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Prevalence and dynamics of missed opportunities for vaccination among children in Africa : applying systems thinking in a systematic review and meta-analysis of observational studies
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Adamu, Abdu A., Sarki, Ahmed M., Uthman, Olalekan A., Wiyeh, Alison B., Gadanya, Muktar A. and Wiysonge, Charles S. (2019) Prevalence and dynamics of missed opportunities for vaccination among children in Africa : applying systems thinking in a systematic review and meta-analysis of observational studies. Expert Review of Vaccines, 18 (5). pp. 547-558. doi:10.1080/14760584.2019.1588728 ISSN 1476-0584.
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WRAP-prevalence-dynamics-missed-opportunities-vaccination-Africa-meta-Uthman-2019.pdf - Accepted Version - Requires a PDF viewer. Download (1667Kb) | Preview |
Official URL: http://dx.doi.org/10.1080/14760584.2019.1588728
Abstract
Objective
To estimate the prevalence of missed opportunities for vaccination (MOV) among children aged 0 – 23 months attending healthcare facilities in Africa and explore the factors responsible for MOV using systems thinking.
Research design and methods
We conducted a systematic review and meta-analysis of studies reporting the proportion MOVs. Five electronic databases were searched. A random effects model was fitted to obtain pooled estimates of MOV and a causal loop diagram (CLD) was constructed to explore the dynamics of the causes of MOV. MOV was defined as any contact with health services in Africa, by an unvaccinated or under-vaccinated child, aged 0 – 23 months, who is eligible for vaccination and free of any contraindication, which does not result in vaccination.
Results
421 publications were found, of which 20 studies from 14 countries were included. The pooled prevalence of MOV was estimated to be 27.26% (95%CI: 18.80 – 36.62). A CLD with seven reinforcing and two balancing loops were constructed.
Conclusion
Our findings suggest that about one in every four children under the age of two who visited health facilities in 14 African countries missed the vaccination they were eligible to receive. To enable continent-wide estimates, more MOV assessments are required.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RJ Pediatrics | ||||||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Vaccination of children -- South Africa | ||||||||
| Journal or Publication Title: | Expert Review of Vaccines | ||||||||
| Publisher: | Taylor & Francis (Routledge) | ||||||||
| ISSN: | 1476-0584 | ||||||||
| Official Date: | 20 March 2019 | ||||||||
| Dates: |
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| Volume: | 18 | ||||||||
| Number: | 5 | ||||||||
| Page Range: | pp. 547-558 | ||||||||
| DOI: | 10.1080/14760584.2019.1588728 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Reuse Statement (publisher, data, author rights): | “This is an Accepted Manuscript of an article published by Taylor & Francis in Expert Review of Vaccines on 01/03/2019, available online: http://www.tandfonline.com/10.1080/14760584.2019.1588728” | ||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||
| Date of first compliant deposit: | 5 March 2019 | ||||||||
| Date of first compliant Open Access: | 1 March 2020 | ||||||||
| RIOXX Funder/Project Grant: |
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