PHE5EBP Assignment: Vaccination in Australia

PHE5EBP Assignment: Vaccination in Australia

PHE5EBP Assignment: Vaccination in Australia

Question:

Discuss about the Interventions for improving coverage of childhood immunisation in low- and middle-income countries.

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PHE5EBP Assignment: Vaccination in Australia – Sample Draft Solution:

Introduction

Preventive healthcare comprises of a set of measures that are undertaken to prevent the occurrence of an illness. Disease and disability consists of a variety of mental and physical states that are affected by disease agents, environmental factors, lifestyle choices and genetic predisposition (Luo, Cook, Wu and Wilson, 2017). The prevention of illnesses thus depends on anticipatory actions that could be classified as primary, secondary or tertiary preventive measures. Preventive care is increasingly becoming an area of much interest within the healthcare sector. Vaccination is currently on of the most effective public health disease prevention initiatives (Barret et al. 2016). The latter involves the use of various methods to prevent illnesses, educate populations and promote health (Hawk and Evans, 2013).  There has been low coverage of vaccination programs among the low-income Australian as compared to the higher earning individuals.

Discussion

Vaccination is one of the main preventive strategies used to control the transmission of communicable diseases (Barett, Bolan, Dawson, Ortmann, Resi and Saenz, 2016). The latter has reduced the world mortality and morbidity rates associated with infectious diseases, protecting up to 2.5 million lives annually according to the World Health Organization (WHO) statistics (Link, 2017). Some vaccines confer herd immunity by protecting both the vaccinated individuals and their close contacts. There are hypodermic needles of various sizes, lengths and gauges that are used to administer vaccines. The bigger the gauge number, the smaller the needle diameter. For instance, 0.5 mm diameter needle is gauge 25 while 0.6 mm needle is gauge 26 (Luo, Cook, Wu and Wilson, 2014). For infants and children between the ages of 2 months and 2 years of age, needle types used for vaccination are 23 to 25 G and 25 mm in length.

The vaccines are usually administered intramuscularly, intradermallly, subcutaneously and orally. The proper sires for pediatric vaccine injection are the anterolateral aspect of the thigh muscle, intradermal part of the forearm, deltoid muscle of the arm, and orally (Link, 2014). Some of the comfort measures that are used for pediatric children after vaccination include applying cold packs on the injection sites, administering Paracetamol syrup 2.5 ml 8 hourly for fever relief, distraction techniques and breastfeeding. The parents should be advised to hold or apply pressure at the injection sites.

Vaccine Information Sheets (VISs) are sheets that are were produced by the CDC to explain the benefits and risks of each vaccine to the recipients. Unfortunately, there exist no vaccine records, so such records are often found at the clinics and doctor’s office (Link, 2014). At birth, the child is usually given oral polio vaccine and BCG, while at two months a child is vaccinated with oral polio vaccine, hepatitis B vaccine 2nd dose, diphtheria, tetanus and pertussis (DPT), Haemophilus influenza type b (Hib), and Pneumococcal vaccine. At 2 years a child should be provided with vitamin A supplement.

Child vaccination Issues

Most of the children from developing countries encounter death from diseases that could get stopped through vaccination (Blume, 2017). Despite the efforts of the government to introduce immunization programs, several factors have contributed to barriers to successful immunization. Among the hindrances that have led to increased deaths among children include low income, lack of education, and lack of access to adequate healthcare knowledge. The situations have led to increased numbers of unvaccinated children. Based on the research analysis the best solution towards introducing vaccination in low and middle?income countries is using evidence-based discussions with community members.

The strategies guarantee creation of acceptable awareness about the significance of vaccination to children (Duckett and Willcox, 2015). The strategy has better results compared to health education. Alternative measures such as community meetings may act as an intervention measure to the problem. However, the strategy is costly and expensive. Another solution is adopting homecare health visits combined with regular immunization (Barett, Bolan, Dawson, Ortmann, Resi and Saenz, 2016). The outreach immunization plan is an effective solution but not enough data to access cost implications. The above solutions guarantee smaller impacts in promoting vaccination however they are easy to manage and sustain for long periods. Using incentives as motivation to accept vaccination has little or no significant influence. For example, monetary incentives do not encourage immunization especially when other barriers exist.

Summary of Findings in Cochrane Review

The most effective strategies leading towards increasing number vaccinations on children include the provision of community-oriented health education (Blume, 2017). The criteria for creating awareness include the use of mass healthcare campaigns and facility?based health education. Parents, society, and other community members should have clear and concise information about immunization through initiating health education. Various facilities such as reminding communities concerning immunization are among the strategies that guarantee effective responses to prevention care. Use of immunization reminding card and regular outreach immunizations are among the strategies that should be adopted (Willis et al. 2012). Other strategies that could improve the rate of childhood immunization include the use of healthcare home-based visits, household incentives, and integrating immunization process with adequate accessibility means in the interior.

The study found that through providing information as well as discussing various benefits of vaccinations with individual or group of parents and other members of community during events such as village meetings or visiting homes guaranteed a moderate probability of improving rate of immunization among children (Oya, Wiysonge, Oringanje, Nwachukwu, Oduwole and Meremikwu, 2016). The research found that through providing vaccination information direct to parents about significance of vaccines during their visit to healthcare clinics and at the same time availing reminding cards to make them recall vaccines dates using immunization cards guaranteed low?certainty of improving immunization of children.

Another significant finding was that introducing regular immunization campaigns through outreach services that include home visits as well as integrating of immunization process with other essential health care services that include services such as preventive care for malaria has a low?certainty in improving rate immunization in children (Blume, 2017). It was also found that there attaching incentives such as household gifts or monetary values both conditional or unconditional transfer of cash had significant low?certainty or equivalent little or no impact on influencing improvements in the rate of immunization.

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Objectives

The objectives of the study are to determine the impact of interventions and strategies applied to boost and sustaining high rates of childhood immunization in low and middle-income countries.

PICOT table for the selection criteria

The various interventions considered in the studies involved evaluating the impact of integrating immunization services, community?based health education, household monetary incentives, home visit, and facility?based health education in preventing natural deaths in children.

P I C O T
Children who received DTP3 at age of one year Assessing impacts of health education, applying or a combining use of cards during healthcare education, as well as testing impact of monetary incentive. Research compared recipient?oriented interventions with  standard care Outcomes included that there was low?certainty evidence that providing facility?based healthcare education combined with a redesigned reminding systems such as immunization card may improve DTP3 coverage 1 year

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