Baral Ranju, Fleming Jessica A, Barros Iracema, Cofie Patience, Dapaah Patience, Khan Sadaf, Knudson Sophia J, Kumar Sandeep, Mehedi Kamran, Munywoki Patrick K, Newhouse Lauren, Nyawanda Bryan O, Nyiro Joyce U, Odiyo Joseph, Otiang Elkanah, Owusu Rosemond, Pecenka Clint, Picolo Melanie, Pinto Judite, Quelhas Diana, Routray Satyabrata, Sultana Sarah, Uranw Surendra
PATH, Seattle, United States of America.
PATH, Seattle, United States of America.
Vaccine. 2025 Jan 25;45:126654. doi: 10.1016/j.vaccine.2024.126654. Epub 2024 Dec 24.
New vaccines for pregnant women have recently been introduced in some high-income countries to protect infants in early life. Implementing maternal immunisation (MI) successfully in low- and middle-income countries will require planning and adaptations to immunisation and maternal health programs. To inform cost of MI delivery studies, we gathered perspectives from key stakeholders in five countries (Bangladesh, Ghana, Kenya, Mozambique, and Nepal) regarding health system requirements, opportunities, and challenges to introducing new maternal vaccines into routine health programs.
We convened national stakeholders for country workshops to deliberate potential delivery strategies, opportunities, and constraints for implementing new MI interventions. Divided into thematic areas, participants discussed health system adaptations needed to establish or strengthen an MI platform.
Stakeholders felt that existing programs that administer vaccines to pregnant women, primarily tetanus-containing vaccines, provide a proven path for the delivery of additional maternal vaccines. Maternal health and immunisation program integration was perceived strongest at the health care provision level and weakest at the national level. Concerted coordination at the national level was identified as critical to the success of introducing new interventions. Stakeholders perceived that most health workforce providing immunisation and antenatal care services undergo similar training and have transferrable skills, however developing operational guidelines with clear roles and responsibilities was deemed critical for ownership and accountability. Human resource constraints were cited as a challenge for some countries. The importance of raising awareness of disease burden and new MI interventions was also highlighted across countries. Sustainable financing was a recurring challenge cited, especially with transitions from Gavi support.
The workshops enabled country stakeholders to deliberate needs to support the introduction of new maternal vaccines. While circumstances and needs differed, stakeholders across countries were optimistic about the capability of their health systems to integrate new maternal vaccines.
一些高收入国家最近推出了针对孕妇的新疫苗，以保护婴儿的早期生命。要在低收入和中等收入国家成功实施孕产妇免疫（MI），需要对免疫规划和孕产妇保健项目进行规划与调整。为了为MI实施成本研究提供信息，我们收集了五个国家（孟加拉国、加纳、肯尼亚、莫桑比克和尼泊尔）关键利益相关者对于将新的孕产妇疫苗引入常规卫生项目的卫生系统要求、机遇和挑战的看法。
我们召集了各国的利益相关者参加国家研讨会，以探讨实施新的MI干预措施的潜在实施策略、机遇和制约因素。参与者分为不同主题领域，讨论了建立或加强MI平台所需的卫生系统调整。
利益相关者认为，现有的为孕妇接种疫苗的项目，主要是含破伤风疫苗的项目，为提供额外的孕产妇疫苗提供了一条经过验证的途径。孕产妇保健和免疫项目的整合在医疗服务提供层面被认为最为紧密，而在国家层面最为薄弱。国家层面的协同协调被认为是引入新干预措施成功的关键。利益相关者认为，大多数提供免疫和产前护理服务的卫生工作者接受过类似的培训，具备可转移的技能，然而制定明确角色和责任的操作指南被认为对所有权和问责制至关重要。一些国家提到人力资源限制是一个挑战。各国还强调了提高对疾病负担和新的MI干预措施认识的重要性。可持续融资是一个反复出现的挑战，特别是在从全球疫苗免疫联盟（Gavi）的支持过渡时。
这些研讨会使各国利益相关者能够探讨支持引入新的孕产妇疫苗的需求。虽然情况和需求各不相同，但各国的利益相关者对其卫生系统整合新的孕产妇疫苗的能力持乐观态度。
