印度北方邦脊髓灰质炎强化免疫活动绩效的决定因素：社会动员网络（SM Net）和核心小组脊髓灰质炎项目（CGPP）的社会动员活动。
Determinants of performance of supplemental immunization activities for polio eradication in Uttar Pradesh, India: social mobilization activities of the Social mobilization Network (SM Net) and Core Group Polio Project (CGPP).
机构信息
Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, USA.
出版信息
BMC Infect Dis. 2013 Jan 17;13:17. doi: 10.1186/1471-2334-13-17.
BACKGROUND
The primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities (SIAs) and routine immunization coverage in priority districts. The CORE Group, part of the Social Mobilization Network (SM Net), has been successful in improving SIA coverage in high-risk areas of Uttar Pradesh (UP). The SM Net works through community level mobilisers (from the CORE Group and UNICEF) and covers more than 2 million children under the age of five. In this paper, we examine the reasons the CORE Group had been successful through exploration of which social mobilization activities of the CORE Group predicted better performance of SIAs.
METHODS
We carried out a secondary data analysis of routine monitoring information collected by the CORE Group and the Government of India for SIAs. These data included information about vaccination outcomes of SIAs in CORE Group areas and non-CORE Group areas within the districts where the CORE Group operates, along with information about the number of various social mobilization activities carried out for each SIA. We employed Generalized Linear Latent and Mixed Model (GLLAMM) statistical analysis methods to identify which social mobilization activities predicted SIA performance, and to account for the intra-class correlation (ICC) between multiple observations within the same geographic areas over time.
RESULTS
The number of mosque announcements carried out was the most consistent determinant of improved SIA performance across various performance measures. The number of Bullawa Tollies carried out also appeared to be an important determinant of improved SIA performance. The number of times other social mobilization activities were carried out did not appear to determine better SIA performance.
CONCLUSIONS
Social mobilization activities can improve the performance of mass vaccination campaigns. In the CORE Group areas, the number of mosque announcements and Bullawa Tollies carried out were important determinants of desired SIA outcomes. The CORE Group and SM Net should conduct sufficient numbers of these activities in support of each SIA. It is likely, however, that the quality of social mobilization activities (not studied here) is as or more important than the quantity of activities; quality measures of social mobilization activities should be investigated in the future as to how they determine vaccination performance.
背景
在印度，阻断野生脊灰病毒传播的主要策略是改善重点地区的补充免疫活动（SIAs）和常规免疫覆盖率。CORE 小组是社会动员网络（SM Net）的一部分，成功提高了北方邦（UP）高危地区的 SIA 覆盖率。SM Net 通过社区一级的动员者（来自 CORE 小组和联合国儿童基金会）开展工作，覆盖了 200 多万五岁以下儿童。在本文中，我们通过探讨 CORE 小组成功的社会动员活动，来研究其成功的原因，并分析哪些活动可以更好地预测 SIA 的表现。
方法
我们对 CORE 小组和印度政府为 SIA 收集的常规监测信息进行了二次数据分析。这些数据包括 CORE 小组地区和 CORE 小组所在地区非 CORE 小组地区的 SIA 接种结果信息，以及每次 SIA 开展的各种社会动员活动的数量信息。我们采用广义线性潜在和混合模型（GLLAMM）统计分析方法，以确定哪些社会动员活动可以预测 SIA 的表现，并考虑到随着时间的推移，同一地理区域内多次观察的组内相关性（ICC）。
结果
进行的清真寺通告数量是各种绩效指标中提高 SIA 绩效的最一致决定因素。进行的 Bullawa Tollies 数量似乎也是提高 SIA 绩效的重要决定因素。开展其他社会动员活动的次数似乎并不能决定更好的 SIA 绩效。
结论
社会动员活动可以提高大规模疫苗接种活动的效果。在 CORE 小组地区，进行的清真寺通告和 Bullawa Tollies 数量是 SIA 预期结果的重要决定因素。CORE 小组和 SM Net 应该在每次 SIA 中开展足够数量的此类活动。然而，社会动员活动的质量（此处未研究）可能与活动的数量一样重要，甚至更重要；未来应调查社会动员活动的质量措施如何影响疫苗接种效果。
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