Introduction of pentavalent vaccine in Indonesia: a policy analysis.
The introduction of pentavalent vaccine containing Haemophilus influenzae type b antigen in Indonesia's National Immunization Program occurred nearly three decades after the vaccine was first available in the United States and 16 years after Indonesia added hepatitis B vaccine into the program. In this study, we analyzed the process that led to the decision to introduce pentavalent vaccine in Indonesia. Using process tracing and case comparison, we used qualitative data gathered through interviews with key informants and data extracted from written sources to identify four distinct but interrelated processes that were involved in the decision making: (a) pentavalent vaccine use policy process, (b) financing process, (c) domestic vaccine development process and (d) political process. We hypothesized that each process is associated with four necessary conditions that are jointly sufficient for the successful introduction of pentavalent vaccine in Indonesia, namely (a) an evidence-based vaccine use recommendation, (b) sufficient domestic financing capacity, (c) sufficient domestic vaccine manufacturing capacity and (d) political support for introduction. This analysis of four processes that led to the decision to introduce a new vaccine in Indonesia may help policy makers and other stakeholders understand and manage activities that can accelerate vaccine introduction in the future.
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Boston, MA 02115, USA Faculty of Medicine, Department of Public Health, Padjadjaran University, Jl. Eyckman 38, West Java, Bandung 40161 Indonesia phadisoe@hsph.harvard.edu.
Panji F
PF
Hadisoemarto
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Boston, MA 02115, USA.
Michael R
MR
Reich
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Boston, MA 02115, USA.
Marcia C
MC
Castro
D016667:Bacterial Capsules / Q000276:immunology*; D003362:Cost-Benefit Analysis / Q000191:economics; D055317:Evidence-Based Practice; D006192:Haemophilus Infections / Q000517:prevention & control; D018073:Haemophilus Vaccines / Q000191:economics / Q000276:immunology*; D006291:Health Policy; D006801:Humans; D017589:Immunization Programs / Q000191:economics*; D007214:Indonesia; D007407:Interviews as Topic; D009313:National Health Programs / Q000191:economics; D011050:Policy Making; D036301:Qualitative Research
D018073:Haemophilus Vaccines; C044237:Haemophilus influenzae type b polysaccharide vaccine
Necessary condition; new vaccine introduction; pentavalent vaccine; process tracing; sufficient condition