Immunization Coverage Research Articles

The role of Zambia's expansive Inter-agency Coordinating Committee (ICC) in supporting evidence-based vaccine and health sector programming.

New vaccines, technologies, and regulations, alongside increased demand for vaccines, all require prioritization and coordination from key players within the vaccine sector. Inter-agency Coordinating Committees (ICC) support decision-making and coordination at the national-level and act as key drivers for sustainable improvements in vaccination programming. We utilized a previous qualitative case study, which investigated critical success factors for high routine immunization coverage in Zambia from 2000-2018, specifically to study the Zambian ICC. Qualitative data were collected between October 2019 and February 2020, including key informant interviews (n = 66) at the national, provincial, district, and health facility levels. Thematic analysis was applied to understand the role of the Zambian ICC and its impact on the policy environment over time. Within our study period, the ICC demonstrated the following improvements: 1) expanded membership to include diverse representation; 2) expanded scope and mandate to include maternal and child health in decision-making; and 3) distinct roles for collaboration with the Zambia Immunization Technical Advisory Group (ZITAG). The diverse and expansive membership of the Zambian ICC, along with its ability to foster government commitment and lobby for additional resources, supported improvements in immunization programming. The Zambian ICC holds considerable influence on government agencies and external partners, which facilitates procurement of funding, policy decisions, and strategic planning.

Determinant of Complete Basic Immunization of Children


 
 
 
 Abstract
 WHO mention about 1.5 million children die each year because diseases that can be prevented by immunization. Immunization is one of the health interventions that has proven to be the cheapest, because it can prevent and reduce the incidence number of morbidity, disability, and death due to PD3I (Ministry of Health RI, 2020). Infants aged 0-11 months must receive complete basic immunization consisting of 1 dose of Hepatitis B, 1 dose of BCG, 3 doses of DPT-HB-HiB, 4 doses of polio drops (OPV), 1 dose of injectable polio (IPV) and 1 dose of measles rubella. In 2020, complete basic immunization in the city of palembang is 81.9% and this means that it has not reached the 2023 national target of 100%. The immunization coverage of Boom Baru Health Center reached 96.4%. The purpose of this study was to find out what factors are related to the coverage of complete basic immunization in children at the Boom Baru Health Center in Palembang City. This study used quantitative methods with a cross sectional approach. Data collectiom used a questionnaire and analyzed univariately to describe distribution and proportion, and bivariate used Chi Square. This study found that there was no relationship between mother’s last education with complete basic immunization coverage (p = 0.143), and there was a relationship between mother’s knowledge (p = 0.000), Trust (p = 0.000), family support (p = 0.000). This study suggest for health workers provide counseling and increase the motivation of mothers regarding the importance of immunization and do monitor the completeness of their immunization, while mothers who have babies should take the time to immunize their chidren. to immunize their children.
 
 
 

Faktor Penentu Imunisasi Dasar Lengkap pada Anak di Wilayah Kerja Puskesams di Kota Palembang

WHO mention about 1.5 million children die each year because diseases that can be prevented by immunization. Immunization is one of the health interventions that has proven to be the cheapest, because it can prevent and reduce the incidence number of morbidity, disability, and death due to PD3I (Ministry of Health RI, 2020). Infants aged 0-11 months must receive complete basic immunization consisting of 1 dose of Hepatitis B, 1 dose of BCG, 3 doses of DPT-HB-HiB, 4 doses of polio drops (OPV), 1 dose of injectable polio (IPV) and 1 dose of measles rubella. In 2020, complete basic immunization in the city of palembang is 81.9% and this means that it has not reached the 2023 national target of 100%. The immunization coverage of Boom Baru Health Center reached 96.4%. The purpose of this study was to find out what factors are related to the coverage of complete basic immunization in children at the Boom Baru Health Center in Palembang City. This study used quantitative methods with a cross sectional approach. Data collectiom used a questionnaire and analyzed univariately to describe distribution and proportion, and bivariate used Chi Square. This study found that there was no relationship between mother’s last education with complete basic immunization coverage (p = 0.143), and there was a relationship between mother’s knowledge (p = 0.000), Trust (p = 0.000), family support (p = 0.000). This study suggest for health workers provide counseling and increase the motivation of mothers regarding the importance of immunization and do monitor the completeness of their immunization, while mothers who have babies should take the time to immunize their chidren.
 
 Bibliography : 2010-2023
 Keywords : Basic Immunizations, Education, Knowledge, Trust, Family Support

RELATED FACTORS TO G IV ING OF IPV (INACTIVA TED POLIO VACCINE) P OLIO IMMUNIZATION TO BABY IN THE WORKING AREA OF THE PAUH HEALTH CENT ER, CENTER OF PARIAMAN D ISTRICT, PARIAMAN CI TY

In the Indonesian context, the IPV polio immunization program has been introduced since 2015 as part of the national immunization program. However, even though this program has been running for several years, there are still challenges in increasing immunization coverage in infants. The urgency of this research, with the status of Indonesia being a Polio Outbreak (Extraordinary Incident) of Polio, it is important to pay attention to these factors in developing an immunization program and determine an effective strategy to increase immunization coverage. This research can also provide important information for health care providers, including doctors and nurses, to understand parents' perceptions of IPV polio immunization and how they can increase parental support and involvement in immunizing their children. This study aims to analyze the factors that influence parents' decisions to provide polio immunization using IPV to their children, which this study has not specifically investigated. The factors that will be analyzed in this study include knowledge, attitudes, motivation, accessibility of health services, availability of health services, role of health workers, family support, socio-culture. This type of research is analytic research with an observational study design, a cross sectional study approach. Data will be analyzed univariately, bivariately, and up to multivariate analysis. The results of this study can provide important information for the government and health institutions in developing an effective and efficient polio immunization program and increasing coverage in infants and toddlers. This research can also provide insight into the factors that influence parental non-adherence to vaccine side effects or their belief in alternative treatments that influence their decision not to give their children IPV polio immunization. In conclusion, this research is very important in increasing the coverage of IPV polio immunization in children under five and preventing the spread of polio in Indonesia.

FAKTOR TINGKAT KEPATUHAN IBU DALAM PEMBERIAN IMUNISASI DASAR PADA MASA PANDEMI COVID-19 DI WILAYAH KERJA PUSKESMAS SINGOSARI KABUPATEN MALANG

Background: Immunization is a low-cost health measure to lower morbidity, mortality, and disability resulting from diseases that can be prevented by vaccination (PD3I). The implementation of health programs, such as immunization services and surveillance of diseases that can be prevented by immunization (PD3I) has been impacted by the COVID- 19 outbreak in Indonesia. For instance, Integrated Healthcare Center service disruptions and a decline in immunization coverage rates. Objective: To determine the level of maternal compliance in providing primary immunization during the COVID-19 pandemic in the Singosari Public Health Center’s Work Area, Malang Regency. These factors consist of knowledge, family support and perceived barriers that mothers feel towards compliance in providing basic immunizations. Methods: A cross-sectional strategy was used in this study along with an analytical observational methodology. There were 110 mother’s of youngsters under 2 years old as respondents. Data were collected using online survey and the data analyzed using chi-square test. Results and Discussion: The findings of the chi-square test on the knowledge variable and compliance to primary immunization revealed no association (p-value = 0,617), as well as there was no relationship between the family support and compliance (p-value = 0,632). There was a substantial correlation between mother's barriers perceptions and primary immunization compliance (p-value = 0,020). Conclusions: In providing primary immunization during the COVID-19 pandemic in the Singosari Public Health Center, Malang Regency. There is a relationship between the barriers perceived by the mother and immunization compliance. There is no relationship between knowledge and immunization compliance, and there is no relationship between family support and immunization compliance.

Socio-demography, nutritional status, age-appropriate immunization coverage and morbidity among under-five children in rural Maharashtra

Background: Morbidities among under-five children in rural areas is a major public health problem. This study was conducted to assess the nutritional status, age-appropriate immunization coverage, personal hygiene and morbidity pattern among under-5 children and their socio-demographic determinates in rural slum dwellings. Methods: A community based cross sectional study was conducted in rural area of Maharashtra using purposive sampling technique. The survey was done by using predesigned and pretested proforma along with recording of socio-demographic factors, anthropometric measurements, immunization status and clinical examination of the study subjects. Results: The study included 86 under-5 children from a rural slum dwelling. 16 (18.60%) subjects were underweighted, 35 (40.70%) were stunted and 14 (16.28%) were wasted. 04 (04.65%) and 02 (02.33%) subjects were MAM and SAM respectively. 35 (40.70%) subjects were morbid. 20 (23.26%) subjects were suffering from louse infestation of which 07 (14.58%) were boys and 13 (34.21%) were girls (p<0.05). 17 (19.77%) subjects were suffering from dental caries. 12 (13.95%) subjects were suffering from skin diseases. 23 (26.74%) subjects were suffering from oral health problems. All subjects’ personal hygiene was poor. 72 (83.72%) subjects were age-appropriate fully immunized. The association between monthly family income and presence of stunting among the subjects is statistically significant (p<0.05). Conclusions: Underweight, stunting, wasting, MAM, SAM, louse infestation, skin diseases, dental caries, oral health problems and poor immunization coverage are found to be major health problems among the under-five children in rural areas. Poor personal hygiene of under-5 children is also a major issue. Capacity building of parents for early health seeking and strengthening of primary health care services is essential to act timely in managing these morbidities.

Penyuluhan Kesehatan Tentang Pentingnya Imunisasi Di Puskesmas Antang Kota Makassar

Immunization is an effort to actively create/increase a person's immunity against a disease so that if one day they are exposed to that disease they will not get sick or only experience mild illness. The low level of complete basic immunization coverage is still a very difficult problem to face. The government's program in an effort to improve children's health status is that before the child is one year old, basic immunization should be given completely according to his age. In this condition, it is hoped that the immune system can work optimally with minimal side effects. The aim of this service is to increase public knowledge about complete basic immunization so that basic immunization coverage can increase. The methods used are lectures and discussions. This service was carried out in the working area of the Batua Community Health Center, Makassar City with a total of 30 mothers participating. From the results of this counseling, there was an increase in mothers' knowledge and understanding, so it is hoped that this training activity can be implemented in all health center work areas with government support.

Unlocking potential of data: A localized data-driven approach for stunting reduction in South Kalimantan Province

This study addresses the issue of stunting in South Kalimantan Province, where high stunting prevalence rates persist. Through a comprehensive analysis of factors influencing stunting prevalence, predictive modeling using machine learning, and clustering analysis of districts based on stunting rates, the research aims to support the provincial government in formulating effective and sustainable strategies. The findings highlight influential factors such as HDI, poverty rates, immunization coverage, breasfed babies, number of uninhabitable houses, and access to clean water. The study also utilise machine learning to build model that aids in predicting future stunting prevalence, while clustering analysis categorizes districts into distinct groups. These insights guide the government in prioritizing interventions, setting prevalence targets, and determining strategic areas for stunting reduction efforts.

A modified recombinant adenovirus vector containing dual rabies virus G expression cassettes confers robust and long-lasting humoral immunity in mice, cats, and dogs

During the COVID-19 epidemic, the incidence of rabies has increased in several countries, especially in remote and disadvantaged areas, due to inadequate surveillance and declining immunization coverage. Multiple vaccinations with inactivated rabies virus vaccines for pre- or post-exposure prophylaxis are considered inefficient, expensive and impractical in developing countries. Herein, three modified human recombinant adenoviruses type 5 designated Adv-RVG, Adv-E1-RVG, and Adv-RVDG, carrying rabies virus G (RVG) expression cassettes in various combinations within E1 or E3 genomic regions, were constructed to serve as rabies vaccine candidates. Adv-RVDG mediated greater RVG expression both in vitro and in vivo and induced a more robust and durable humoral immune response than the rabies vaccine strain SAD-L16, Adv-RVG, and Adv-E1-RVG by more effectively activating the dendritic cells (DCs)- follicular helper T (Tfh) cells- germinal centre (GC) / memory B cells (MBCs)- long-lived plasma cells (LLPCs) axis with 100% survival after a lethal RABV challenge in mice during the 24-week study period. Similarly, dogs and cats immunized with Adv-RVDG showed stronger and longer-lasting antibody responses than those vaccinated with a commercial inactivated rabies vaccine and showed good tolerance to Adv-RVDG. In conclusion, our study demonstrated that simultaneous insertion of protective antigens into the E1 and E3 genomic regions of adenovirus vector can significantly enhance the immunogenicity of adenoviral-vectored vaccines, providing a theoretical and practical basis for the subsequent development of multivalent and multi-conjugated vaccines using recombinant adenovirus platform. Meanwhile, our data suggest Adv-RVDG is a safe, efficient, and economical vaccine for mass-coverage immunization.

THE EFFECTIVENESS OF THE EDUCATIONS TO POSTPARTUM ON IMMUNIZATION BEHAVIOR

Introduction: Immunization coverage in Cipelah village, Rancabali sub-district Bandung Regency in the last 3 months has decreased. So that the immunization coverage rate is below the set target of 80% (UCI). This happens, among others, because the education and knowledge of mothers is lacking so that mothers consider that immunizing babies is not necessary, while immunization itself has a very important function, namely to increase immunity in infants.. Method: This research uses analytic quantitative method with quasy experimental design. The population in this study were first-day postpartum mothers in Cipelah Village, Rancabali District, while 36 sample to be used in this study was taken from the population using purposive sampling technique where each member of the population must meet the inclusion criteria to become a sample in this study. Data analysis used in this study is the Chi square test.. Objectives: The purpose of this study was to determine the effect of providing education on maternal behavior in providing immunization to infants in Cipelah Village, Rancabali District, Bandung Regency. Result: The results showed that the characteristics of the two groups were homogeneous, namely most of them were 20-35 years old, had 1-3 children, the last education was high school, and the respondents' work status was housewives. The statistical test results show a value of p=0.01 <0.05 which means that there is a relationship between the provision of education to postpartum mothers with the behavior of immunization in infants.. Conclusion: There is an influence between the provision of education on maternal behavior in providing immunization to infants.

Landscape Analysis of Primary Healthcare Integration; Understanding Barriers and Enablers for People-Centered Care in Low-And-Middle Income Countries

Background: Healthcare interventions in Low-and-Middle Income Countries (LMICs) are mostly disease-specific and exist independently, leading to fragmentation of services and inefficiencies in healthcare delivery. Therefore, the need to integrate interventions and share resources between programs is exigent. The dearth of evidence on the barriers and enablers for seamlessly integrated interventions in LMICs compared to high-income settings, necessitated the conduct of a landscape analysis of integration in LMICs to understand the extent of integration, barriers, and enablers for people-centered care in three countries – Nigeria, Nepal, and Madagascar. 
 Method: The study adopted a mixed-method approach involving a systematic review and qualitative study. Relevant literature and policy documents on healthcare integration in LMICs were reviewed. Also, 76 interviews (IDI and KII) were conducted with healthcare administrators at the national and local levels, healthcare workers, and caregivers in Nigeria, Madagascar, and Nepal. Content and thematic analyses of the systematic review and interviews were then conducted using Covidence software and Dedoose software respectively.
 Result: The result of the landscape analysis showed the different factors that impede health integration in LMICs include the inadequate number of the skilled health workforce, poor financing, inadequate supply of medicines and equipment, poor monitoring of policies and guidelines, poor supervision and M&E systems, and poor community engagement. To address these barriers, large investments in structural reforms must take place in these settings. From the policy landscape of the three countries, health integration of primary health care services is on the agenda of the health system as a priority. However, strong political will which is pivotal to monitoring the implementation of existing healthcare integration policies and advocating for sustainable funding opportunities from development partners will help to address the infrastructure deficits in the countries and subsequently help to promote integrated care. A key enabler for integrated care is community engagement; human-centered approach should be adopted from the program design phase to the implementation phase to ensure acceptance and uptake of integrated care especially when financial protection is not provided by the government.
 Implications for healthcare integration in LMICs: Integrated health services directly improve well-being and quality of life, which will bring important economic, social, and individual benefits. Integration has been proposed as a strategy to improve coverage and/or efficiency of immunization and other health programs. Therefore, to mitigate the bottlenecks to health integration in LMICs, efforts should be geared towards (i) building the capacity of health workers through training across all cadres. (ii) Government at all levels should recruit more staff to fill HRH gaps. (iii) Supervisory efforts should be increased as a key enabler to health integration. (iv) Provision of funds for healthcare integration in LMICs, and the development of a sustainable Financing plan (v) Strengthening supply chain support through investments in supplies, equipment, diagnostics, human resources, medicines, and commodities to support the provision of integrated services. (vi) Addressing the gaps and the design of integrated service delivery at the national and sub-national levels, considering feasibility, compatibility between the interventions, care plan needs, and goals of all stakeholders.

Vaccination Covid-19

Introduction: After the first vaccination campaign, a low vaccination coverage was observed in Brussels. This is linked to an accumulation of factors such as limited accessibility, confidence in the effectiveness and safety of the vaccine or in the public institutions combined with complicated transport solutions and a lack of vaccinators. These are significant barriers to improving immunization coverage, particularly in vulnerable neighborhoods.
 In order to increase coverage and also in the perspective of vaccinating everyone (vacci4all project), Common Community Commission (COCOM) has decentralized vaccination through temporary initiatives: local antennas, mobile teams, door-to-door visits, GP’s, awareness-raising by pharmacists, call-centers,...
 The results have reinforced the idea of decentralization to reach the most vulnerable. The idea of vaccination in pharmacies was explored, bringing new perspectives regarding long-term management.
 Method: 
 1. Pharma-on-tour
 Through an application system and the establishment of quality criteria, 5 pharmacies with
 experience in vaccination centers are integrated into the pilot project: doctors come to the
 pharmacy to vaccinate patients previously sensitized by the pharmacist. The pharmacists prepare the vaccines; the doctors administer them. The project is financed by the Brussels-Capital Region (BCR).
 2. Vaccipharma
 A few days after the publication of the March 11, 2022 law allowing pharmacists to vaccinate, the
 Vaccipharma project is launched: vaccination by pharmacists starts in 5 pharmacies that meet the quality requirements.
 3. Timesheet
 Without a remuneration framework, the acts of preparation and vaccination are still
 covered by the region on the basis of an hourly rate determined by Timesheets which are
 filled in by the pharmacists who keep track of the acts related to the vaccination which helped determine a remuneration in accordance with reality/practice.
 4. Implementation of the NIHDI remuneration framework and extension to the entire BRSince September 1, 2022, pharmacists can be remunerated for the acts of preparation of vaccine doses and vaccinations by the NIHDI. Any person, insured or not, can be vaccinated in a pharmacy.
 In addition to the vaccination in the pharmacy, the COCOM takes care of the delivery to the first line as well as the preparation and delivery to the nursing homes and communities.
 5. Extension of the project from 28 to 135pharmacies
 All Brussels municipalities have vaccinating pharmacies. Each pharmacy was inspected and given training to ensure the respect of the government's quality requirements.
 Results/Lessons learned: The need to focus on decentralized vaccination initiatives that combine proximity, quality and trust was reaffirmed. This is demonstrated by the fact that the preferred location for patients seeking a primary vaccination is the pharmacy. 
 This promising and sustainable project enables a local supplying and is a catalyst for first line vaccination in an infrastructure that provides a quality of reception and service in a place familiar to the public, with a very interesting cost-benefit-quality ratio. The individual approach and direct communication can increase vaccination coverage, particularly in vulnerable neighborhoods. A survey of patients reveals a high level of satisfaction both in terms of reception, booking, information received, privacy, proximity, ease, speed, accessibility and in the trust-based relationship.

Strengthening Immunisation Services in India through Digital Transformation from Co-WIN to U-WIN: A Review

Abstract In India, the immunisation programme has made a few technology-dependent advancements. The electronic vaccine intelligence network is to manage the immunisation supply chain and logistics. eVIN ensures the timely and effective distribution of vaccines, contributing to successful immunisation campaigns. The other platform is Co-WIN, which served as the digital backbone for India’s COVID-19 vaccination programme. It facilitates the registration and scheduling of vaccine appointments, tracking of vaccination coverage, monitoring adverse events, enabling a swift and organised response to the pandemic. The U-WIN (universal immunisation) is a comprehensive digital system aligned with the Ayushman Bharat Digital Mission. It connects various key components, including the Healthcare Professional Registry, Healthcare Facility Registry and Ayushman Bharat Health Account. This integrated approach aims to strengthen the Universal Immunisation Programme by leveraging digital technology. Overall, these digital initiatives represent a significant leap in India’s immunisation efforts. They enhance data management, supply chain logistics and healthcare infrastructure while ensuring that the immunisation programme is efficient, accessible and responsive to the needs of the population. This integration of technology and health-care systems is a crucial step toward achieving universal immunisation coverage in the country.

Epidemiological Investigation of Diphtheria Extraordinary Events (KLB) In Gili Ketapang Village, Probolinggo Regency In 2022

Diphtheria infection is caused by a toxigenic strain of Corynebacterium diphtheriae with humans as the only reservoir. Diphtheria attacks children under 10 years old and is highly contagious, especially in susceptible populations. Diphtheria can cause an outbreak although it can be prevented by immunization. In 2022, 3 cases of diphtheria were reported in Gili Ketapang Village, Probolinggo Regency. Objective: to describe the epidemiology of the outbreak and identify the risk factors for countermeasures. Methods: This research is a descriptive study with an outbreak investigation report design. Results: There were 3 cases of diphtheria within 7 months (February-August 2022) in Gili Ketapang Village with a CFR of 100% and the highest attack rate in the toddler age group (0-4 years) of 0.5%. There were 2 positive contacts (close contacts of 2nd Case) who were asymptomatic. Transmission is strongly suspected to be caused by the carrier. The identified risk factors were low IDL coverage, limited health facilities and availability of ADS, sociodemographic conditions, and population mobility at risk of diphtheria transmission. The problems found were the absence of PMO in providing prophylaxis and ORI coverage was still low and incomplete. Conclusions and suggestions: The diphtheria outbreak in Gili Ketapang Village has been confirmed by the laboratory test. The increase in the incidence and mortality from diphtheria is caused by multi factors. The government's role in increasing immunization coverage, early warning through active case finding surveillance, monitoring, and evaluation of obstacles in prevention is urgently needed.

Benefits and Challenges of Sealing Deceased Individual Immunization Records in Immunization Information Systems (IIS): An Overview of Iowa's Process.

Data cleansing practices aimed to improve data quality in immunization information systems (IIS) continue to be identified and evaluated by immunization programs to generate accurate and reliable immunization coverage rates. The Iowa Immunization Program has implemented several automated, daily data cleansing practices to improve the quality of records in Iowa's Immunization Registry Information System (IRIS), including the process of sealing records of deceased individuals through vital records matching. This process removes deceased individual records from the active IIS population, which helps reduce denominator inflation and improve the accuracy of immunization rate calculations. Other benefits to this process include decreasing record fragmentation, increasing completeness and accuracy of IIS data, improving reminder/recall functionality, and supporting better clinical decision-making for providers. This process is one of multiple practices implemented in IIS to improve data quality and is limited by several factors, including the inability to capture deaths for out-of-state records.

Determinant Factors of Immunization Coverage in Toddlers Under 5 Years Old in Banda Aceh, Indonesia: Cross Sectional Study

The aim of this research is to determine the factors related to providing complete basic immunization to toddlers in the working area of ​​the Meuraxa Health Center, Banda Aceh. This research is analytical by design cross sectional. The population in this study were all mothers who had toddlers in the working area of ​​the Meuraxa Health Center in 2023, totaling 1860 people and a sample of 95 people. The research was conducted from 7 to 15 June 2023. Data was processed univariate and bivariate. The research results showed that there was a relationship between knowledge (P value = 0.006), there was a relationship between attitudes (P value = 0.000), there was a relationship between health education (P value = 0.003) and there was a relationship between the role of religious leaders (P value = 0.003) with the provision of complete basic immunization in toddlers at Meuraxa Community Health Center, Banda Aceh City in 2023. The Community Health Center can provide routine outreach to the community, especially mothers who have babies, either individually or in groups. Increase the support of religious figures for immunization by involving them in every immunization activity and making religious figures partners in disseminating immunization information

Leveraging the CORE Group Partners Project Polio Infrastructure to Integrate COVID-19 Vaccination and Routine Immunization in South Sudan.

Countries with fragile health systems like South Sudan experienced significant impacts on routine immunization during the COVID-19 pandemic. Routine immunization in children aged younger than 1 year declined due to pandemic-related constraints and was compounded by the introduction of the COVID-19 vaccine, which was met with hesitancy and reluctance. When South Sudan reported the first COVID-19 case in March 2020, the CORE Group Partners Project (CGPP) rapidly integrated the COVID-19 outbreak response into its ongoing polio eradication activities, leveraging the existing polio infrastructure and human resources. We describe the integration process, results, and challenges and detail the impact of the integration on coverage for both routine immunization and COVID-19 vaccinations. Efforts to integrate COVID-19 vaccination and routine immunization service delivery were implemented in 5 phases: assessing the need, developing multisector collaborations, developing a service delivery plan, assessing implementation readiness, and implementing and evaluating the service delivery plan. Integration efforts prioritized coordination, training vaccinators and volunteers, development of microplans, data management, and last-mile vaccine delivery. Integrated service delivery was implemented through "one-stop shop" sessions where communities accessed routine immunizations for children, COVID-19 vaccinations for adults, and other primary health services. Integrating health service delivery contributed to improved routine immunization coverage among children, improved COVID-19 vaccination coverage among adults, reduced cost for service delivery, and increased access to more comprehensive health services in hard-to-reach communities. COVID-19 vaccinations were delivered at US$4.70 per dose, a cost substantially lower than other reported delivery mechanisms. Integration can yield positive results and improve access to vaccination and other health services for communities. However, it requires clear policy guidelines, commitment, and strong collaboration. Challenges included resistance from stakeholders, overstretched human resources, and diversion of funding and attention from program areas, which were overcome through deliberate high-level advocacy, partnership, and intensified community engagement.

Understanding the Trend of Diphtheria Outbreak in Nigeria from 1941-2023: A Narrative Review

Diphtheria is a contagious infection caused by Corynebacterium diphtheriae spread through respiratory droplets, typically from coughing or sneezing, and characterized by difficulty in breathing, heart rhythm challenges, and even death. Objective: This narrative review explored the trend of Diphtheria outbreaks in Nigeria and suggested a way to forestall reoccurrence. We search two bibliographic databases, PubMed and Scopus, to identify studies using the keywords “Diphtheria” and “Nigeria”. Approximately eighty-two (82) years after isolating virulent strains of Corynebacterium diphtheriae in Nigeria, the country still suffers recurrent outbreaks of Diphtheria, a vaccine-preventable infection. Between the years 1974 to 2021, the World Health Organization (WHO) documented 40258 reported cases of diphtheria in Nigeria, although it missed 117 cases reported in Lagos, Benin, Katsina, and Borno between 2007 and 2017, where a 21.4% fatality was recorded in Borno alone. The current outbreak, labeled as one of the most severe outbreaks in Nigeria in recent years, so far, has 798 cases and 10% case fatality with the northern part of the country being particularly hard hit. The recurrence of the Diphtheria outbreak in Nigeria is attributed to incomplete vaccination exacerbated by poor vaccination coverage (e.g., < 50% in 2016), waning vaccine-induced immunity, maternal knowledge, and poverty. Incomplete immunization resulting from poor immunization coverage, poor sensitization, and lack of access to healthcare facilities is undoubtedly the single predominant determinant of Diphtheria outbreaks in Nigeria. There is an urgent need to promote complete immunization to prevent resurgence and re-emergence.

Peningkatan Literasi Kader dan Masyarakat Melalui Pelatihan Pembuatan Konten Edukasi Kesehatan Tentang Imunisasi

<span class="s20">Immunization is an effort to increase a person's immunity against a disease. One of the things that influence someone to immunize is knowledge about immunization itself. This community empowerment aims to improve the knowledge and skills of cadres through making educational videos on health content related to immunization. Posyandu Anggrek Hitam is one of the posyandu located in Loa Bakung Village which has low immunization coverage. The method used in community empowerment is with education related to immunization and health promotion media. Then continued with training on scripting and video making of health content related to immunization. The results of this empowerment found that there was an increase in knowledge about immunization and health promotion media, as well as an increase in cadre skills related to script making and video content through making educational videos of health </span><span class="s20">content related to immunization. </span><span class="s20">After the community empowerment of these cadres, it is hoped that in the future cadres can be more operational in organizing posyandu in health promotion efforts using media for the community.</span>

Poliovirus serological assay after the cVDPV1 outbreak in Papua New Guinea: a cross-sectional study from 2020 to 2021

In June 2018, a type 1 circulating vaccine-derived poliovirus (cVDPV1) outbreak was declared in Papua New Guinea (PNG), resulting in a total of 26 paralytic confirmed cases. Eight vaccination campaign rounds with bivalent oral poliovirus vaccine (bOPV) were carried out in response. Prevalence of neutralizing polio antibodies in children was assessed two years after the outbreak response was completed. We conducted a cross-sectional serological survey among children aged 6 months-10 years selected from six provinces in PNG to evaluate seroprevalence of neutralizing polio antibodies to the three poliovirus serotypes and analyse sociodemographic risk factors. We included 984 of 1006 enrolled children in the final analysis. The seroprevalence of neutralizing polio antibodies for serotype 1, 2 and 3 was 98.3% (95% CI: 97.4-98.9), 63.1% (95% CI: 60.1-66.1) and 95.0% (95% CI: 93.6-96.3), respectively. Children <1 year had significantly lower type 1 seroprevalence compared to older children (p<0.001); there were no significant differences in seroprevalence among provinces. PNG successfully interrupted transmission of cVDPV1 with several high coverage bOPV campaigns and seroprevalence remained high after two years. The emergence of cVDPV strains underscores the importance of maintaining high levels of routine immunization coverage and effective surveillance systems for early detection. World Health Organization through a Rotary International IPPC grant.