Browsing by Author "Amponsah-Dacosta, Edina"

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    Characterisation of National Immunisation Programmes (NIPs) in the context of Public Health Emergencies (PHEs): A Case Study of 13 Countries in the WHO African Region
    (ResearchSquare, 2020) Chepkurui, Viola; Amponsah-Dacosta, Edina; Eposi, Haddison Christiana; Kagina, Benjamin Mugo
    In the World Health Organisation African region (WHO-Afro), multiple public health emergencies (PHEs) are experienced annually. PHEs are known to affect the provision of health services including immunisation. To our knowledge, there is limited information on the characterisation of PHEs and the performance of national immunisation programmes (NIPs) in countries within the WHO-Afro. This study assessed PHEs (armed conflicts, disasters, and disease outbreaks) and the performance of NIPs within PHE contexts using global and regional immunisation targets. Countries recorded to have benefitted from PHE mitigation funds from the African Public Health Emergency Fund (APHEF) were used as case studies. Data on PHEs and immunisation indicators between 2010 and 2019 in the selected countries were extracted from different PHE electronic databases and the WHO/UNICEF immunisation database, respectively. The PHEs and immunisation indicators were stratified by country and summarised using descriptive statistics. The Mann-Whitney U test was carried out to determine the association between the frequency of PHEs and the performance of NIPs. Statistical significance was defined at p-value < 0.05. Between 2010 and 2019 there were a total of 175 disease outbreaks, 288 armed conflicts, and 318 disasters in the 13 countries selected as case studies. The Democratic Republic of Congo had the highest total PHE count (n=208), while Liberia had the lowest (n=20). Only three of the 13 countries had a median coverage value for the third dose of the combined Diphtheria, Tetanus, and Pertussis vaccine (DTP3) that had attained the target for ≥90% immunisation coverage. Higher counts of armed conflict and total PHEs were associated with not meeting the immunisation targets for national DTP3 coverage of ≥90% and Maternal and Neonatal Tetanus (MNT) elimination, p<0.01. Higher disaster counts were also associated with not attaining MNT elimination, p=0.03. PHEs are prevalent in the WHO-Afro, irrespective of the level of a country’s immunisation maturity. In absence of effective interventions, the PHEs have the potential to derail the progress of NIPs in the WHO-Afro. As we transition towards the Immunisation Agenda 2030, we recommend that the WHO-Afro prioritises interventions to mitigate the impacts of PHEs on the NIPs.
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    Characterization of National Immunization Programs in the Context of Public Health Emergencies: A Case Study of 13 Countries in the WHO Africa Region
    (Frontiers in public health, 2021) Chepkurui, Viola; Amponsah-Dacosta, Edina; Haddison, Eposi Christiana; Kagina, Benjamin Mugo
    Multiple public health emergencies (PHEs) experienced annually in the World Health Organisation (WHO) Africa region affect the provision of health services, including immunization. However, there is limited information on the performance of national immunization programs (NIPs) in WHO Africa countries that experience PHEs. This study assessed PHEs (armed conflicts, disasters, and disease outbreaks) and the performance of NIPs using global and regional immunization targets outlined for the Decade of Vaccines. Thirteen beneficiary countries of PHE mitigation funds from the African Public Health Emergency Fund were used as case studies. Data on PHEs and immunization indicators between 2010 and 2019 in selected countries were extracted from different PHE databases and the WHO/UNICEF immunization database, respectively. The data were stratified by country and summarized using descriptive statistics. Mann-Whitney U test was done to determine the association between the frequency of PHEs and the performance of NIPs. There were 175 disease outbreaks, 288 armed conflicts, and 318 disasters in the examined countries between 2010 and 2019. The Democratic Republic of Congo had the highest total PHE count (n = 208), while Liberia had the lowest (n = 20). Only three of the 13 countries had a median coverage value for the third dose of the combined Diphtheria, Tetanus, and Pertussis vaccine (DTP3) that had attained the target for ≥90% immunization coverage. Higher counts of armed conflict and total PHEs were associated with not meeting immunization targets for national DTP3 coverage of ≥90% and Maternal and Neonatal Tetanus elimination, p < 0.01. It was clear that in the WHO Africa region, PHEs are prevalent, irrespective of a country’s level of immunization maturity, and have the potential to derail the progress of NIPs in the absence of effective interventions. As we transition toward the Immunization Agenda 2030, we recommend that the WHO Africa region prioritizes interventions to mitigate the impacts of PHEs on NIPs.
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    Developing vaccinology expertise for Africa: fifteen years and counting
    (The Pan African Medical Journal, 2021) Amponsah-Dacosta, Edina; Muloiwa, Rudzani; Wiysonge, Charles Shey; Kagina, Benjamin Mugo
    For 15 years, the Annual African Vaccinology Course (AAVC) hosted by the Vaccines for Africa Initiative, has been at the forefront of vaccinology training in Africa. The AAVC was developed in 2005 in response to the growing demand for vaccinology training in Africa. To date, 958 policy makers, immunization managers, public and private health practitioners, scientists, postgraduate and postdoctoral students have been trained. These participants are from 44 of the 54 African countries. The course content covers diverse topics such as considerations for new vaccine introduction, mathematical modelling, and emerging and re-emerging vaccine preventable diseases. As the landscape of vaccinology continues to evolve, the AAVC aims to expand the reach of vaccinology training using blended learning approaches which will incorporate online and face-to-face formats, while expanding access to this popular course. Ultimately, the AAVC endeavours to develop a big pool of vaccinology expertise in Africa and to strengthen regional ownership for immunization programmes.
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    Health systems constraints and facilitators of human papillomavirus immunization programmes in sub-Saharan Africa: a systematic review
    (Health policy and planning, 2020) Amponsah-Dacosta, Edina; Kagina, Benjamin M.; Olivier, Jill
    Given the vast investments made in national immunization programmes (NIPs) and the significance of NIPs to public health, it is important to understand what influences the optimal performance of NIPs. It has been established that well-performing NIPs require enabling health systems. However, systematic evidence on how the performance of health systems impacts on NIPs is lacking, especially from sub-Saharan Africa. We conducted a qualitative systematic review to synthesize the available evidence on health systems constraints and facilitators of NIPs in sub-Saharan Africa, using human papillomavirus immunization programmes as a proxy. Fifty-four articles published between 2008 and 2018 were found to be eligible. Data extraction was guided by an analytical model on the interface between NIPs and health systems. A cross-cutting thematic analysis of the extracted data was performed. This systematic review provides evidence necessary for informing ongoing health systems strengthening initiatives in sub-Saharan Africa. There is evidence to suggest that NIPs in sub-Saharan Africa have surmounted significant health systems constraints and have achieved notable public health success. This success can be attributed to strong political endorsement for vaccines, clear governance structures and effective collaboration with global partners. Despite this, significant health systems constraints persist in service delivery, vaccine communication, community engagement, the capacity of the health workforce and sustainable financing. These constraints could derail further progress if not addressed through health systems strengthening efforts. There is a need to expand the research agenda to include the comprehensive evaluation of health systems constraints and facilitators of NIPs within sub-Saharan Africa.