ABSTRACT
Immunization is a global success story. It has saved millions of lives and prevented disease worldwide and millions more have been spared the permanent disabilities caused by diseases such as polio and the long-term morbidity caused by other diseases such as measles. Despite the compelling evidence of the public health and economic value of vaccines, vaccine hesitancy has become a growing concern globally. By calling into question the safety and efficacy of vaccines, vaccine hesitancy threatens the progress made in combating morbidity and mortality including efforts to introduce COVID-19 vaccines. This paper a) examines key factors that drive limited demand for vaccines and vaccine hesitancy, (b) highlights the role of demand promotion for immunization and of risk communication and community engagement to address those challenges, (c) discusses vaccine demand and hesitancy in Eastern Europe and Central Asia, and (d) makes recommendations for public health policy and programming for the introduction of the COVID-19 vaccine and beyond.Recommendations include strengthen social listening and digital engagement to address the concerns of caregivers and healthcare professionals, improve the availability and use of social data for evidence-based programming, reinforce public trust in health institutions and service providers, mainstream demand for immunization, strengthen the communication competencies of health service providers, test and apply solutions based on behavioral insights to reinforce demand, engage regularly with local governments and local actors, and strengthen resilience and response capacities for diseases outbreaks and public health emergencies.
Subject(s)
COVID-19 Vaccines/therapeutic use , Patient Acceptance of Health Care/statistics & numerical data , Asia , COVID-19/prevention & control , Europe, Eastern , Female , Humans , Male , Patient Acceptance of Health Care/psychology , TrustABSTRACT
PURPOSE: Parental influence over early marriage of girls is well-documented in qualitative research, but little quantitative work in this area has been conducted. This study assesses the effects of the parent-child relationship in early adolescence (aged 12 years) on early marriage of girls. METHODS: We analyzed survey data from a multicountry prospective cohort of girls (n = 1,648) followed over four rounds from age 8 to 19 years (2002-2013), as part of the Young Lives study in India, Ethiopia, Vietnam, and Peru. Multinomial logistic regression models assessed the effects of parent-child communication and parent-child relationship quality, as reported when girls were aged 12 years on child and early marriage (married <16 years, married 16-17 years, married 18-19 years, unmarried). Covariates were wealth, rural/urban residence, maternal education, parents' value of education, early menarche, and country. RESULTS: One in five girls (18.04%) reported marriage before 18 years of age, and 8.1% reported marrying before 16 years (8.3% and 13.7% in India and Ethiopia). Multinomial regression found that girls reporting good parent-child communication and high parent-child relationship quality at age 12 years were significantly less likely to marry before age 16 years (moderate relationship quality, adjusted relative risk ratio: .23, 95% confidence interval: .07-.72; high relationship quality, adjusted relative risk ratio: .34, 95% confidence interval: .11-.99). CONCLUSION: Parent-child relationship quality and communication in early adolescence are protective against very early marriage of girls cross-nationally, although communication may facilitate marriage soon on completion of school. Primary prevention interventions targeting child marriage may benefit from components focused on improving the parent-child relationship.
Subject(s)
Communication , Marriage/ethnology , Parent-Child Relations , Rural Population , Adolescent , Age Factors , Child , Educational Status , Ethiopia , Female , Humans , Peru , Prospective Studies , VietnamSubject(s)
Child Health Services , Child Welfare , Education, Nursing , Schools, Medical , Health EducationABSTRACT
Esta guía ofrece una serie de herramientas prácticas y sencillas para que cualquier persona responsable de acciones de promoción y comunicación de la AIEPI, y en general de salud infantil, pueda desarrollar planes y estrategias aplicables en diferentes contextos (nacional, regional y local) y que respondan a las tres dimensiones arriba descritas. Esta guía se suma a la diversidad de herramientas con las que cuenta la AIEPI y esperamos que rápidamente se convierta en una herramienta complementaria para sus acciones, articulándose especialmente con la herramienta Conversando con las Madres, con la Guía de Mensajes Clave y de Apoyo, con el Curso de Organización Local y con las diversas guías del componente comunitario dirigidas a actores locales. Igualmente, esta guía es también un testimonio de la constante evolución de la estrategia. De ninguna manera es esta guía una fórmula o receta, sino por el contrario, es un instrumento que puede adaptarse en diversas formas para así responder a las necesidades de cada equipo de trabajo. El usuario puede manejar cada sección de manera separada de acuerdo a sus intereses y demandas, o puede desarrollarla en su totalidad si fuere necesario. A través de esta guía, la Organización Panamericana de la Salud (OPS), por intermedio del Área de Salud Familiar y Comunitaria y de la Unidad de Salud del Niño y del Adolescente, espera seguir contribuyendo al mejoramiento de la salud de niños y niñas de la región y a la reducción de la mortalidad en menores de 5 años, como parte de los esfuerzos por apoyar a los países de las Américas en el logro de los Objetivos de Desarrollo del Milenio, particularmente las metas 4 y 5 relacionadas con la salud materno-infantil.