16 research outputs found
Sociobehavioural Research Methods for the Introduction of Vaccines in the Diseases of the Most Impoverished Programme
Participation in vaccination campaigns worldwide, particularly the
Expanded Programme on Immunization, has increased significantly in
recent years. However, there remain multiple and integrated
behavioural, sociocultural and political-economic barriers to
vaccination. The Diseases of the Most Impoverished (DOMI) Programme has
undertaken shigellosis disease-burden studies and oral cholera and
typhoid Vi polysaccharide vaccine trials in seven Asian countries. As
part of these projects, sociobehavioural studies have been undertaken
to determine the potential demand for vaccines for these diseases and
the obstacles and enabling factors that may affect acceptance,
delivery, and use of vaccines. A theoretical model of acceptance of
vaccination and a triangulation of qualitative and quantitative methods
have been used for fully elucidating the range of issues relating to
vaccination for shigellosis, cholera, and typhoid fever. In this paper,
the theoretical and methodological basis of the DOMI projects has been
reviewed in a context of current sociobehavioural research on the
acceptability and desirability of vaccination
The Health Belief Model and Factors Relating to Potential Use of a Vaccine for Shigellosis in Kaeng Koi District, Saraburi Province, Thailand
Shigellosis is an important cause of morbidity and mortality throughout
the world. Approximately, 1.1 million deaths occur a year due to this
disease, making it the fourth leading cause of mortality worldwide.
This paper explores local interest in and potential use of a vaccine
for shigellosis in Thailand where Shigella poses an important
public-health concern. Data for this study were collected during
June-November 2002 from 522 subjects surveyed using a sociobehavioural
questionnaire in Kaeng Koi district in central Thailand. The community
demand and likely use of a vaccine were examined in relation to the
Health Belief Model, which provides analytical constructs for
investigating the multiple issues of local readiness to accept and
access a new vaccine. As the key outcome variable, most respondents
showed interest in receiving a vaccine against dysentery which they
thought would provide useful protection against the disease. However,
there was only a moderate number who perceived dysentery as serious and
themselves as susceptible to it, although it was perceived to cause
some burden to and additional expense for families. Most people
identified a number of groups who were thought to be especially
vulnerable to dysentery, such as the elderly, pre-school, and
school-age children, and poor labourers. Other outcomes of the study
included the identification of acceptable and convenient sites for its
delivery, such as government health clinics and private clinics, and
respected sources for information about the vaccine, such as health
clinic personnel and community health volunteers. This information
suggests that components of the Health Belief Model may be useful in
identifying community acceptance of a vaccine and the means of
introducing it. This health information is important for planning and
implementing vaccine programmes
Adults\u27 perceived prevalence of enteric fever predicts laboratory-validated incidence of typhoid fever in children
This study was undertaken to develop a model to predict the incidence of typhoid in children based on adults’ perception of prevalence of enteric fever in the wider community. Typhoid cases among children, aged 5-15 years, from epidemic regions in five Asian countries were confirmed with a positive Salmonella Typhi culture of the blood sample. Estimates of the prevalence of enteric fever were obtained from random samples of adults in the same study sites. Regression models were used for establishing the prediction equation. The percentages of enteric fever reported by adults and cases of typhoid incidence per 100,000, detected through blood culture were 4.7 and 24.18 for Viet Nam, 3.8 and 29.20 for China, 26.3 and 180.33 for Indonesia, 66.0 and 454.15 for India, and 52.7 and 407.18 for Pakistan respectively. An established prediction equation was: incidence of typhoid (1/100,000= −2.6946 + 7.2296 × reported prevalence of enteric fever (%) (F=31.7, p2=0.992). Using adults’ perception of prevalence of disease as the basis for estimating its incidence in children provides a cost-effective behavioural epidemiologic method to facilitate prevention and control of the disease
Adults' Perceived Prevalence of Enteric Fever Predicts Laboratory-validated Incidence of Typhoid Fever in Children
This study was undertaken to develop a model to predict the incidence
of typhoid in children based on adults' perception of prevalence of
enteric fever in the wider community. Typhoid cases among children,
aged 5-15 years, from epidemic regions in five Asian countries were
confirmed with a positive Salmonella Typhi culture of the blood
sample. Estimates of the prevalence of enteric fever were obtained from
random samples of adults in the same study sites. Regression models
were used for establishing the prediction equation. The percentages of
enteric fever reported by adults and cases of typhoid incidence per
100,000, detected through blood culture were 4.7 and 24.18 for Viet
Nam, 3.8 and 29.20 for China, 26.3 and 180.33 for Indonesia, 66.0 and
454.15 for India, and 52.7 and 407.18 for Pakistan respectively. An
established prediction equation was: incidence of typhoid (1/100,000=
-2.6946 + 7.2296
7 reported prevalence of enteric fever (%)
(F=31.7, p<0.01; R2=0.992). Using adults' perception of prevalence
of disease as the basis for estimating its incidence in children
provides a cost-effective behavioural epidemiologic method to
facilitate prevention and control of the disease
Quality of Medical Care and Choice of Medical Treatment in Kenya: An Empirical Analysis
Underutilization of medical facilities in African countries is widely believed to be a result of consumer disappointments with quality of care. This paper uses data from a randomized household survey, enriched with exogenous information on health facility attributes, to examine more deeply the quality factor in health care demand in rural Kenya. We find that broad availability of drugs in a medical facility is positively related to medical care use. Contrary to intuitive expectations, lack of prescription drugs is also positively related to medical care demand, while lack of aspirin reduces demand. We explain this counter-intuitive result by noting that any measure of availability of a consumable input is evidence of both demand and supply. Demand may be positively correlated with lack of drugs, for example, precisely because there is excess demand for available supplies. The results indicate the importance of selecting truly exogenous indicators of service quality for demand analysis. We also find that health care demand decreases with user fees and with greater distance to the provider, but increases with income. Gender is not a significant determinant of the choice of medical care in this dataset-whether considered separately or interacted with service variables.
Private demand for cholera vaccines in Beira, Mozambique.
In the summer of 2005, we interviewed 996 randomly selected respondents in Beira, Mozambique concerning their willingness and ability to pay for cholera vaccine for themselves and for other household members. Respondents were told that two doses of the vaccine would be required 2 weeks apart, and that the cholera vaccine would offer excellent protection against infection for the first year following vaccination, and some protection during the second and third year after a person is vaccinated. This research was carried out in order to learn more about private demand for vaccines in a cholera-endemic area. We asked two types of valuation questions: (1) a discrete-price offer for a vaccine that could be purchased for household members and (2) a payment card designed to assess uncertainty in the respondent's demand for a vaccine for self-protection. We estimate average household willingness to pay (WTP) for cholera vaccines in Beira to be 2005 US$ 8.45. This estimate of household WTP represents the perceived private economic benefits to a household--six persons on average--of giving all members free cholera vaccines
Sociobehavioural Research Methods for the Introduction of Vaccines in the Diseases of the Most Impoverished Programme
Participation in vaccination campaigns worldwide, particularly the
Expanded Programme on Immunization, has increased significantly in
recent years. However, there remain multiple and integrated
behavioural, sociocultural and political-economic barriers to
vaccination. The Diseases of the Most Impoverished (DOMI) Programme has
undertaken shigellosis disease-burden studies and oral cholera and
typhoid Vi polysaccharide vaccine trials in seven Asian countries. As
part of these projects, sociobehavioural studies have been undertaken
to determine the potential demand for vaccines for these diseases and
the obstacles and enabling factors that may affect acceptance,
delivery, and use of vaccines. A theoretical model of acceptance of
vaccination and a triangulation of qualitative and quantitative methods
have been used for fully elucidating the range of issues relating to
vaccination for shigellosis, cholera, and typhoid fever. In this paper,
the theoretical and methodological basis of the DOMI projects has been
reviewed in a context of current sociobehavioural research on the
acceptability and desirability of vaccination
RELIABILITY OF STATED PREFERENCES FOR CHOLERA AND TYPHOID VACCINES WITH TIME TO THINK IN HUE, VIETNAM
"We examine the effect of giving respondents time to think about their stated choices (SC) in a survey of cholera and typhoid vaccine preferences in Hue, Vietnam. Because neither vaccine is widely available in Vietnam, we used the SC approach (a stated preference technique) and gave half of our respondents overnight to think about their choices to make the hypothetical valuation scenario as similar to a real-life choice situation as possible. Respondents who were given extra time made fewer choices that violated internal validity tests of utility theory, and had lower average willingness to pay (WTP), confirming a result found in similar studies in the contingent valuation literature". ("JEL" D12, I18, C25) Copyright 2006 Western Economic Association International.
The Health Belief Model and Factors Relating to Potential Use of a Vaccine for Shigellosis in Kaeng Koi District, Saraburi Province, Thailand
Shigellosis is an important cause of morbidity and mortality throughout
the world. Approximately, 1.1 million deaths occur a year due to this
disease, making it the fourth leading cause of mortality worldwide.
This paper explores local interest in and potential use of a vaccine
for shigellosis in Thailand where Shigella poses an important
public-health concern. Data for this study were collected during
June-November 2002 from 522 subjects surveyed using a sociobehavioural
questionnaire in Kaeng Koi district in central Thailand. The community
demand and likely use of a vaccine were examined in relation to the
Health Belief Model, which provides analytical constructs for
investigating the multiple issues of local readiness to accept and
access a new vaccine. As the key outcome variable, most respondents
showed interest in receiving a vaccine against dysentery which they
thought would provide useful protection against the disease. However,
there was only a moderate number who perceived dysentery as serious and
themselves as susceptible to it, although it was perceived to cause
some burden to and additional expense for families. Most people
identified a number of groups who were thought to be especially
vulnerable to dysentery, such as the elderly, pre-school, and
school-age children, and poor labourers. Other outcomes of the study
included the identification of acceptable and convenient sites for its
delivery, such as government health clinics and private clinics, and
respected sources for information about the vaccine, such as health
clinic personnel and community health volunteers. This information
suggests that components of the Health Belief Model may be useful in
identifying community acceptance of a vaccine and the means of
introducing it. This health information is important for planning and
implementing vaccine programmes