Uddin Jasim, Sarma Haribondhu, Bari Tajul I, Koehlmoos Tracey P
icddr,b, GPO Box 128, Dhaka 1000, Bangladesh.
J Health Popul Nutr. 2013 Jun;31(2):211-7. doi: 10.3329/jhpn.v31i2.16385.
The understanding of the decision-making process in the introduction of new vaccines helps establish why vaccines are adopted or not. It also contributes to building a sustainable demand for vaccines in a country. The purpose of the study was to map and analyze the formal decision-making process in relation to the introduction of new vaccines within the context of health policy and health systems and identify the ways of making decisions to introduce new vaccines in Bangladesh. During February-April 2011, a qualitative assessment was made at the national level to evaluate the decision-making process around the adoption of new vaccines in Bangladesh. The study population included: policy-level people, programme heads or associates, and key decision-makers of the Government, private sector, non-governmental organizations, and international agencies at the national level. In total, 13 key informants were purposively selected. Data were collected by interviewing key informants and reviewing documents. Data were analyzed thematically. The findings revealed that the actors from different sectors at the policy level were involved in the decision-making process in the introduction of new vaccines. They included policy-makers from the ministries of health and family welfare, finance, and local government and rural development; academicians; researchers; representatives from professional associations; development partners; and members of different committees on EPI. They contributed to the introduction of new vaccines in their own capacity. The burden of disease, research findings on vaccine-preventable diseases, political issues relating to outbreaks of certain diseases, initiatives of international and local stakeholders, pressure of development partners, the Global Alliance for Vaccines and Immunization (GAVI) support, and financial matters were the key factors in the introduction of new vaccines in Bangladesh. The slow introduction and uptake of new vaccines is a concern in the country. Rapid action on the application of GAVI support and less time taken by the Government in processing the implementation and administrative work may expedite the introduction of new vaccines in future in this country.
了解新疫苗引入过程中的决策过程有助于明确疫苗被采用或未被采用的原因。这也有助于在一个国家建立对疫苗的可持续需求。本研究的目的是在卫生政策和卫生系统背景下，梳理并分析与新疫苗引入相关的正式决策过程，并确定在孟加拉国引入新疫苗的决策方式。2011年2月至4月期间，在国家层面进行了定性评估，以评价孟加拉国新疫苗采用的决策过程。研究对象包括：政策层面人员、项目负责人或其助手，以及政府、私营部门、非政府组织和国家层面国际机构的关键决策者。总共特意挑选了13名关键信息提供者。通过访谈关键信息提供者和查阅文件收集数据。对数据进行了主题分析。研究结果显示，政策层面不同部门的行为者参与了新疫苗引入的决策过程。他们包括卫生和家庭福利部、财政部、地方政府和农村发展部的政策制定者；学者；研究人员；专业协会代表；发展伙伴；以及扩大免疫规划不同委员会的成员。他们以各自的身份为新疫苗的引入做出了贡献。疾病负担、疫苗可预防疾病的研究结果、与某些疾病暴发相关的政治问题、国际和地方利益攸关方的举措、发展伙伴的压力、全球疫苗和免疫联盟（GAVI）的支持以及财政问题是孟加拉国引入新疫苗的关键因素。新疫苗引入和采用缓慢是该国令人担忧的问题。加快利用GAVI的支持并减少政府在处理实施和行政工作上花费的时间，可能会加快该国未来新疫苗的引入。
