From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary

Q&A with WHO: Cholera vaccine stockpile – a new tool to avoid needless suffering
Thomson Reuters Foundation – Mon, 3 Mar 2014 11:20 AM
Alisa Tang
Excerpt
The World Health Organization (WHO) has activated for the first time a new cholera vaccine emergency stockpile to protect hundreds of thousands displaced by conflict in South Sudan and living in temporary camps.

Although there is currently no outbreak of cholera – an acute diarrhoeal infection caused by ingestion of contaminated food or water – the risk is high due to poor sanitary conditions and overcrowding, the WHO said.

With WHO coordinating the campaign, Médecins Sans Frontières (MSF) on Feb. 22 started vaccinations for 94,000 people in Minkaman camp in Awerial county, and the humanitarian organisation Medair was to vaccinate an additional 43,000 in camps in South Sudan’s capital, Juba.

Two oral doses of the cholera vaccine are required for an individual to be protected. The campaign begins with an initial round of vaccinations followed after a required 14-day interval by a second round.

William Perea, the WHO’s coordinator for the control of epidemic diseases, spoke to Thomson Reuters Foundation by phone from Geneva about the emergency stockpile – which is managed by WHO, the International Federation of the Red Cross and Red Crescent Societies (IFRC), MSF and UNICEF – as a tool to fight cholera…

Special Focus Newsletter/Projects
The Vaccine Confidence Project :: Confidence Commentary from Dr Heidi Larson
“Why we need “\’science understanding the public’ more than just ‘public understanding of science’: the case of vaccines”
London School of Hygiene and Tropical Medicine
www.vaccineconfidence.org

BMC Health Services Research
2014, 14:111
http://www.biomedcentral.com/bmchealthservres/content
Research article
Urban settings do not ensure access to services: findings from the immunisation programme in Kampala Uganda
Juliet N Babirye, Ingunn MS Engebretsen, Elizeus Rutebemberwa, Juliet Kiguli and Fred Nuwaha
Published: 6 March 2014
Author Affiliations
http://www.biomedcentral.com/1472-6963/14/111/abstract
Abstract (provisional)
Background
Previous studies on vaccination coverage in developing countries focus on individual- and community-level barriers to routine vaccination mostly in rural settings. This paper examines health system barriers to childhood immunisation in urban Kampala Uganda.
Methods
Mixed methods were employed with a survey among child caretakers, 9 focus group discussions (FGDs), and 9 key informant interviews (KIIs). Survey data underwent descriptive statistical analysis. Latent content analysis was used for qualitative data.
Results
Of the 821 respondents in the survey, 96% (785/821) were mothers with a mean age of 26 years (95% CI 24-27). Poor geographical access to immunisation facilities was reported in this urban setting by FGDs, KIIs and survey respondents (24%, 95% CI 21-27). This coupled with reports of few health workers providing immunisation services led to long queues and long waiting times at facilities. Consumers reported waiting for 3-6 hours before receipt of services although this was more common at public facilities. Only 33% (95% CI 30-37) of survey respondents were willing to wait for three or more hours before receipt of services. Although private-for-profit facilities were engaged in immunisation service provision their participation was low as only 30% (95% CI 27-34) of the survey respondents utilised these facilities. The low participation could be due to lack of financial support for immunisation activities at these facilities. This in turn could explain the rampant informal charges for services in this setting. Charges ranged from US$ 0.2 to US$4 and these were more commonly reported at private (70%, 95% CI 65-76) than at public (58%, 95% CI 54-63) facilities. There were intermittent availability of vaccines and transport for immunisation services at both private and public facilities.
Conclusions
Complex health system barriers to childhood immunisation still exist in this urban setting; emphasizing that even in urban areas with great physical access, there are hard to reach people. As the rate of urbanization increases especially in sub-Saharan Africa, governments should strengthen health systems to cater for increasing urban populations.

Journal of Epidemiology and Community Health
Online First doi:10.1136/jech-2013-203272
Commentary
International institutional legitimacy and the World Health Organization
Jennifer Prah Ruger
http://jech.bmj.com/content/early/2014/03/05/jech-2013-203272.extract
Extract
The global health community continues to look to the World Health Organization (WHO) to solve current global health governance (GHG) problems. Until the 1990s, nation-states and multilateral organisations with state members governed international health, and WHO played a prominent role, coordinating worldwide efforts such as smallpox eradication with a few partner organisations. WHO also provided international reporting and handled disease outbreaks through the International Health Regulations. The world still sees WHO as the leading global health governor, and proposals abound to reform it,1–4 to use its treaty abilities more regularly and to give it enforcement powers—all in the absence of real institutional alternatives.

But today’s WHO is a compromised institution; some interrogate its relevance altogether2 and WHO Director-General Margaret Chan herself questions WHO’s ability to respond to global health challenges.5 On a theoretical level, WHO lacks a substantive justice oriented conception of international institutional legitimacy. On a more pragmatic plane, WHO is riddled with budgetary weaknesses, power politics and diminishing reputation and effectiveness. WHO’s early successes were laudable and the organisation has the potential to make an impact on future global health problems, but the institution lacks a number of key ingredients of success: coordination capacity, authority, accountability, fairness, a master global health plan, effectiveness and credible compliance mechanisms.

While WHO reforms could help it do its job better, a new vision, based on a substantive conception of justice and legitimacy, and associated reforms in the broader GHG system will more effectively and efficiently serve GHG functions and the WHO itself. WHO Director-General Margaret Chan states “[t]he level of WHO engagement should not be governed by the size of a health problem. Instead it should be governed by the extent to which WHO can have an impact on the problem. Others may be positioned to do a …

Communication, Somali culture and decision-making about the human papillomavirus (HPV) Vaccine
Dailey, Phokeng 2014-02
28th Edward F. Hayes Graduate Research Forum. Ohio State University
http://hdl.handle.net/1811/59265
Abstract
The current study uses a multiple goals theoretical perspective to explore how Somali immigrant families in the United States make decisions regarding whether to vaccinate their children against human papillomavirus (HPV). A focus was placed on the communication goals of parents in HPV vaccine discussions with their child and health care provider. 16 semi-structured interviews were audiotaped, transcribed, and analyzed using a grounded theory approach. Key themes were the implications of the vaccine for early sexual activity, confusion between HPV and human immunodeficiency virus (HIV), the perception that the HPV vaccine is unnecessary, uncertainty about the vaccine’s efficacy and side effects, avoidance of parent-child communication about the vaccine, and a preference for framing the vaccine as a health promotion behavior. Framing the threat of HPV in the context of initiation of sexual activity, uncertainty regarding vaccine efficacy, and anticipated regret account for the inconsistency in HPV vaccine uptake among Somali parents. Health care providers should consider talking about HPV as a distal versus an immediate threat and HPV vaccine uptake as a health-promotion rather than a sexually transmitted infection (STI) prevention behavior.

Trends in HPV Vaccination of US Adolescent Females: How Policies, Education, and Health Care Providers Influence Immunization Rates
Grant, Jennifer Lyn (2013)
Dissertation (88 pages)
Program: Laney Graduate School, Health Services and Research Health Policy
Permanent url: http://pid.emory.edu/ark:/25593/f4mjs
Abstract
In my first paper, The Impact of State Immunization Financing Policies on HPV Vaccination Rates among US Adolescent Females, I examine the impact of expanded enrollment eligibility for The Vaccines for Children (VFC) program on HPV vaccine series initiation and completion among US adolescent girls. The VFC program provides certain vaccines at a reduced or no cost to eligible children. It was designed to help ensure all children receive recommended vaccinations on schedule, even if their parents are not be able to afford them. Specifically, I hypothesized that adolescent girls living in states in which all recommended vaccines were provided free of cost to all children in the state would be more likely to initiate and complete the HPV vaccine series than their peers living in states with more restricted VFC eligibility requirements.

In my second paper, Maternal Educational Inequalities in HPV Vaccine Utilization among US adolescent females- The relative roles of economics and awareness, I evaluate the relative influences of household-level socioeconomic status, specific health knowledge, and general healthcare utilization and timeliness in mediating the relationship between maternal educational attainment and HPV vaccine utilization among adolescent girls.

In my third and final paper, Factors Associated with Health Care Provider Recommendation of the Human Papillomavirus Vaccine and effect of provider recommendation on vaccine series initiation and completion, I examine the relative influences of adolescent and household sociodemographic characteristics and characteristics of their health-seeking behavior on the likelihood of receiving a health care provider recommendation of the HPV vaccine for US Adolescent girls. I also estimate the effect of provider recommendation on vaccine series initiation and completion