London School of Hygiene and Tropical Medicine (LSHTM), Department of Global Health and Development, Tavistock Place, London WC1H 9SH, United Kingdom.
Vaccine. 2018 Sep 5;36(37):5536-5543. doi: 10.1016/j.vaccine.2018.07.063. Epub 2018 Jul 31.
Improving evidence informed decision-making in immunisation is a global health priority and many low and middle-income countries have established National Immunisation Technical Advisory Groups (NITAGs) as independent technical advisory bodies for this purpose. NITAG development and strengthening has received financial and technical support over the past decade, but relatively little evaluation. This study examined NITAGs in six low and middle-income countries (i.e. Armenia, Ghana, Indonesia, Nigeria, Senegal, Uganda), to examine functionality, quality of recommendation development, and integration with national decision-making bodies and processes.
A mixed-method case-series design, used semi-structured interviews, NITAG meeting observations, and document review. Data were analysed thematically.
Five NITAGs had been legally established with terms of reference and appeared well functioning, with Ghana's in development. All NITAGs had standard operating procedures and nomination procedures to ensure a range of expertise, generally comprising 10-15 core, 1-5 secretariat, and several ex-officio members. Aside from economics, NITAGs reported a wide range of member expertise. Newer NITAGs had particular concerns about funding. Four used formal conflict of interest procedures, although some commented that implications were not always understood. NITAGs valued local data, and limited evidence suggested NITAG presence might reinforce data production through surveillance and local research studies. All observed meetings demonstrated due process and evidence-based decision-making processes were generally followed, with a critical role played by working-group data syntheses and assessments. NITAGs were seen as well integrated with ministry of health (MoH) decision-making and MoH interviewees were positive about NITAG contributions, indicating NITAGs had an important role. Collaboration with other bodies was more limited, but mitigated by NITAG members' cross-membership in other bodies.
NITAGs have an important and valued role within national immunisation decision-making. However, their position remains insecure, with the need for sustainable technical and financial support.
提高免疫规划中循证决策的水平是全球卫生的重点之一，许多低收入和中等收入国家已成立国家免疫技术咨询小组（NITAG）作为独立的技术咨询机构来实现这一目标。在过去十年中，NITAG 的发展和加强得到了财政和技术支持，但评估相对较少。本研究对六个低收入和中等收入国家（即亚美尼亚、加纳、印度尼西亚、尼日利亚、塞内加尔和乌干达）的 NITAG 进行了检查，以研究其功能、建议制定的质量以及与国家决策机构和流程的整合情况。
采用混合方法病例系列设计，使用半结构化访谈、NITAG 会议观察和文件审查。数据进行了主题分析。
五个 NITAG 已依法成立，具有职权范围，并表现出良好的运作状态，加纳的 NITAG 正在发展中。所有 NITAG 都有标准操作程序和提名程序，以确保涵盖广泛的专业知识，通常包括 10-15 名核心成员、1-5 名秘书处成员和几名当然成员。除了经济学之外，NITAG 报告了广泛的成员专业知识。较新的 NITAG 特别关注资金问题。有四个 NITAG 使用了正式的利益冲突程序，尽管有些人认为并不总是理解其影响。NITAG 重视本地数据，并且有限的证据表明，NITAG 的存在可能通过监测和本地研究来加强数据生产。所有观察到的会议都展示了正当程序，并且通常遵循循证决策过程，工作组的数据综合和评估发挥了关键作用。NITAG 被认为与卫生部（MoH）的决策高度整合，MoH 的受访者对 NITAG 的贡献给予了积极评价，表明 NITAG 发挥了重要作用。与其他机构的合作较为有限，但通过 NITAG 成员在其他机构的交叉任职得到缓解。
NITAG 在国家免疫决策中具有重要和有价值的作用。然而，它们的地位仍然不稳定，需要可持续的技术和财政支持。
