scholarly journals Health System Barriers and Facilitators to Delivering Additional Vaccines through the National Immunisation Programme in China: A Qualitative Study of Provider and Service-User Perspectives

Vaccines ◽  
2021 ◽  
Vol 9 (5) ◽  
pp. 476
Author(s):  
Dan Gong ◽  
Qiyun Jiang ◽  
Tracey Chantler ◽  
Fiona Yueqian Sun ◽  
Jiatong Zou ◽  
...  
Keyword(s):  
Public Health ◽  
Information Systems ◽  
Qualitative Study ◽  
Health System ◽  
Barriers And Facilitators ◽  
System Capacity ◽  
Cold Chain ◽  
Western China ◽  
Process Data ◽  
National Immunisation Programme

In China, there are two categories of vaccines available from the Chinese Center for Disease Control and associated public health agencies. Extended Program of Immunization (EPI) vaccines are government-funded and non-EPI vaccines are voluntary and paid for out-of-pocket. The government plans to transition some non-EPI vaccines to EPI in the coming years, which may burden public health system capacity, particularly in terms of budget, workforce, supply chains, and information systems. Our study explored vaccinator and caregiver perspectives on introducing non-EPI vaccines into routine immunization and perceived facilitators and barriers affecting this transition. We conducted a qualitative study from a realist perspective, analysing semi-structured interviews with 26 vaccination providers and 160 caregivers in three provinces, selected to represent regional socioeconomic disparities across Eastern, Central, and Western China. Data were analysed thematically, using deductive and inductive coding. Most participants were positive about adding vaccines to the national schedule. Candidate EPI vaccines most frequently recommended by participants were varicella, mumps vaccine, and hand–foot–mouth disease. Providers generally considered existing workspaces, cold-chain equipment, and funding sufficient, but described frontline staffing and vaccine information systems as requiring improvement. This is the first qualitative study to explore interest, barriers, and facilitators related to adding vaccines to China’s national schedule from provider and caregiver perspectives. Findings can inform government efforts to introduce additional vaccines, by including efforts to retain and recruit vaccine programme staff and implement whole-process data management and health information systems that allow unified nationwide data collection and sharing.

Who Counts Where? COVID-19 Surveillance in Federal Countries

2021 ◽  
Author(s):  
Philip Rocco ◽  
Jessica A. J. Rich ◽  
Katarzyna Klasa ◽  
Kenneth A. Dubin ◽  
Daniel Béland
Keyword(s):  
Public Health ◽  
Data Quality ◽  
Health System ◽  
Case Studies ◽  
Fiscal Decentralization ◽  
Public Health System ◽  
System Capacity ◽  
Democratic Institutions ◽  
Subnational Governments

Abstract Context: While the World Health Organization (WHO) has established guidance on COVID-19 surveillance, little is known about implementation of these guidelines in federations, which fragment authority across multiple levels of government. This study examines how subnational governments in federal democracies collect and report data on COVID-19 cases and mortality associated with COVID-19. Methods: We collected data from subnational government websites in 15 federal democracies to construct indices of COVID-19 data quality. Using bivariate and multivariate regression, we analyzed the relationship between these indices and indicators of state capacity, the decentralization of resources and authority, and the quality of democratic institutions. We supplement these quantitative analyses with qualitative case studies of subnational COVID-19 data in Brazil, Spain, and the United States. Findings: Subnational governments in federations vary in their collection of data on COVID-19 mortality, testing, hospitalization, and demographics. There are statistically significant associations (p<0.05) between subnational data quality and key indicators of public health system capacity, fiscal decentralization, and the quality of democratic institutions. Case studies illustrate the importance of both governmental and civil-society institutions that foster accountability. Conclusions: The quality of subnational COVID-19 surveillance data in federations depends in part on public health system capacity, fiscal decentralization, and the quality of democracy.

scholarly journals Health system plan for implementation of Paris agreement on climate change (COP 21): a qualitative study in Iran

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Arefeh Mousavi ◽  
Ali Ardalan ◽  
Amirhossein Takian ◽  
Abbas Ostadtaghizadeh ◽  
Kazem Naddafi ◽  
...  
Keyword(s):  
Public Health ◽  
Climate Change ◽  
Qualitative Study ◽  
Health System ◽  
Health Effects ◽  
Policy Making ◽  
Early Warning Systems ◽  
Paris Agreement ◽  
Evidence Based ◽  
Mitigation And Adaptation

Abstract Background Ensuring public health is crucial in any policy debate on climate change. Paris Agreement on climate change is a global contract, through which countries have committed themselves to a public health treaty. The agreement has laid the foundation for mitigation and adaptation. This study was conducted to provide an evidence-based framework for policy-making in the health system of Iran in order to reduce the adverse effects of climate change on public health and to increase the adaptation of the health system as a result. Methods This is a qualitative study. We first used Delphi method to extract the components of Paris Agreement on climate change that were related to the functions and policymaking of health system in Iran. Twenty-three experts in health and climate change were identified purposefully and through snowball sampling as participants in Delphi. Data collection instrument was a structured questionnaire. We used SPSS software version 25 for data analysis based on the descriptive indices including the mean, the percentage of consensus above 75%, and the Kendall coordination coefficient. Results Seventy-nine components classified within nine categories were extracted. The most important examples of the implementation of Paris Agreement on climate change in the health system of Iran were: participation in the formulation of strategies for mitigation and adaptation, identifying vulnerable groups, assessing vulnerability, increasing the capacity of health services delivery during extreme events, using early warning systems, using new technologies to increase the adaptation, evaluation of interventions, financial support, increasing the number of researches, increasing the knowledge and skills of staff, and finally public awareness. Conclusions Evidence-based policy-making is pivotal to develop effective programs to control the health effects of climate change. This research provided policy translation and customization of micro and macro provisions of Paris Agreement on climate change, in line with the political context of health system in Iran. Our finding will pave the ground, we envisage, for further steps towards capacity building and enhancement of resiliency of the health system, adaptation interventions, and evaluation, identification of barriers and facilitators for adaptation and decreasing the adverse health effects caused by the climate change, in Iran and perhaps beyond.

Analysis of the Challenges and Problems in the Development of Public Health System in Beijing, China

2020 ◽  
Author(s):  
Ayan Mao ◽  
Cordia Chu ◽  
Yujie Yang ◽  
Yueli Meng ◽  
Wuqi Qiu
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
Municipal Government ◽  
Legal Framework ◽  
System Capacity ◽  
Health Staff ◽  
The Public ◽  
Information Strategies ◽  
The Impact

Abstract Background: To discern the main problems of Beijing’s public health service system, in order to provide suggestions to modernize the public health system and to enforce the implementation of the “Health Beijing 2030” plan. Methods: We carried out a quantitative study mostly based on interviews. There are over 40 directors and scholars who came from public health institutions and government sectors or organization that related to the public health work in Beijing were interviewed. The interview records were summary analyzed on key issues in accordance with the interview outline. Results: The challenges for the system include the change of structure of the population, the impact of the changing spectrum of diseases and changing environmental factors, and macro-institutional changes. The main problems include structure of the public health system, capacity of public health staff, systems for information management and legal framework for public health. On this basis, several relevant policy recommendations are put forward. Conclusion: To improve the public health system, the Beijing municipal government should design and construction of a system planning and perfecting their investment mechanism on public health. Stability of personnel and encouragement of innovation in scientific research and reliable health information strategies are also urgent needed.

125 Risk perception of obstetrician for the prescription of magnesium sulfate in severe preeclampsia and eclampsia: A qualitative study in the public health system in Brazil

2016 ◽  
Vol 6 (3) ◽  
pp. 241 ◽  
Author(s):  
Maria Laura Laura Costa ◽  
Fatima Aparecida Lotufo ◽  
Mary Angela Parpinelli ◽  
Maria Jose Osis ◽  
Fernanda Garanhani Surita ◽  
...  
Keyword(s):  
Public Health ◽  
Risk Perception ◽  
Qualitative Study ◽  
Health System ◽  
Magnesium Sulfate ◽  
Public Health System ◽  
Severe Preeclampsia ◽  
The Public
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