PDF(Pubmed)
Abstract：
In 2019, national immunization programs in Ghana, Kenya, and Malawi commenced the implementation of RTS,S/AS01 vaccination in large-scale pilot schemes. Understanding the implementation context of this malaria vaccination in the pilot countries can provide useful insights for enhancing implementation outcomes in new countries. There has not yet been a proper synthesis of the implementation determinants of malaria vaccination programs. A rapid review was conducted to identify the implementation determinants of the pilot malaria vaccination programs in Ghana, Kenya, and Malawi, and describe the mechanism by which these determinants interact with each other. A literature search was conducted in November 2023 in PubMed and Google Scholar to identify those studies that described the factors affecting malaria vaccine implementation in Ghana, Kenya, and Malawi. Thirteen studies conducted between 2021 and 2023 were included. A total of 62 implementation determinants of malaria vaccination across all five domains of the consolidated framework for implementation research (CFIR) were identified. A causal loop diagram showed that these factors are interconnected and interrelated, identifying nine reinforcing loops and two balancing loops. As additional countries in Africa prepare for a malaria vaccine roll-out, it is pertinent to ensure that they have access to adequate information about the implementation context of countries that are already implementing malaria vaccination programs so that they understand the potential barriers and facilitators. This information can be used to inform context-specific systems enhancement to maximize implementation success. Going forward, primary implementation studies that incorporate the causal loop diagram should be integrated into the malaria vaccine implementation program to enable immunization program managers and other key stakeholders to identify and respond to emerging implementation barriers in a timely and systematic manner, to improve overall implementation performance.
摘要：
2019年，加纳国家免疫计划，肯尼亚,马拉维开始实施RTS，大规模试点计划中的S/AS01疫苗接种。了解这种疟疾疫苗在试点国家的实施背景，可以为加强新国家的实施成果提供有用的见解。尚未对疟疾疫苗接种计划的实施决定因素进行适当的综合。进行了快速审查，以确定加纳疟疾疫苗接种试点计划的实施决定因素，肯尼亚,马拉维,并描述这些决定因素相互作用的机制。2023年11月在PubMed和GoogleScholar进行了文献检索，以确定那些描述影响加纳疟疾疫苗实施的因素的研究。肯尼亚,和马拉维。纳入了2021年至2023年之间进行的13项研究。在综合实施研究框架（CFIR）的所有五个领域中，总共确定了62种疟疾疫苗接种的实施决定因素。因果循环图表明，这些因素是相互关联的，确定九个加强回路和两个平衡回路。随着更多的非洲国家准备推出疟疾疫苗，有必要确保他们能够获得有关已经在实施疟疾疫苗接种计划的国家的实施背景的充分信息，以便他们了解潜在的障碍和促进因素。该信息可用于通知上下文特定的系统增强,以最大化实现成功。展望未来,纳入因果循环图的主要实施研究应纳入疟疾疫苗实施计划，以使免疫计划管理人员和其他主要利益相关者能够及时和系统地识别和应对新出现的实施障碍，以提高整体实施性能。
