scholarly journals New vaccine adoption: qualitative study of national decision-making processes in seven low- and middle-income countries

2012 ◽  
Vol 27 (suppl 2) ◽  
pp. ii5-ii16 ◽  
Author(s):  
H. E. D. Burchett ◽  
S. Mounier-Jack ◽  
U. K. Griffiths ◽  
R. Biellik ◽  
P. Ongolo-Zogo ◽  
...  
Keyword(s):  
Decision Making ◽  
Qualitative Study ◽  
Middle Income ◽  
Middle Income Countries ◽  
Decision Making Processes ◽  
Low And Middle Income

scholarly journals Value and effectiveness of National Immunization Technical Advisory Groups in low- and middle-income countries: a qualitative study of global and national perspectives

2019 ◽  
Vol 34 (4) ◽  
pp. 271-281 ◽  
Author(s):  
Sadie Bell ◽  
Laurence Blanchard ◽  
Helen Walls ◽  
Sandra Mounier-Jack ◽  
Natasha Howard
Keyword(s):  
Decision Making ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Immunization Programme ◽  
National Immunization ◽  
National Immunization Programme ◽  
Management Procedures ◽  
Decision Making Processes ◽  
Low And Middle Income

Abstract The Global Vaccine Action Plan proposes that every country establish or have access to a National Immunization Technical Advisory Group (NITAG) by 2020. The NITAG role is to produce evidence-informed recommendations that incorporate local context, to guide national immunization policies and practice. This study aimed to explore the value and effectiveness of NITAGs in low- and middle-income countries (LMICs), identifying areas in which NITAGs may require further support to improve their functionality and potential barriers to global investment. A multi-methods study design was used, comprising 134 semi-structured interviews and 82 literature review sources that included 38 countries. Interviews were conducted with 53 global/regional and 81 country-level participants able to provide insight into NITAG effectiveness, including NITAG members, national immunization programme staff, and global agency representatives (e.g. the World Health Organisation, the Bill and Melinda Gates Foundation, Gavi the Vaccine Alliance). The review, including published and unpublished sources on NITAGs in LMICs, was conducted to supplement and corroborate interview findings. Data were analysed thematically. NITAGs were described as valuable in promoting evidence-informed vaccination decision-making, with NITAG involvement enhancing national immunization programme strength and sustainability. Challenges to NITAG effectiveness included: (1) unreliable funding; (2) insufficient diversity of member expertise; (3) inadequate conflicts of interest management procedures; (4) insufficient capacity to access and use evidence; (5) lack of transparency; and (6) limited integration with national decision-making processes that reduced the recognition and incorporation of NITAG recommendations. LMIC NITAGs have developed significantly in the past decade. Well-functioning NITAGs were trusted national resources that enhanced country ownership of immunization provision. However, many LMIC NITAGs require additional technical and funding support to strengthen quality and effectiveness, while maintaining impartiality and ensuring sufficient integration with national decision-making processes. Barriers to sustainable global support need to be addressed for LMIC NITAGs to both continue and develop further.

Health Care Coverage Decision Making in Low- and Middle-Income Countries: Experiences from 25 Coverage Schemes

2015 ◽  
Vol 18 (4) ◽  
pp. 265-271 ◽  
Author(s):  
Hialy Gutierrez ◽  
Ashwini Shewade ◽  
Minghan Dai ◽  
Pedro Mendoza-Arana ◽  
Octavio Gómez-Dantés ◽  
...  
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Middle Income ◽  
Health Care Coverage ◽  
Middle Income Countries ◽  
Coverage Decision ◽  
Low And Middle Income

scholarly journals How does performance-based financing affect the availability of essential medicines in Cameroon? A qualitative study

2019 ◽  
Vol 34 (Supplement_3) ◽  
pp. iii4-iii19 ◽  
Author(s):  
Isidore Sieleunou ◽  
Anne-Marie Turcotte-Tremblay ◽  
Manuela De Allegri ◽  
Jean-Claude Taptué Fotso ◽  
Habakkuk Azinyui Yumo ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Health Services ◽  
Healthcare Providers ◽  
Study Data ◽  
Essential Medicines ◽  
Middle Income ◽  
Middle Income Countries ◽  
Performance Based Financing ◽  
Low And Middle Income

Abstract Performance-based financing (PBF) is being implemented across low- and middle-income countries to improve the availability and quality of health services, including medicines. Although a few studies have examined the effects of PBF on the availability of essential medicines (EMs) in low- and middle-income countries, there is limited knowledge of the mechanisms underlying these effects. Our research aimed to explore how PBF in Cameroon influenced the availability of EMs, and to understand the pathways leading to the experiential dimension related with the observed changes. The design was an exploratory qualitative study. Data were collected through in-depth interviews, using semi-structured questionnaires. Key informants were selected using purposive sampling. The respondents (n = 55) included health services managers, healthcare providers, health authorities, regional drugs store managers and community members. All interviews were recorded, transcribed and analysed using qualitative data analysis software. Thematic analysis was performed. Our findings suggest that the PBF programme improved the perceived availability of EMs in three regions in Cameroon. The change in availability of EMs experienced by stakeholders resulted from several pathways, including the greater autonomy of facilities, the enforced regulation from the district medical team, the greater accountability of the pharmacy attendant and supply system liberalization. However, a sequence of challenges, including delays in PBF payments, limited autonomy, lack of leadership and contextual factors such as remoteness or difficulty in access, was perceived to hinder the capacity to yield optimal changes, resulting in heterogeneity in performance between health facilities. The participants raised concerns regarding the quality control of drugs, the inequalities between facilities and the fragmentation of the drug management system. The study highlights that some specific dimensions of PBF, such as pharmacy autonomy and the liberalization of drugs supply systems, need to be supported by equity interventions, reinforced regulation and measures to ensure the quality of drugs at all levels.

scholarly journals 22A Survey-Based Women's Empowerment Index for Low- and Middle-Income Countries: The SWPER Goes Global

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Fernanda Ewerling ◽  
Anita Raj ◽  
Cesar G Victora ◽  
Franciele Hellwig ◽  
Carolina VN Coll ◽  
...  
Keyword(s):  
Decision Making ◽  
Women's Empowerment ◽  
Women’S Empowerment ◽  
African Countries ◽  
Middle Income ◽  
Household Decision ◽  
Middle Income Countries ◽  
World Regions ◽  
Country Rankings ◽  
Low And Middle Income

Abstract Background In 2017, a survey-based women's empowerment index (SWPER) was proposed for African countries, including three domains: social independence, decision making and attitude to violence. We explored the applicability of the SWPER in national health surveys from countries in other world regions. Methods We used data from the latest Demographic and Health Survey for 62 low- and middle-income countries (LMICs) since 2000, and adapted the indicator so that it could be used for any LMIC. Adaptations included the exclusion of women's working status and recategorization of the household decision-making related items. We compared the loading patterns obtained from principal components analysis for each country separately with those obtained in a pooled dataset with all countries combined. Country rankings based on the score of each SWPER domain were correlated with their rankings in the Gender Development Index (GDI) and the Gender Inequality Index (GII). Results Most countries presented similar patterns regarding item loadings for the three SWPER empowerment domains. Correlations between the country-specific and global individual-level scores were 0.89 or higher for all countries. Correlations between the country rankings according to SWPER and GDI were, respectively, 0.74, 0.71 and 0.67 for social independence, decision-making, and attitude to violence domains. The correlations were equal to 0.82, 0.67, and 0.44, respectively, with GDI. Conclusions The SWPER global is a suitable common measure of women's empowerment for LMICs, addressing the need for a single consistent survey-based indicator of women's empowerment and allowing wider comparisons across countries and world regions.

scholarly journals Data Equity to Advance Health and Health Equity in Low- and Middle-Income Countries: A Scoping Review

2021 ◽  
Vol 7 ◽  
pp. 205520762110619
Author(s):  
So O‘Neil ◽  
Sydney Taylor ◽  
Anitha Sivasankaran
Keyword(s):  
Decision Making ◽  
Health Outcomes ◽  
Health Equity ◽  
Scoping Review ◽  
Data Use ◽  
Data Access ◽  
Middle Income ◽  
Middle Income Countries ◽  
Improve Health ◽  
Low And Middle Income

Objective To assess a common hypothesis that data serve as a mechanism to improve health and health equity in low-and middle-income countries (LMICs), we conducted a synthesis of the evidence about the linkage between data capabilities in LMICs and health outcomes. Methods We searched and reviewed peer-reviewed and grey literature published in the past decade that focused on at least one aspect of health data or health equity or provided insights on the relationship between data use and improved health outcomes, decision-making, or both. We supplemented this with expert interviews and convenience-sampled literature. Results Of the 50 included articles, 33 discussed data collection, with 23 stating that poor accuracy, reliability, and completeness hindered data-informed decision-making. Of 27 articles discussing data access, 18 described how lack of interoperability between data systems hampered governments’ and other organizations’ ability to leverage the full value of data available. Of 19 articles discussing data use, 13 discussed how data were not getting to those doing work on the ground. Although key informants postulated a virtuous cycle between data and improved health outcomes, evidence did not support this connection. Conclusions Findings indicate better data might improve health service delivery. However, more work is needed to examine whether improvements in data yield improvements in health outcomes in LMICs. Our conceptual framework of data equity for health and health equity developed through this scoping review helps identify the key components along which to assess improvements in LMICs’ data capabilities.

Sign in / Sign up

Export Citation Format

Share Document