Accepted for/Published in: JMIR Research Protocols
Date Submitted: Oct 14, 2019
Date Accepted: Apr 21, 2020
Protocol for a country-level assessment of missed opportunities for vaccination in South Africa: multilevel analysis
ABSTRACT
Background:
Vaccination is one of the greatest public health interventions of all time. The vaccination coverage in South Africa has shown a steady improvement in reaching the national target for vaccine coverage. However, while there is progress nationally, there are districts within the country that are below the set target for vaccine coverage. One of the main drivers of suboptimal vaccination coverage is thought to be missed opportunities for vaccination (MOV).
Objective:
This study aims to understand the magnitude and determinants of MOV in South Africa.
Methods:
The 2016 South African Demographic and Health Survey (SADHS) will be used to conduct multilevel regression analyses to determine individual and contextual factors associated with MOV in South Africa. Parental perspectives of parents attending healthcare facilities in South Africa will be explored through exit interviews and focus group discussions. Similarly, perspectives of the healthcare providers will be sought to understand enablers and barriers to vaccine uptake at the facility level. Insights to such factors will aid in designing tailor-made interventions to improve vaccination coverage in South Africa.
Results:
The extent of missed opportunities in South Africa coupled with the associated factors presents an opportunity for efforts to increase vaccine coverage in districts that are below the national target. The population-level data such as the South African Demographic Health Survey 2016 will provide hints on the magnitude of MOV in South Africa at national and sub-national levels.
Conclusions:
The findings of the study will inform policy implementation on national and sub-national immunization scale and sort to find context-specific interventions to improve vaccine coverage
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