PDF(Pubmed)
Abstract：
Zero-dose children, or children who have not received any routine vaccination, are a priority population for global health policy makers as these children are at high risk of mortality from vaccine-preventable illnesses. We conducted a narrative review to identify potential interventions, both within and outside of the health sector, to reach zero-dose children. We reviewed the peer-reviewed and grey literature and identified 27 relevant resources. Additionally, we interviewed six key informants to enhance the synthesis of our findings. Data were organized into three priority settings: (1) urban slums, (2) remote or rural communities, and (3) conflict settings. We found that zero-dose children in the three priority settings face differing barriers to vaccination and, therefore, require context-specific interventions, such as leveraging slum health committees for urban slums or integrating with existing humanitarian response services for conflict settings. Three predominant themes emerged for grouping the various interventions: (1) community engagement, (2) health systems\' strengthening and integration, and (3) technological innovations. The barriers to reaching zero-dose children are multifaceted and nuanced to each setting, therefore, no one intervention is enough. Technological interventions especially must be coupled with community engagement and health systems\' strengthening efforts. Evaluations of the suggested interventions are needed to guide scale-up, as the evidence base around these interventions is relatively small.
摘要：
零剂量儿童，或未接受任何常规疫苗接种的儿童，是全球卫生政策制定者的优先人群，因为这些儿童面临因疫苗可预防疾病而死亡的高风险。我们进行了叙述性审查，以确定潜在的干预措施，卫生部门内外，达到零剂量儿童。我们回顾了同行评审和灰色文献，并确定了27种相关资源。此外,我们采访了六名主要的线人，以加强我们发现的综合。数据分为三个优先设置:(1)城市贫民窟，（2）偏远或农村社区，和(3)冲突设置。我们发现，在三个优先环境中，零剂量儿童面临不同的疫苗接种障碍，因此,需要针对具体情况的干预，例如利用城市贫民窟的贫民窟卫生委员会，或与现有的冲突环境人道主义应急服务相结合。将各种干预措施分组时出现了三个主要主题：(1)社区参与，(2)卫生系统的加强和整合，(3)技术创新。达到零剂量儿童的障碍是多方面的，每个环境都有细微差别，因此,没有人干预就足够了。技术干预尤其必须与社区参与和卫生系统加强努力相结合。需要对建议的干预措施进行评估，以指导扩大规模，因为围绕这些干预措施的证据基础相对较小。
