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Introduction of New Vaccines: Decision-making Process in Bangladesh
Uddin, Jasim; Sarma, Haribondhu; Bari, Tajul I. & Koehlmoos, Tracey P.
Abstract
The understanding of the decision-making process in the introduction of new vaccines helps establish why
vaccines are adopted or not. It also contributes to building a sustainable demand for vaccines in a country.
The purpose of the study was to map and analyze the formal decision-making process in relation to the
introduction of new vaccines within the context of health policy and health systems and identify the
ways of making decisions to introduce new vaccines in Bangladesh. During February-April 2011, a qualitative
assessment was made at the national level to evaluate the decision-making process around the
adoption of new vaccines in Bangladesh. The study population included: policy-level people, programme
heads or associates, and key decision-makers of the Government, private sector, non-governmental organizations,
and international agencies at the national level. In total, 13 key informants were purposively selected.
Data were collected by interviewing key informants and reviewing documents. Data were analyzed
thematically. The findings revealed that the actors from different sectors at the policy level were involved
in the decision-making process in the introduction of new vaccines. They included policy-makers from the
ministries of health and family welfare, finance, and local government and rural development; academicians;
researchers; representatives from professional associations; development partners; and members of
different committees on EPI. They contributed to the introduction of new vaccines in their own capacity.
The burden of disease, research findings on vaccine-preventable diseases, political issues relating to
outbreaks of certain diseases, initiatives of international and local stakeholders, pressure of development
partners, the Global Alliance for Vaccines and Immunization (GAVI) support, and financial matters were
the key factors in the introduction of new vaccines in Bangladesh. The slow introduction and uptake of
new vaccines is a concern in the country. Rapid action on the application of GAVI support and less time
taken by the Government in processing the implementation and administrative work may expedite the
introduction of new vaccines in future in this country.
Keywords
Decision-making; Qualitative research; Vaccines; Bangladesh
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