Childhood Vaccines in Uganda and Zambia: Determinants and Barriers to Effective Coverage
Childhood Vaccines in Uganda and Zambia: Determinants and Barriers to Effective Coverage David E Vogt Phillips A dissertation Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy University of Washington 2017 Reading Committee: Stephen Lim, Chair Joseph Dieleman Jessica Shearer Program Authorized to Offer Degree: Global Health ©Copyright 2017 David E Vogt Phillips University of Washington Abstract Childhood Vaccines in Uganda and Zambia: Determinants and Barriers to Effective Coverage David E Vogt Phillips Chair of the Supervisory Committee: Professor Stephen Lim, PhD Global Health As a target of the Sustainable Development Goals, improving childhood immunization is a major priority for global health. Despite progress in recent times however, coverage (vaccination) and effective coverage (immunity) remain a challenge in low and middle-income countries (LMICs). Policy makers, public health practitioners and global organizations such as Gavi, the Vaccine Alliance focus much of their efforts on removing the barriers that prevent children from successful immunization. Barriers to effective coverage are complex and difficult to measure though. Extensive research effort has been devoted to understanding them, but most studies and systematic reviews have been limited in bread and depth. As vaccine programs in LMICs continue progress toward effective coverage of immunizations, better understanding of determinants and barriers will be imperative to close remaining gaps and inequities. Policies and programs like Gavi’s health system strengthening support would benefit from a more rigorous examination of the determinants and barriers to immunization. The work presented here represents a small step towards better understanding of why some children remain unvaccinated, and why some vaccines fail to produce immunity.
[Show full text]