Preventive healthcare comprises of a set of measures that are undertaken to prevent the occurrence of an illness. Disease and disability consists of a variety of mental and physical states that are affected by disease agents, environmental factors, lifestyle choices and genetic predisposition (Luo, Cook, Wu and Wilson, 2017). The prevention of illnesses thus depends on anticipatory actions that could be classified as primary, secondary or tertiary preventive measures. Preventive care is increasingly becoming an area of much interest within the healthcare sector. Vaccination is currently on of the most effective public health disease prevention initiatives (Barret et al. 2016). The latter involves the use of various methods to prevent illnesses, educate populations and promote health (Hawk and Evans, 2013). There has been low coverage of vaccination programs among the low-income Australian as compared to the higher earning individuals.
Vaccination is one of the main preventive strategies used to control the transmission of communicable diseases (Barett, Bolan, Dawson, Ortmann, Resi and Saenz, 2016). The latter has reduced the world mortality and morbidity rates associated with infectious diseases, protecting up to 2.5 million lives annually according to the World Health Organization (WHO) statistics (Link, 2017). Some vaccines confer herd immunity by protecting both the vaccinated individuals and their close contacts. There are hypodermic needles of various sizes, lengths and gauges that are used to administer vaccines. The bigger the gauge number, the smaller the needle diameter. For instance, 0.5 mm diameter needle is gauge 25 while 0.6 mm needle is gauge 26 (Luo, Cook, Wu and Wilson, 2014). For infants and children between the ages of 2 months and 2 years of age, needle types used for vaccination are 23 to 25 G and 25 mm in length.
The vaccines are usually administered intramuscularly, intradermallly, subcutaneously and orally. The proper sires for pediatric vaccine injection are the anterolateral aspect of the thigh muscle, intradermal part of the forearm, deltoid muscle of the arm, and orally (Link, 2014). Some of the comfort measures that are used for pediatric children after vaccination include applying cold packs on the injection sites, administering Paracetamol syrup 2.5 ml 8 hourly for fever relief, distraction techniques and breastfeeding. The parents should be advised to hold or apply pressure at the injection sites.
Vaccine Information Sheets (VISs) are sheets that are were produced by the CDC to explain the benefits and risks of each vaccine to the recipients. Unfortunately, there exist no vaccine records, so such records are often found at the clinics and doctor’s office (Link, 2014). At birth, the child is usually given oral polio vaccine and BCG, while at two months a child is vaccinated with oral polio vaccine, hepatitis B vaccine 2nd dose, diphtheria, tetanus and pertussis (DPT), Haemophilus influenza type b (Hib), and Pneumococcal vaccine. At 2 years a child should be provided with vitamin A supplement.
Most of the children from developing countries encounter death from diseases that could get stopped through vaccination (Blume, 2017). Despite the efforts of the government to introduce immunization programs, several factors have contributed to barriers to successful immunization. Among the hindrances that have led to increased deaths among children include low income, lack of education, and lack of access to adequate healthcare knowledge. The situations have led to increased numbers of unvaccinated children. Based on the research analysis the best solution towards introducing vaccination in low and middle?income countries is using evidence-based discussions with community members.
The strategies guarantee creation of acceptable awareness about the significance of vaccination to children (Duckett and Willcox, 2015). The strategy has better results compared to health education. Alternative measures such as community meetings may act as an intervention measure to the problem. However, the strategy is costly and expensive. Another solution is adopting homecare health visits combined with regular immunization (Barett, Bolan, Dawson, Ortmann, Resi and Saenz, 2016). The outreach immunization plan is an effective solution but not enough data to access cost implications. The above solutions guarantee smaller impacts in promoting vaccination however they are easy to manage and sustain for long periods. Using incentives as motivation to accept vaccination has little or no significant influence. For example, monetary incentives do not encourage immunization especially when other barriers exist.
The most effective strategies leading towards increasing number vaccinations on children include the provision of community-oriented health education (Blume, 2017). The criteria for creating awareness include the use of mass healthcare campaigns and facility?based health education. Parents, society, and other community members should have clear and concise information about immunization through initiating health education. Various facilities such as reminding communities concerning immunization are among the strategies that guarantee effective responses to prevention care. Use of immunization reminding card and regular outreach immunizations are among the strategies that should be adopted (Willis et al. 2012). Other strategies that could improve the rate of childhood immunization include the use of healthcare home-based visits, household incentives, and integrating immunization process with adequate accessibility means in the interior.
The study found that through providing information as well as discussing various benefits of vaccinations with individual or group of parents and other members of community during events such as village meetings or visiting homes guaranteed a moderate probability of improving rate of immunization among children (Oya, Wiysonge, Oringanje, Nwachukwu, Oduwole and Meremikwu, 2016). The research found that through providing vaccination information direct to parents about significance of vaccines during their visit to healthcare clinics and at the same time availing reminding cards to make them recall vaccines dates using immunization cards guaranteed low?certainty of improving immunization of children.
Another significant finding was that introducing regular immunization campaigns through outreach services that include home visits as well as integrating of immunization process with other essential health care services that include services such as preventive care for malaria has a low?certainty in improving rate immunization in children (Blume, 2017). It was also found that there attaching incentives such as household gifts or monetary values both conditional or unconditional transfer of cash had significant low?certainty or equivalent little or no impact on influencing improvements in the rate of immunization.
The objectives of the study are to determine the impact of interventions and strategies applied to boost and sustaining high rates of childhood immunization in low and middle-income countries.
The various interventions considered in the studies involved evaluating the impact of integrating immunization services, community?based health education, household monetary incentives, home visit, and facility?based health education in preventing natural deaths in children.
|
P |
I |
C |
O |
T |
|
Children who received DTP3 at age of one year |
Assessing impacts of health education, applying or a combining use of cards during healthcare education, as well as testing impact of monetary incentive. |
Research compared recipient?oriented interventions with standard care |
Outcomes included that there was low?certainty evidence that providing facility?based healthcare education combined with a redesigned reminding systems such as immunization card may improve DTP3 coverage |
1 year |
|
Children subjected to all types of vaccines aged 12 to 23 months |
Checking the outcomes of children who received all recommended vaccines |
The session compared monetary incentives and disincentives with lack of interventions |
Outcomes indicated that there was low?certainty evidence on providing monetary incentives such incentives have little or no impact in improving rate of vaccination on children |
2 years |
The steps applied in analyzing the risks involved pooling data from reviewed research studies that had similar interventions such as participant or community, care provider, health system (Oya, Wiysonge, Oringanje, Nwachukwu, Oduwole and Meremikwu, 2016). The approach applied involved a meta-analysis process using the whereby a random?effects model was applied in the process of selecting participants.
The process of dealing with reported studies that had estimates with uncertainty measures as well as lacking numbers of participants and numbers of events, the procedure for assessing biases involved the use of generic inverse variance approach the reported study approach applied level and slope strategy to report (Oya, Wiysonge, Oringanje, Nwachukwu, Oduwole and Meremikwu, 2016). The criteria used analyzed data based on the following subcategories. The first strategy involved setting up the study scope in the rural and urban centers. The process also applied the concept of individuals or group interventions. It also involved multi?faceted, single and integrated intervention with non?conditional and conditional incentives (Lin et al. 2014). Finally the analysis integrated community or facility oriented interventions.
Among the interventions for promoting immunization among children inducing communication interventions, The intention of the strategy is informing and educating target groups, communities, individuals, and care givers or involving a including targeted groups through one on one dialogues interactions through systems such as printed material and mass media among other systems. The purpose of intervention is to improve understanding concerning vaccination. It focuses on developing and explaining relevant benefits as well as risks associated with vaccination. The strategy provides essential information such as where, when, and how to acquire vaccination services as well as defining who is legible to receive vaccine services. Recipients should receive signals that enable them to recall by reminding them through face to face interactions, initiating a telephone call or sending e-mails (Hawk and Evans, 2013). The strategy would help in reminding those who have reached overdue for the vaccine in for the purpose of reducing the drop?out rate.
The caregivers should be provided with sufficient training to help them in acquiring knowledge on vaccination as well as improving their skills. Training enables them to have a positive attitude towards clients and to develop ethical aspects that help clients to avoid missing opportunities for vaccination. Interventions such auditing caregivers are essential for ensuring delivery of quality vaccination services (Estes, Calleja, Theobald, and Harvey, 2015). Clients should provide feedback to access levels of satisfaction with services provided. Healthcare systems should have well-developed infrastructures to facilitate easy access to health facilities. Among the structures provided include construction of good roads that guarantee access to health facilities.
Health care systems should establish adequate service delivery strategies such as outreach movements that involve home visits, and integrating the vaccine process with other services such as charity work (Boxall and Gillepsie, 2013). Outreach services are essential because they improve access to vaccination services. Facilitating activities such as home visits help in reminding parents about vaccines as well as identifying unimmunized children for immunization. Integrating various services help in encouraging vaccine uptake
According to the analysis presented by various authors, they found that the relevant studies have not adequately addressed people’s financial capacity such as the capability to afford and sustain the strategies. The impact of the study revealed that the situation was highly heterogeneous based on specific environmental settings as well as outcomes of the study. The study has limited facts for effective comparability. Another reason is that researchers identified insufficient data and information that could allow drawing appropriate conclusions in terms of cost?effectiveness that could enable health workers to intervene in the process of promoting vaccination uptake. Most of the studies reviewed have specifically concentrated on health outcomes (Martin, 2018). They failed to effectively illustrate the extent to which various stakeholders such as government and non-government institutional affect communities. Governance, as well as other sources of financial supports, has an impact on the sustainability of vaccination processes (Willis et al. 2012). These limitations trigger the need for future research as well as the establishment of reliable outcomes.
According to the research analysis, it is true that most of the pieces of evidence obtained were characterized by low certainty as well as the insignificant probability of events. Therefore implementing the obtained results has a high likelihood of that implied high chances that the acceptable effect and actions suggested have a high likelihood of providing different results (Kozier, Erb, Berman, Snyder, Levett and Dwyer, 2014). The impact implies that scholars, researchers, and other stakeholders need to conduct further randomized controlled trials to assess verify, and validate the impact of factors associated with improving children immunization perceptions in low? and middle?income countries. The research analyzed has not identified any certain factor that promotes high rates of immunization.
References
Barrett, D. H. et al. (2016). Public Health Ethics: Cases Spanning the Globe. Cham: Springer International Publishing: Imprint: Springer
Blume, S. S. (2017). Immunization: How vaccines became controversial. Reaktion Books
Boxall, A.-M., & Gillespie, J. A. (2013). Making Medicare: The politics of universal health care in Australia.
Duckett, S. J., & Willcox, S. (2015). The Australian health care system. South Melbourne, Victoria, Australia : Oxford University Press
Estes, M. E. Z., Calleja, P., Theobald, K., & Harvey, T. (2015). Health assessment and physical examination. South Melbourne, Vic. Cengage Learning
Hawk, C., & Evans, W. (2013). Health promotion and wellness: An evidence-based guide to clinical preventive services. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Haley, C. (2012). Child and family health nursing in Australia and New Zealand. Sydney: Lippincott Williams & Wilkins.
Kozier, B. et al. (2014). Kozier and Erb’s Fundamentals of Nursing Volumes 1-3 Australian Edition eBook. Melbourne: P.Ed Australia.
Lin, V., Smith, J., Fawkes, S., Robinson, P., & Gifford, S. M. (2014). Public health practice in Australia: The organized effort. Crows Nest, NSW: Allen & Unwin
Link, K. (2014). The vaccine controversy: the history, use, and safety of vaccinations. Westport, Conn. [u.a.], Praeger Publishers.
Luo, H., Zhang, X., Cook, B., Wu, B., & Wilson, M. R. (2014). Racial/Ethnic Disparities in Preventive Care Practice among U.S. Nursing Home Residents (Journal of aging and health). Thousand Oaks, Calif: Sage Publications
Marrocco, A., & Krouse, H. J. (2017). Obstacles to preventive care for individuals with disability: Implications for nurse practitioners. Wiley-Blackwell Publishing
Martin, B. R. (2018). Vaccination Panic in Australia. s.l.: irene publishing.
Oyo-Ita A, Wiysonge CS, Oringanje C, Nwachukwu CE, Oduwole O, Meremikwu MM. Interventions for improving coverage of childhood immunisation in low- and middle-income countries. Cochrane Database of Systematic Reviews 2016, Issue 7. Art. No.: CD008145. DOI: 10.1002/14651858.CD008145.pub3. At: https://onlinelibrary.wiley.com/doi/10.1002/14651858.CD008145.pub3/full
Willis, E., In Reynolds, L., & In Keleher, H. (2012). Understanding the Australian Health Care System – E-Book. Churchill Livingstone Australia
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