Africa Resource Centre for Nigeria, 2 Ajose Adeogun, Victoria Island, Lagos, Nigeria.
TiSEM, Tilburg University, 5037 AB Tilburg, Netherlands.
Vaccine. 2019 Aug 14;37(35):5104-5110. doi: 10.1016/j.vaccine.2019.06.006. Epub 2019 Jul 15.
Improving immunization coverage requires creating reliable supply of vaccines and immunization supplies; trained and incentivized health workers; and strategies to improve the demand for immunization. Yet, the interplay of demand and supply side factors on immunization coverage has not been evaluated in literature with data. We use data from Nigeria and a mixed-effects general linear model to estimate the effect of vaccine availability on routine immunization coverage and to identify demand and health system factors which affect this relationship. We find that when vaccine stockouts occur at Local Government Area stores in Nigeria, they significantly decrease the number of children immunized, and for most vaccines, the effect lasts for several months after a stockout. Some of the demand lost when a stockout occurs is recovered over the following six months as children catch up with the regimen. The magnitude of the impact varies across different vaccines.
提高免疫接种覆盖率需要有可靠的疫苗和免疫接种供应品供应；需要有经过培训和激励的卫生工作者；还需要有提高免疫接种需求的战略。然而，文献中尚未利用数据评估需求和供应方因素对免疫接种覆盖率的相互作用。我们利用来自尼日利亚的数据和混合效应一般线性模型，来估计疫苗供应对常规免疫接种覆盖率的影响，并确定影响这种关系的需求和卫生系统因素。我们发现，当尼日利亚地方政府地区的疫苗库存告罄时，接受免疫接种的儿童人数会显著减少，而且对于大多数疫苗来说，这种影响在库存告罄后会持续数月。当发生缺货时，一些流失的需求会在随后的六个月中随着儿童补种而得到恢复。这种影响的大小因不同的疫苗而有所不同。
