Nnaji Chukwudi A, Wiysonge Charles S, Lesosky Maia, Mahomed Hassan, Ndwandwe Duduzile
Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Anzio Road, Observatory, Cape Town 7925, South Africa.
Cochrane South Africa, South African Medical Research Council, Francie Van Zijl Drive, Parow Valley, Cape Town 7501, South Africa.
Vaccines (Basel). 2021 Jun 23;9(7):691. doi: 10.3390/vaccines9070691.
Despite South Africa's substantial investments in and efforts at ensuring universal access to immunisation services, progress has stalled and remains suboptimal across provinces and districts. An additional challenge is posed by the ongoing coronavirus disease 2019 (COVID-19) pandemic, which has disrupted immunisation services globally, including in South Africa. While there is growing evidence that missed opportunities for vaccination (MOV) are a major contributor to suboptimal immunisation progress globally, not much is known about the burden and determinants of MOV in the South African context. Herein, we make a case for assessing MOV as a strategy to address current immunisation coverage gaps while mitigating the adverse impacts of the COVID-19 pandemic on immunisation services. We illustrate a practical implementation research approach to assessing the burden of MOV among children in primary care settings; for understanding the factors associated with MOV; and for designing, implementing, and evaluating context-appropriate quality improvement interventions for addressing missed opportunities. Such efforts are vital for building health system resilience and maintaining immunisation programme capacity to optimally deliver essential health services such as routine childhood immunisation, even during pandemics.
尽管南非在确保普遍获得免疫服务方面投入了大量资金并做出了努力，但进展已经停滞，各省和地区的情况仍未达到最佳状态。持续的2019冠状病毒病（COVID-19）大流行带来了额外挑战，它扰乱了包括南非在内的全球免疫服务。虽然越来越多的证据表明，疫苗接种错失机会（MOV）是全球免疫进展未达最佳状态的主要原因，但在南非背景下，关于MOV的负担和决定因素却知之甚少。在此，我们主张将评估MOV作为一种策略，以解决当前的免疫覆盖率差距，同时减轻COVID-19大流行对免疫服务的不利影响。我们阐述了一种实用的实施研究方法，用于评估初级保健环境中儿童的MOV负担；了解与MOV相关的因素；以及设计、实施和评估适合具体情况的质量改进干预措施，以解决错失的机会。即使在大流行期间，此类努力对于增强卫生系统的复原力和维持免疫规划能力以最佳方式提供诸如儿童常规免疫等基本卫生服务至关重要。
