Infectious Diseases Division, icddr,b, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh
Research Program, Bangladesh Institute of Governance and Management, Dhaka, Bangladesh.
BMJ Open. 2022 Sep 26;12(9):e061742. doi: 10.1136/bmjopen-2022-061742.
To assess the contribution of partners in the introduction of two new vaccines concurrently: pneumococcal 10-valent conjugate vaccine (PCV-10) and inactivated polio vaccine (IPV) into the routine Expanded Programme on Immunization (EPI) in Bangladesh.
We conducted a prospective process evaluation that included the theory of change development, root cause analysis and in-depth investigation. As part of process tracking, we reviewed relevant documents, observed trainers' and vaccinators' training and key stakeholder meetings. We analysed the data thematically.
We purposively selected eight (subdistrict) and one city corporation covering nine districts and seven administrative divisions of Bangladesh.
Nineteen national key informants were interviewed and 16 frontline health workers were invited to the group discussions considering their involvement in the vaccine introduction process.
The EPI experienced several challenges during the joint introduction of PCV-10 and IPV, such as frequent changes in the vaccine introduction schedule, delays in budget allocation, vaccine supply shortage and higher wastage rates of IPV. EPI addressed these challenges in collaboration with its partners, that is, the World Health Organization (WHO) and United Nations Children's Fund (UNICEF), who provided technical assistance to develop a training curriculum and communication materials and enhanced demand generation at the community level. In addition, the WHO conducted a country readiness assessment for PCV-10, and UNICEF supported vaccine shipment. Other government ministries, City Corporations and municipalities also supported the EPI.
The partnership among the EPI stakeholders effectively addressed various operational challenges during the joint introduction of PCV-10 and IPV helped strengthen Bangladesh's immunisation systems. These accomplishments are attributed to several factors that should be supported and strengthened for future vaccine introductions in Bangladesh and other low and-middle countries.
评估合作伙伴在将两种新疫苗（肺炎球菌 10 价结合疫苗 [PCV-10] 和灭活脊髓灰质炎疫苗 [IPV]）同时引入孟加拉国常规扩大免疫规划（EPI）中的贡献。
我们进行了一项前瞻性的过程评估，包括变革理论的发展、根本原因分析和深入调查。作为过程跟踪的一部分，我们审查了相关文件、观察了培训师和疫苗接种者的培训以及主要利益攸关方会议。我们对数据进行了主题分析。
我们有目的地选择了 8 个（分区）和 1 个城市公司，涵盖了孟加拉国的 9 个区和 7 个行政区。
我们采访了 19 名国家主要知情者，并邀请了 16 名一线卫生工作者参加小组讨论，考虑到他们参与疫苗引入过程。
EPI 在联合引入 PCV-10 和 IPV 期间经历了多次挑战，例如疫苗引入时间表频繁变化、预算分配延迟、疫苗供应短缺以及 IPV 的浪费率更高。EPI 与合作伙伴合作应对这些挑战，即世界卫生组织（WHO）和联合国儿童基金会（UNICEF），他们提供技术援助，制定培训课程和沟通材料，并在社区层面增强需求生成。此外，世界卫生组织对 PCV-10 进行了国家准备情况评估，联合国儿童基金会支持疫苗运输。其他政府部委、市公司和市政府也支持 EPI。
EPI 利益攸关方之间的伙伴关系有效地解决了在联合引入 PCV-10 和 IPV 期间的各种运营挑战，有助于加强孟加拉国的免疫接种系统。这些成就归因于一些因素，这些因素应该在孟加拉国和其他中低收入国家的未来疫苗引入中得到支持和加强。
