Lahariya Chandrakant
(Formerly at) Department of Community Medicine, Gajara Raja Medical College, Gwalior, MP, India.
J Family Med Prim Care. 2015 Oct-Dec;4(4):487-94. doi: 10.4103/2249-4863.174263.
Immunization programs are one of the most well-recognized and successful public health programs across the world. The immunization programs have achieved significant successes in a number of countries; however, the coverage with available vaccines remains sub-optimal in many low- and middle-income countries (LMICs). This article, based upon extensive review of literature and using universal immunization program (UIP) in India as a case study, summarizes the latest developments and initiatives in the area of vaccination and immunization in the last few years. The article analyzes initiatives under UIP in India from the "health system approach" and argues that it is possible to increase coverage with available vaccines and overall program performance by focused attention on various functions of health systems. It also discusses the emerging evidence that health systems could be strengthened prior to the introduction of new interventions (vaccines included) and the introduction of new interventions (including vaccines) could be planned in a way to strengthen the health systems. It concludes that immunization programs could be one of the entry points for strengthening health systems in the countries and lessons from vaccine introduction could pave pathway for scaling up other health interventions and therefore, could contribute to advancing Universal Health Coverage (UHC).
免疫规划是全球最广为人知且最成功的公共卫生项目之一。免疫规划在许多国家都取得了显著成效；然而，在许多低收入和中等收入国家，现有疫苗的接种覆盖率仍未达到最佳水平。本文在广泛查阅文献的基础上，以印度的通用免疫规划（UIP）为例，总结了过去几年疫苗接种和免疫领域的最新发展及举措。文章从“卫生系统方法”的角度分析了印度UIP下的各项举措，并认为通过重点关注卫生系统的各项功能，有可能提高现有疫苗的接种覆盖率及整体项目绩效。文章还讨论了新出现的证据，即可以在引入新的干预措施（包括疫苗）之前加强卫生系统，并且可以以加强卫生系统的方式来规划新干预措施（包括疫苗）的引入。文章得出结论，免疫规划可以成为各国加强卫生系统的切入点之一，疫苗引入的经验教训可为扩大其他卫生干预措施铺平道路，因此有助于推进全民健康覆盖（UHC）。
