型：
--
作者：
Ostermann, Jan;Hair, Nicole L.;Moses, Sara;Ngadaya, Esther;Mfinanga, Sayoki Godfrey;Brown, Derek S.;Baumgartner, Joy Noel;Vasudevan, Lavanya
关键词：
这是撒哈拉以南非洲地区第一项针对常规儿童疫苗接种的WTP研究。几乎所有的妇女都认为及时为子女接种疫苗是一件好事。及时接种疫苗的价值因接种态度和接种途径而异。系统层面的障碍、获取途径和态度似乎共同影响疫苗接种。对于及时接种疫苗，大多数妇女更喜欢非货币奖励而不是货币奖励。在全球范围内，约有1 970万儿童仍然接种不足;更多的儿童推迟接种疫苗。要在实现全球疫苗接种目标方面取得持续进展，就需要克服或弥补越来越大的障碍，为难以接触和难以接种疫苗的儿童接种疫苗。我们前瞻性地评估了孕妇对常规儿童疫苗接种的评价和对替代激励措施的偏好，以告知旨在提高坦桑尼亚南部疫苗接种覆盖率和及时性的干预措施。在2017年8月至12月期间，406名怀孕最后三个月的妇女从坦桑尼亚姆特瓦拉地区的卫生设施和社区招募，并询问了关于她们是否愿意为孩子接种疫苗的随机评估问题，如果她们（a）获得奖励，或（B）每次接种疫苗都要支付费用。区间删失回归评估相关的妇女愿意支付（WTP）及时接种疫苗。参与者被要求对及时为他们的孩子接种疫苗的货币和非货币激励方案进行排名。所有妇女都希望根据建议的时间表给孩子接种疫苗，即使没有激励措施。几乎所有妇女（393人; 96.8%）都愿意支付疫苗接种费用。每次疫苗接种的平均支付意愿为坦桑尼亚先令（Tsh）3，066（95%置信区间Tsh 2，523 - 3，610; 1美元/Tsh 2，200）。妇女对及时接种疫苗的评价因疫苗相关知识和态度、经济状况以及农村与城市居住地而存在显著差异。为了及时给子女接种疫苗，妇女倾向于选择非货币奖励而不是货币奖励。妇女高度重视儿童及时接种疫苗，这表明意外的系统层面障碍而不是个人层面的需求因素可能是错过疫苗接种的主要驱动因素。妇女接种疫苗价值的系统性差异反映了感知效益和机会成本的差异。在这种情况下，非货币激励措施和其他干预措施，以增加需求和补偿系统层面的障碍，具有提高疫苗接种覆盖率和及时性的巨大潜力。NCT 03252288。
This is the first WTP study for routine childhood vaccination in sub-Saharan Africa. Almost all women place a positive value on the timely vaccination of their children. The value of timely vaccination varies with vaccination attitudes and access. System-level barriers, access, and attitudes appear to jointly impact vaccine uptake. Most women prefer non-monetary over monetary incentives for timely vaccinations. Globally, approximately 19.7 million children remain under-vaccinated; many more receive delayed vaccinations. Sustained progress towards global vaccination targets requires overcoming, or compensating for, incrementally greater barriers to vaccinating hard-to-reach and hard-to-vaccinate children. We prospectively assessed pregnant women’s valuations of routine childhood vaccinations and preferences for alternative incentives to inform interventions aiming to increase vaccination coverage and timeliness in southern Tanzania. Between August and December 2017, 406 women in their last trimester of pregnancy were enrolled from health facilities and communities in the Mtwara region of Tanzania and asked contingent valuation questions about their willingness to vaccinate their child if they were (a) given an incentive, or (b) facing a cost for each vaccination. Interval censored regressions assessed correlates of women’s willingness to pay (WTP) for timely vaccinations. Participants were asked to rank monetary and non-monetary incentive options for the timely vaccination of their children. All women expected to get their children vaccinated according to the recommended schedule, even without incentives. Nearly all women (393; 96.8 %) were willing to pay for vaccinations. The average WTP was Tanzania Shilling (Tsh) 3,066 (95 % confidence interval Tsh 2,523–3,610; 1 USD ∼ Tsh 2,200) for each vaccination. Women’s valuations of timely vaccinations varied significantly with vaccine-related knowledge and attitudes, economic status, and rural vs urban residence. Women tended to prefer non-monetary over monetary incentives for the timely vaccination of their children. Women placed a high value on timely childhood vaccinations, suggesting that unexpected system-level barriers rather than individual-level demand factors are likely to be the primary drivers of missed vaccinations. Systematic variation in the value of vaccinations across women reflects variation in perceived benefits and opportunity costs. In this setting, nonmonetary incentives and other interventions to increase demand and compensate for system-level barriers hold significant potential for improving vaccination coverage and timeliness. NCT03252288.
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DOI：
10.1017/s026646230808063x
发表时间：
2008-09-01
影响因子：
3.2
作者：
Heinzen, Rebekah R.;Bridges, John F. P.
通讯作者：
Bridges, John F. P.
影响因子：
3.3
作者：
Islam, Ziaul;Maskery, Brian;Whittington, Dale
通讯作者：
Whittington, Dale
影响因子：
5.5
作者：
Chandir, S.;Khan, A. J.;Omer, S. B.
通讯作者：
Omer, S. B.
影响因子：
2.8
作者：
Kessing, Sebastian G.;Nuscheler, Robert
通讯作者：
Nuscheler, Robert
影响因子：
3.7
作者：
DUAN, N
通讯作者：
DUAN, N