Haeuser Emily, Nguyen Jason Q, Rolfe Sam, Nesbit Olivia, Fullman Nancy, Mosser Jonathan F
Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195, USA.
Department of Global Health, School of Medicine and School of Public Health, University of Washington, Seattle, WA 98195, USA.
Vaccines (Basel). 2023 Apr 5;11(4):802. doi: 10.3390/vaccines11040802.
The integration of immunization with other essential health services is among the strategic priorities of the Immunization Agenda 2030 and has the potential to improve the effectiveness, efficiency, and equity of health service delivery. This study aims to evaluate the degree of spatial overlap between the prevalence of children who have never received a dose of the diphtheria-tetanus-pertussis-containing vaccine (no-DTP) and other health-related indicators, to provide insight into the potential for joint geographic targeting of integrated service delivery efforts. Using geospatially modeled estimates of vaccine coverage and comparator indicators, we develop a framework to delineate and compare areas of high overlap across indicators, both within and between countries, and based upon both counts and prevalence. We derive summary metrics of spatial overlap to facilitate comparison between countries and indicators and over time. As an example, we apply this suite of analyses to five countries-Nigeria, Democratic Republic of the Congo (DRC), Indonesia, Ethiopia, and Angola-and five comparator indicators-children with stunting, under-5 mortality, children missing doses of oral rehydration therapy, prevalence of lymphatic filariasis, and insecticide-treated bed net coverage. Our results demonstrate substantial heterogeneity in the geographic overlap both within and between countries. These results provide a framework to assess the potential for joint geographic targeting of interventions, supporting efforts to ensure that all people, regardless of location, can benefit from vaccines and other essential health services.
将免疫接种与其他基本卫生服务相结合是《2030年免疫议程》的战略重点之一，有可能提高卫生服务提供的有效性、效率和公平性。本研究旨在评估从未接种过一剂含白喉-破伤风-百日咳疫苗（未接种DTP）的儿童患病率与其他健康相关指标之间的空间重叠程度，以便深入了解综合服务提供工作联合地理定位的潜力。利用疫苗接种覆盖率和比较指标的地理空间模型估计值，我们开发了一个框架，用于划定和比较各国国内及国家之间指标高度重叠的区域，同时基于计数和患病率进行比较。我们得出空间重叠的汇总指标，以促进各国、各指标之间以及随时间变化的比较。例如，我们将这套分析方法应用于五个国家——尼日利亚、刚果民主共和国、印度尼西亚、埃塞俄比亚和安哥拉——以及五个比较指标——发育迟缓儿童、五岁以下儿童死亡率、未接受口服补液疗法剂量的儿童、淋巴丝虫病患病率和经杀虫剂处理的蚊帐覆盖率。我们的结果表明，各国国内和国家之间在地理重叠方面存在很大差异。这些结果提供了一个框架，用于评估联合地理定位干预措施的潜力，支持确保所有人，无论身处何地，都能从疫苗和其他基本卫生服务中受益的努力。
