London School of Hygiene and Tropical Medicine Reports Findings in Immunization (Resilience in childhood vaccination: analysing delivery system responses to shocks in Lebanon): Public Health – Immunization

2023 NOV 20 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- New research on Public Health - Immunization is the subject of a report. According to news reporting from London, United Kingdom, by NewsRx journalists, research stated, “Despite rapidly growing academic and policy interest in health system resilience, the empirical literature on this topic remains small and focused on macrolevel effects arising from single shocks. To better understand health system responses to multiple shocks, we conducted an in-depth case study using qualitative system dynamics.”

Financial support for this research came from Wellcome Trust.

The news correspondents obtained a quote from the research from the London School of Hygiene and Tropical Medicine, “We focused on routine childhood vaccination delivery in Lebanon in the context of at least three shocks overlapping to varying degrees in space and time: large-scale refugee arrivals from neighbouring Syria; COVID-19; and an economic crisis. Semistructured interviews were performed with 38 stakeholders working at different levels in the system. Interview transcripts were analysed using purposive text analysis to generate individual stakeholder causal loop diagrams (CLDs) mapping out relationships between system variables contributing to changes in coverage for routine antigens over time. These were then combined using a stepwise process to produce an aggregated CLD. The aggregated CLD was validated using a reserve set of interview transcripts. Various system responses to shocks were identified, including demand promotion measures such as scaling-up community engagement activities and policy changes to reduce the cost of vaccination to service users, and supply side responses including donor funding mobilisation, diversification of service delivery models and cold chain strengthening. Some systemic changes were introduced-particularly in response to refugee arrivals-including task-shifting to nurse-led vaccine administration. Potentially transformative change was seen in the integration of private sector clinics to support vaccination delivery and depended on both demand side and supply side changes. Some resilience-promoting measures introduced following earlier shocks paradoxically increased vulnerability to later ones. Flexibility in financing and human resource allocation appear key for system resilience regardless of the shock.”

According to the news reporters, the research concluded: “System dynamics offers a promising method for ex ante modelling of ostensibly resilience-strengthening interventions under different shock scenarios, to identify-and safeguard against-unintended consequences.”

For more information on this research see: Resilience in childhood vaccination: analysing delivery system responses to shocks in Lebanon. BMJ Global Health, 2023;8(11). BMJ Global Health can be contacted at: Bmj Publishing Group, British Med Assoc House, Tavistock Square, London WC1H 9JR, England.

Our news journalists report that additional information may be obtained by contacting Sharif A. Ismail, Dept. of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK. Additional authors for this research include Andrada Tomoaia-Cotisel, Aya Noubani, Fouad M. Fouad, Sadie Bell, Josephine Borghi and Karl Blanchet.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1136/bmjgh-2023-012399. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

Publisher contact information for the journal BMJ Global Health is: Bmj Publishing Group, British Med Assoc House, Tavistock Square, London WC1H 9JR, England.

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