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Abstract：
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.
摘要：
将免疫与其他基本卫生服务相结合是《2030年免疫议程》的战略优先事项之一，有可能提高免疫效果，效率,以及卫生服务提供的公平性。这项研究旨在评估从未接受过一剂含白喉-破伤风-百日咳疫苗（no-DTP）的儿童的患病率与其他健康相关指标之间的空间重叠程度。深入了解综合服务交付工作的联合地理定位的潜力。使用地理空间建模的疫苗覆盖率估计和比较指标，我们制定了一个框架来划分和比较各指标高度重叠的领域，国家内部和国家之间，并基于计数和患病率。我们得出了空间重叠的汇总指标，以促进国家和指标之间以及随着时间的推移进行比较。作为一个例子,我们将这套分析应用于五个国家-尼日利亚，刚果民主共和国(DRC)印度尼西亚,埃塞俄比亚,安哥拉和五个比较指标-发育迟缓的儿童，5岁以下死亡率，儿童缺少口服补液疗法的剂量，淋巴丝虫病的患病率，和杀虫剂处理过的蚊帐覆盖率。我们的结果表明，国家内部和国家之间的地理重叠存在很大的异质性。这些结果提供了一个框架，以评估干预措施的联合地理定位的潜力，支持努力确保所有人，无论地点,可以从疫苗和其他基本卫生服务中受益。
