Innovative use of surveillance data to harness political will to accelerate measles elimination: experience from Guangxi, China.
ABSTRACT The major challenge for measles elimination is to harness sufficient political will to provide the necessary financial and human resources. This is particularly relevant for local governments (at county and township levels in China) and communities that generally have not accepted measles as a serious health burden and thus have not made its prevention a high priority. An effort has been made to use surveillance data to harness political will and overcome or mitigate the shortage of resources in the impoverished province of Guangxi, one of China's 31 administrative divisions. A comprehensive information system collecting data pertaining to Expanded Program on Immunization (EPI-info) was refined to align with China's political system and translate international and national commitments into sustainable local actions. The EPI-info has proved an effective tool in identifying high-risk areas, strengthening routine immunization services, conducting mass measles immunization campaigns, and catalyzing capacity building at both county and local community levels. We outline the principles and operational features of the EPI-info and the rationale and steps taken to refine it.
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ABSTRACT: Ten provinces of China were selected to estimate the cost per immunization of the 1994-95 national immunization days (NIDs) at five levels (e.g. province, prefecture, county, township and village). Personnel costs accounted for the largest overall share of costs (39 per cent), followed by publicity and promotion costs (27 per cent), and logistic costs (15 per cent). Without consideration of vaccine costs, the major part of NID expenses were shouldered at the township level, which paid for 47 per cent of all incremental costs, while county and village level covered 28 per cent and 18 per cent respectively. Estimation of average costs per immunization was 2.86 RMB yuan, or $0.34, including vaccine costs, buildings and equipment amortization and salaries at all levels. The factors affecting average cost of NID included the output volume, socio-economic development and geographic features. Various approaches were recommended: to intensify the productivity of time and staff, to employ alternative inexpensive manpower resources, to make the best use of publicity and social promotion, the expansion of the age groups and utilization of multi-intervention strategies. Good planning at township level was a decisive factor to ensure an effective NID conducted in an efficient manner. The average cost of China's NID was the lowest among all mass immunization campaigns ever documented. Much of the reduced average cost was attributable to economies of scale.International Journal of Health Planning and Management 01/1998; 13(1):5-25. · 0.79 Impact Factor
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ABSTRACT: Measles eradication would avert the current annual 1 million deaths and save the $1.5 billion in treatment and prevention costs due to measles in perpetuity. The authors evaluate the biological feasibility of eradicating measles according to 4 criteria: (1) the role of humans in maintaining transmission, (2) the availability of accurate diagnostic tests, (3) the existence of effective vaccines, and (4) the need to demonstrate elimination of measles from a large geographic area. Recent successes in interrupting measles transmission in the United States, most other countries in the Western Hemisphere, and selected countries in other regions provide evidence for the feasibility of global eradication. Potential impediments to eradication include (1) lack of political will in some industrialized countries, (2) transmission among adults, (3) increasing urbanization and population density, (4) the HIV epidemic, (5) waning immunity and the possibility of transmission from subclinical cases, and (6) risk of unsafe injections. Despite these challenges, a compelling case can be made in favor of measles eradication, and the authors believe that it is in our future. The question is when.American Journal of Public Health 11/2000; 90(10):1521-5. · 3.93 Impact Factor
Article: Waving goodbye to measles.Nature 01/2002; 414(6865):695-6. · 38.60 Impact Factor