Factors affecting the introduction of new vaccines to poor nations: a comparative study of the Haemophilus influenzae type B and hepatitis B vaccines.
BACKGROUND
A major effort to introduce new vaccines into poor nations of the world was initiated in recent years with the help of the GAVI alliance. The first vaccines introduced have been the Haemophilus influenzae type B (Hib) and the hepatitis B (Hep B) vaccines. The introduction of these vaccines during the first phase of GAVI's operations demonstrated considerable variability. We set out to study the factors affecting the introduction of these vaccines. The African Region (AFRO), where new vaccines were introduced to a substantial number of countries during the first phase of GAVI's funding, was selected for this study.


RESULTS
GAVI-eligible AFRO countries with a population of 0.5 million or more were included in the study. Countries were analyzed and compared for new vaccine introduction, healthcare indicators, financial indicators related to healthcare and country-level Governance Indicators, using One Way ANOVA, correlation analysis and Qualitative Comparative Analysis (QCA). Introduction of new vaccines into AFRO nations was associated primarily with high country-level Governance Indicator scores. The use of individual Governance Indicator scores, as well as a combined Governance Indicator score we developed, demonstrated similar results.


CONCLUSIONS
Our study results indicate that good country-level governance is an imperative pre-requisite for the successful early introduction of new vaccines into poor African nations. Enhanced support measures may be required to effectively introduce new vaccines to countries with low governance scores. The combined governance score we developed may thus constitute a useful tool for helping philanthropic organizations make decisions regarding the type of support needed by different countries to achieve success.
Global Public Health Master's Program, New York University, New York, New York, United States of America. af1200@nyu.edu
Aharona
A
Glatman-Freedman
Mary-Louise
ML
Cohen
Katherine A
KA
Nichols
Robert F
RF
Porges
Ivy Rayos
IR
Saludes
Kevin
K
Steffens
Victor G
VG
Rodwin
David W
DW
Britt
D000349:Africa; D000704:Analysis of Variance; D018073:Haemophilus Vaccines / Q000191:economics*; D006291:Health Policy; D006297:Health Services Accessibility / Q000191:economics / Q000331:legislation & jurisprudence; D017325:Hepatitis B Vaccines / Q000191:economics*; D006801:Humans; D017589:Immunization Programs / Q000191:economics* / Q000458:organization & administration; D011634:Public Health / Q000191:economics / Q000331:legislation & jurisprudence
D018073:Haemophilus Vaccines; D017325:Hepatitis B Vaccines