Division of Global Health Protection, Centre for Global Health Research, Kenya Medical Research Institute, PO Box 1578-40100, Kisumu, Kenya.
Hubert Department of Global Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
Implement Sci. 2021 Apr 12;16(1):39. doi: 10.1186/s13012-021-01101-7.
Maternal immunization is a key strategy for reducing morbidity and mortality associated with infectious diseases in mothers and their newborns. Recent developments in the science and safety of maternal vaccinations have made possible development of new maternal vaccines ready for introduction in low- and middle-income countries. Decisions at the policy level remain the entry point for maternal immunization programs. We describe the policy and decision-making process in Kenya for the introduction of new vaccines, with particular emphasis on maternal vaccines, and identify opportunities to improve vaccine policy formulation and implementation process.
We conducted 29 formal interviews with government officials and policy makers, including high-level officials at the Kenya National Immunization Technical Advisory Group, and Ministry of Health officials at national and county levels. All interviews were recorded and transcribed. We analyzed the qualitative data using NVivo 11.0 software.
All key informants understood the vaccine policy formulation and implementation processes, although national officials appeared more informed compared to county officials. County officials reported feeling left out of policy development. The recent health system decentralization had both positive and negative impacts on the policy process; however, the negative impacts outweighed the positive impacts. Other factors outside vaccine policy environment such as rumours, sociocultural practices, and anti-vaccine campaigns influenced the policy development and implementation process.
Public policy development process is complex and multifaceted by its nature. As Kenya prepares for introduction of other maternal vaccines, it is important that the identified policy gaps and challenges are addressed.
母婴免疫接种是减少母亲及其新生儿因传染病而发病和死亡的关键策略。母婴疫苗在科学和安全性方面的最新进展使得开发新的、适合在中低收入国家使用的母婴疫苗成为可能。政策层面的决策仍然是母婴免疫规划的切入点。我们描述了肯尼亚在引入新疫苗（特别是母婴疫苗）方面的政策和决策过程，并确定了改善疫苗政策制定和实施过程的机会。
我们对政府官员和决策者进行了 29 次正式访谈，包括肯尼亚国家免疫技术咨询小组和卫生部的高级官员，以及国家和县级官员。所有访谈均进行了记录和转录。我们使用 NVivo 11.0 软件对定性数据进行了分析。
所有关键信息提供者都了解疫苗政策的制定和实施过程，尽管与县级官员相比，国家官员似乎更了解情况。县级官员报告说他们被排除在政策制定之外。最近的卫生系统权力下放对政策过程产生了积极和消极的影响；然而，负面影响超过了积极影响。疫苗政策环境以外的其他因素，如谣言、社会文化习俗和反疫苗运动，也影响了政策的制定和实施过程。
公共政策的制定过程本质上是复杂和多方面的。随着肯尼亚准备引入其他母婴疫苗，重要的是要解决已确定的政策差距和挑战。
