Understanding Vaccine Policy Decision-Making in the Country of Georgia Público
Legare, Sarah Kathleen (2016)
Published
Abstract
The country of Georgia is in its final year of receiving aid from Gavi, the Vaccine Alliance, which has disbursed over five million dollars to the Georgian government to support its National Immunization Program since 2002. In addition to losing financial support, Georgia is expected to become more independent in its vaccine policy decision-making process in the future. This led to the creation of a National Immunization Technical Advisory Group in 2014 to advise policymakers on evidence-based vaccine policy decisions. This research documented the experiences of actors in Georgia's immunization system as they pertain to national vaccine decision-making during graduation from Gavi, as a formative step in understanding what is needed to ensure the country's successful graduation from Gavi's major financial and technical support. In June and July 2015, we conducted twenty-one semi-structured qualitative interviews in five regions and one autonomous republic in Georgia. Immunization stakeholders including national-level staff, Public Health Center staff, and vaccine providers responded to questions on policy-making processes, use of data, program administration and implementation. At the national level, respondents expressed that while immunization has been prioritized by the central government, there is a lack of national-level decision-making autonomy in that recommendations and research are initiated by external organizations. Within the National Immunization Program, a hierarchical approach to administration provides for a structured and functional system with well-defined roles and responsibilities. Understanding of the realities faced by regional and local staff in implementing the program differed between national-level staff and other respondents. Georgia's immunization system has been strengthened since the country gained independence in 1991 and still has opportunities to improve through increased initiative to produce and use data in policy making and giving more attention to locally relevant issues impacting program performance. Beginning in 2016, Gavi is conducting assessments of country readiness for graduation; quantitative surveys for regional health system staff and vaccination providers informed by the issues raised in this research would improve its understanding of National Immunization Program strengths and challenges.
Table of Contents
Chapter 1: Introduction ..........................................................................................1
Introduction & Rationale .......................................................................................1
Problem Statement.................................................................................................1
Purpose.................................................................................................................2
Research Question and Specific Aims ......................................................................3
Significance ..........................................................................................................3
Definition of Terms ...............................................................................................6
Chapter 2: Literature Review ..................................................................................9
General description of Gavi, the Vaccine Alliance .....................................................9
Graduation from Gavi ...........................................................................................11
National Immunization Technical Advisory Groups.................................................13
Background on Georgia .........................................................................................15
Vaccine Purchase and Import.................................................................................18
Gavi's Role in Georgia and the Region ....................................................................20
Significance of National Immunization Technical Advisory Groups to Graduation from Gavi ........................22
Current National Immunization Program in Georgia ..............................................22
Sustainability of Georgia's National Immunization Program ...................................23
Chapter 3: Methods .............................................................................................24
Chapter 4: Findings .............................................................................................28
Responses on National Immunization Program Administration from National Staff .....................................28
Responses Regarding National Immunization Program Administration from Public Health Center Staff ...................34
Responses from Public Health Center staff and Physicians on National Immunization Program Implementation .......38
Chapter 5: Discussion .........................................................................................44
Chapter 6: Conclusion and Recommendations ......................................................50
References .........................................................................................................51
Appendix ...........................................................................................................54
About this Master's Thesis
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