Yayehyirad Kitaw
University of London
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Publication
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The Journal of Infectious Diseases | 2011
Piya Hanvoravongchai; Sandra Mounier-Jack; V. Oliveira Cruz; Dina Balabanova; Robin Biellik; Yayehyirad Kitaw; Tracey Pérez Koehlmoos; S. Loureiro; Mitike Molla; Ha Nguyen; Pierre Ongolo-Zogo; U. Sadykova; H. Sarma; M. Teixeira; Jasim Uddin; A. Dabbagh; Ulla K. Griffiths
BACKGROUND One of the key concerns in determining the appropriateness of establishing a measles eradication goal is its potential impact on routine immunization services and the overall health system. The objective of this study was to evaluate the impact of accelerated measles elimination activities (AMEAs) on immunization services and health systems in 6 countries: Bangladesh, Brazil, Cameroon, Ethiopia, Tajikistan, and Vietnam. METHODS Primary data were collected from key informant interviews and staff profiling surveys. Secondary data were collected from policy documents, studies, and reports. Data analysis used qualitative approaches. RESULTS This study found that the impact of AMEAs varied, with positive and negative implications in specific immunization and health system functions. On balance, the impacts on immunization services were largely positive in Bangladesh, Brazil, Tajikistan, and Vietnam, while negative impacts were more significant in Cameroon and Ethiopia. CONCLUSIONS We conclude that while weaker health systems may not be able to benefit sufficiently from AMEAs, in more developed health systems, disruptions to health service delivery are unlikely to occur. Opportunities to strengthen the routine immunization service and health system should be actively sought to address system bottlenecks in order to incur benefits to eradication program itself as well as other health priorities.
Health Policy and Planning | 2012
Helen Burchett; Sandra Mounier-Jack; Ulla K. Griffiths; R Biellik; P Ongolo-Zogo; E Chavez; H. Sarma; J Uddin; Mamadou Konate; Yayehyirad Kitaw; M Molla; S Wakasiaka; Lucy Gilson; Anne Mills
As more new and improved vaccines become available, decisions on which to adopt into routine programmes become more frequent and complex. This qualitative study aimed to explore processes of national decision-making around new vaccine adoption and to understand the factors affecting these decisions. Ninety-five key informant interviews were conducted in seven low- and middle-income countries: Bangladesh, Cameroon, Ethiopia, Guatemala, Kenya, Mali and South Africa. Framework analysis was used to explore issues both within and between countries. The underlying driver for adoption decisions in GAVI-eligible countries was the desire to seize GAVI windows of opportunity for funding. By contrast, in South Africa and Guatemala, non-GAVI-eligible countries, the decision-making process was more rooted in internal and political dynamics. Decisions to adopt new vaccines are, by nature, political. The main drivers influencing decisions were the availability of funding, political prioritization of vaccination or the vaccine-preventable disease and the burden of disease. Other factors, such as financial sustainability and feasibility of introduction, were not as influential. Although GAVI procedures have established more formality in decision-making, they did not always result in consideration of all relevant factors. As familiarity with GAVI procedures increased, questioning by decision-makers about whether a country should apply for funding appeared to have diminished. This is one of the first studies to empirically investigate national processes of new vaccine adoption decision-making using rigorous methods. Our findings show that previous decision-making frameworks (developed to guide or study national decision-making) bore little resemblance to real-life decisions, which were dominated by domestic politics. Understanding the realities of vaccine policy decision-making is critical for developing strategies to encourage improved evidence-informed decision-making about new vaccine adoptions. The potential for international initiatives to encourage evidence-informed decision-making should be realised, not assumed.
African Health Sciences | 2015
Sergio Torres-Rueda; Helen Burchett; Ulla K. Griffiths; Pierre Ongolo-Zogo; Jean-Marie Edengue; Yayehyirad Kitaw; Mitike Molla; Lawrence Gelmon; Washington Onyango-Ouma; Mamadou Konate; Sandra Mounier-Jack
BACKGROUND Pneumonia is a main cause of under-five mortality in low-income settings. The pneumococcal conjugate vaccine (PCV) has been introduced in many countries as a tool in the diseases prevention. Although PCVs effectiveness has been established, less is known about the effects of introducing additional injectable vaccines into routine immunisation programmes, particularly in the context of resource-constrained settings. OBJECTIVES To explore the effects of PCV introduction on the immunisation programmes and health systems in four low-income countries. METHODS This study was carried out in Cameroon, Ethiopia, Kenya and Mali. Three to four regions and nine to 10 districts were selected within each country. Semi-structured interviews were carried out at national, regional and district levels (n=173). Researcher-administered questionnaires were completed with facility staff (n=124). Routine data on monthly vaccination activities were collected at district and facility levels. RESULTS PCV was generally well integrated into existing routine immunisation. Little or no impact was found in most areas of the health systems. Some minor effects were found on immunisation programmes, particularly in areas with either planning activities or investments e.g. staff skills were strengthened and there were limited improvements in surveillance. Although health sector workers perceived increases in the coverage of other vaccines following the introduction of PCV, routine service data did not confirm this claim. No substantial impacts were seen in health system management, service delivery or performance. CONCLUSIONS The introduction of PCV had marginal impacts on the Expanded Programme for Immunisation and little to none on broader health systems.
The Ethiopian Journal of Health Development | 2018
Mirgissa Kaba; Yayehyirad Kitaw
The Ethiopian Journal of Health Development | 2018
Yayehyirad Kitaw; Mirgissa Kaba
The Ethiopian Journal of Health Development | 2018
Yayehyirad Kitaw
The Ethiopian Journal of Health Development | 2018
Damen Hailemariam; Yayehyirad Kitaw; Mirgissa Kaba; Dawit Siraw; Yibeltal Tebekaw; Hibret Alemu
Ethiopian Journal of Health Development | 2018
Yayehyirad Kitaw; Mirgissa Kaba
The Ethiopian Journal of Health Development | 2017
Mitike Molla; Helen Burchett; Sandra Mounier-Jack; Habtamu Belete; Yayehyirad Kitaw
The Ethiopian Journal of Health Development | 2017
Habtamu Belete; Teklay Kidane; Filimona Bisrat; Mitike Molla; Sandra Mounier-Jack; Yayehyirad Kitaw