■儿童接种疫苗是降低传染病负担的有效干预措施。全球疫苗覆盖率增加,但是疫苗的犹豫和拒绝威胁着这些收益。5C疫苗接种的心理先例(“5C”)提供了“疫苗犹豫或信心”的有效度量,以评估疫苗接种背后的个人思想和行为。我们调查了导致赞比亚疫苗接种覆盖率高和持续的人群水平因素,尼泊尔,塞内加尔,并与5C对齐。
■数据是在较大的疫苗交付示例研究中收集的,从全国焦点小组讨论(FDG)和关键线人访谈(KIIs)中,区域,区,卫生机构,以及赞比亚卫生系统的社区水平,尼泊尔,塞内加尔。我们评估了需求环境,正如参与者传达的那样,并确定了据报道对需求产生成功的干预措施,然后将干预措施与5C结构追溯对齐。
■需求与高信心和集体责任呈正相关。心理约束有时会影响需求。身体上的限制在一些社区造成了障碍,特别难以访问(即,山区)。偶尔,身体限制并不影响疫苗接种行为-父母认为疫苗接种的益处值得追求.与需求和意图负相关的因素,自满和计算,影响有限。关键干预措施是:有针对性和量身定制的健康教育活动(媒体伙伴关系、学校外展);社区参与;社区所有权;和社区参与(社区卫生工作者,领导人,宗教人物)。
■我们发现了用于产生需求的类似干预措施,与5C结构保持一致的策略。按需求驱动因素对干预措施进行分类可能有助于战略规划和资源分配;决策者可以选择实施我们建议的干预措施。评估5C允许决策者将需求产生转化为具体的干预措施和政策,并确定这些结构对人口的个人影响,并将重点放在针对特定需求的干预措施上。
UNASSIGNED: Childhood vaccination is an effective intervention for lowering the burden of infectious disease. Vaccine coverage has increased globally, but vaccine hesitancy and refusal threatens these gains. The 5C psychological antecedents of vaccination (\"5C\") provides a validated measure of \"vaccine hesitancy or confidence\" to assess individual thoughts and behaviors behind vaccination. We investigated population-level factors that contributed to high and sustained vaccination coverage in Zambia, Nepal, and Senegal, and alignment with the 5Cs.
UNASSIGNED: Data was collected in the larger Exemplars in Vaccine Delivery study, from focus group discussions (FDGs) and key informant interviews (KIIs) at the national, regional, district, health facility, and community levels of health systems in Zambia, Nepal, and Senegal. We assessed the demand environment, as relayed by participants, and identified interventions reported as successful for demand generation, then retroactively aligned the interventions with the 5C constructs.
UNASSIGNED: Demand was positively correlated with high confidence and collective responsibility. Psychological constraints sometimes impacted demand. Physical constraints created barriers in some communities, particularly difficult to access (i.e., mountainous). Occasionally, physical constraints did not affect vaccination behavior - parents believed the benefits of vaccination worth pursuing. Factors negatively correlated with demand and intent, complacency and calculation, had limited impact. Critical interventions were: targeted and tailored health education activities (media partnerships, school outreach); community engagement; community ownership; and community involvement (community health workers, leaders, religious figures).
UNASSIGNED: We found similar interventions used to generate demand, with strategies aligned with the 5C constructs. Categorizing interventions by drivers of demand may help strategic planning and the division of resources; decision makers may choose to implement our suggested interventions. Assessing the 5Cs allows decision-makers to operationalize demand generation into concrete interventions and policies, and determine the individual impact of these constructs on the population and focus efforts on interventions tailored to a specific need.