Public Health最新文献

{"title":"Wearable device-measured bouted and sporadic physical activity patterns and incident COPD: A prospective cohort study from UK Biobank","authors":"Qingling Yang ,&nbsp;Tongyu Ma ,&nbsp;Kin Cheung ,&nbsp;Harry Haoxiang Wang ,&nbsp;Yao Jie Xie","doi":"10.1016/j.puhe.2024.10.027","DOIUrl":"10.1016/j.puhe.2024.10.027","url":null,"abstract":"<div><h3>Objectives</h3><div>Moderate-to-vigorous physical activity (MVPA) is associated with a reduced risk of chronic obstructive pulmonary disease (COPD), but the optimal accumulation patterns are unclear. We aimed to investigate the associations between accelerometer-measured bouted and sporadic MVPA and incident COPD in the UK Biobank.</div></div><div><h3>Study design</h3><div>Prospective cohort study.</div></div><div><h3>Methods</h3><div>We included 94161 COPD-free participants (median age of 61.74 years at baseline) from the UK Biobank who wore a wrist accelerometer. A random forest classifier was used to differentiate sporadic and bouted MVPA. Multivariable Cox proportional hazard models and restricted cubic splines were used to examine the MVPA-COPD associations.</div></div><div><h3>Results</h3><div>During a median follow-up of 7.95 years, 1380 incident COPD cases were identified. Bouted MVPA was inversely associated with COPD incidence in an L-shaped manner, with hazard ratios of 0.62 (95 % CI: 0.52–0.75) for intermediate vs lowest quintile and 0.43 (95 % CI: 0.34–0.55) for highest vs lowest quintile. In those with insufficient bouted MVPA, sporadic MVPA had a U-shaped association with incident COPD, with hazard ratios of 0.82 (95 %: CI: 0.67–0.99) for intermediate vs lowest quintile and 1.11 (95 % CI: 0.88–1.39) for highest vs lowest quintile.</div></div><div><h3>Conclusions</h3><div>Bouted MVPA is a key factor in reducing COPD incidence, while modest sporadic MVPA may offer protection when bouted MVPA is insufficient.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"237 ","pages":"Pages 322-329"},"PeriodicalIF":3.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FAIRSTEPS study - Framework Addressing Inequities in pRimary care using STakEholder PerspectiveS: Integrative evidence review and Delphi consensus","authors":"Ben Jackson,&nbsp;Caroline Mitchell,&nbsp;Joanne Coster,&nbsp;Tom Lawy,&nbsp;Chris Burton,&nbsp;Josephine Reynolds,&nbsp;Munira Essat,&nbsp;Anna Cantrell,&nbsp;Mark Clowes,&nbsp;Steven Ariss","doi":"10.1016/j.puhe.2024.10.009","DOIUrl":"10.1016/j.puhe.2024.10.009","url":null,"abstract":"<div><h3>Objectives</h3><div>Health inequities are unjust and avoidable differences in health outcomes across populations and between population groups. Though these arise predominantly from social determinants of health, healthcare is estimated to contribute around 20 % and primary healthcare reduces inequities in healthcare outcomes. As each provider works in their local context, we sought to provide an evidence-informed framework for designing, implementing, and evaluating local health inequity interventions in primary care.</div></div><div><h3>Study design</h3><div>Mixed methods approach: an integrative evidence review, a multidisciplinary Delphi consensus study and collaborative patient and public participation.</div></div><div><h3>Methods</h3><div>We searched published and grey literature for examples of primary care health inequity interventions. Our Delphi survey then asked primary care professionals how feasible and useful similar interventions would be in their local contexts. We incorporated an ongoing dialogue people with lived experience of health inequity in our design, implementation, and analysis.</div></div><div><h3>Results</h3><div>Sixty-nine published papers and 19 grey literature papers were included. Interventions included multiple objectives (e.g., tailored provision, practitioner training) or focus (e.g., medical care, screening). Theory underpinning intervention design was rarely explicit but some specific tools and theory was identified for the framework. Practitioners and our patient group prioritised 28 example interventions to aid the design of local contextually sensitive interventions.</div></div><div><h3>Conclusions</h3><div>We combined evidence synthesis, practitioner consultation and dialogue with people with lived experience produced an evidence-informed framework for the design, implementation and evaluation of local primary care health inequity interventions. The public and practitioner voice increases the credibility of our framework as a useful tool for service development.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"237 ","pages":"Pages 307-315"},"PeriodicalIF":3.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Coping strategies during legally enforced quarantine and their association to psychological distress level: A cross-sectional study” [Public Health 209 (2022) 52–60]","authors":"L. Klee ,&nbsp;A. Fabrice ,&nbsp;N. Eisenburger ,&nbsp;S. Feddern ,&nbsp;C. Gabriel ,&nbsp;A. Kossow ,&nbsp;J. Niessen ,&nbsp;N. Schmidt ,&nbsp;G.A. Wiesmüller ,&nbsp;B. Grüne ,&nbsp;C. Joisten ,&nbsp;on behalf of the CoCo-Fakt-Group","doi":"10.1016/j.puhe.2024.10.014","DOIUrl":"10.1016/j.puhe.2024.10.014","url":null,"abstract":"","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"237 ","pages":"Page 466"},"PeriodicalIF":3.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethnic inequalities in primary care experiences for people with multiple long-term conditions: Evidence from the general practice patient survey","authors":"Brenda Hayanga ,&nbsp;Mai Stafford ,&nbsp;Laia Bécares","doi":"10.1016/j.puhe.2024.10.018","DOIUrl":"10.1016/j.puhe.2024.10.018","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the relationship between ethnicity and experiences of primary care for people with multiple long-term conditions (MLTCs) and assess the relative importance of demographic, practice, and area-level factors as influences on primary care experiences across ethnic groups.</div></div><div><h3>Study design</h3><div>A retrospective study using 2018–19 GP Patient Survey data linked to General Practice Workforce data and small area data published by the Office for National Statistics.</div></div><div><h3>Methods</h3><div>We conducted multilevel regression analysis to assess the relationship between ethnicity and experience of accessing primary care and interacting with healthcare professionals. We built separate regression models for each outcome and included (i) each covariate separately, (ii) demographic factors and (iii) demographic, practice, and area-level factors.</div></div><div><h3>Results</h3><div>Upon full adjustment Arab, Bangladeshi, Chinese, Indian, Pakistani, other Asian, mixed white and Asian, and other white people with MLTCs have lower levels of satisfaction with primary care access and interacting with healthcare professionals compared with white British people. The influence of demographic, practice and area-level factors is not uniform across ethnic groups; demographic factors account for the inequalities in levels of satisfaction with access to primary care between white British people and Black other, mixed other, mixed white &amp; Black Caribbean and Gypsy &amp; Irish Travellers. However, practice and area-level factors strengthen inequalities in the experience of accessing primary care for Bangladeshi, Indian and Pakistani people.</div></div><div><h3>Conclusions</h3><div>Given the link between patient satisfaction and patient-related health outcomes, the lower levels of satisfaction with accessing primary care and interacting with healthcare professionals among the aforementioned minoritised ethnic groups are concerning and require further scrutiny. Qualitative studies are required to understand and address the sources of poor experiences in primary care for minoritised people with MLTCs to improve patient-centred healthcare and outcomes.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"237 ","pages":"Pages 291-298"},"PeriodicalIF":3.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does health anxiety and vaccine concern predict self-reported adverse events following COVID-19 vaccination?–A Danish national cohort study","authors":"Kristoffer Torp Hansen ,&nbsp;Fiona Kusk Povlsen ,&nbsp;Bodil Hammer Bech ,&nbsp;Stefan Nygaard Hansen ,&nbsp;Charlotte Ulrikka Rask ,&nbsp;Per Fink ,&nbsp;Henrik Nielsen ,&nbsp;Thomas Meinertz Dantoft ,&nbsp;Sanne Marie Thysen ,&nbsp;Dorte Rytter","doi":"10.1016/j.puhe.2024.10.007","DOIUrl":"10.1016/j.puhe.2024.10.007","url":null,"abstract":"<div><h3>Objectives</h3><div>The nocebo effect refers to an expectation of sickness that leads to sickness in the expectant. Studies have found COVID-19 vaccines to be associated with the nocebo effect. However, the literature in this field is sparse yet important with the continuation of booster vaccines.</div></div><div><h3>Study design</h3><div>National cohort study.</div></div><div><h3>Methods</h3><div>This study used data from the Danish national cohort “BiCoVac”, which contains self-reported information on both health anxiety and specific COVID-19 vaccine concern, as well as 19 systemic AEs following COVID-19 vaccination. Simple and multiple logistic regression was used to estimate the association between health anxiety and specific COVID-19 vaccine concern with having one or more systemic AEs following COVID-19 vaccination. Inverse probability weights were used to compensate for the initial dropout and loss to follow-up.</div></div><div><h3>Results</h3><div>Of the 85,080 participants in the study, 4 % reported health anxiety, 30 % reported specific COVID-19 vaccine concern, and 26 % one or more systemic AEs following vaccination. After adjusting for covariates, participants with health anxiety had higher odds of reporting one or more systemic AEs following vaccination compared to those without (OR, 1·21 CI 95 % [1·10; 1·33]). For specific COVID-19 vaccine concern, the OR was 1·51 CI 95 % [1·45; 1·58].</div></div><div><h3>Conclusions</h3><div>Participants with specific COVID-19 vaccine concern had higher odds of reporting one or more systemic AEs following vaccination compared with those who had no specific COVID-19 vaccine concern. There might be a potential to reduce AEs, with positive framing of AEs and information about nocebo. Reporting of AEs was also associated with health anxiety, but to a lesser degree.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"237 ","pages":"Pages 299-306"},"PeriodicalIF":3.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental support in adolescence: A potential moderator of the relationship between racial discrimination and adult suicidality","authors":"Natalie Guerrero ,&nbsp;Fangqian Ouyang ,&nbsp;Patrick Monahan ,&nbsp;Steven A. Brown ,&nbsp;Tamika C. Zapolski ,&nbsp;Matthew C. Aalsma","doi":"10.1016/j.puhe.2024.10.005","DOIUrl":"10.1016/j.puhe.2024.10.005","url":null,"abstract":"<div><h3>Objectives</h3><div>It is critical to understand supportive factors that may help mitigate the negative effects of racial discrimination on mental health. Supportive family environments positively impact adolescent health, yet less is known about the impact of family support on adult health outcomes as a consequence of experiences of racial discrimination. The primary objective of this study was to evaluate parental support in adolescence as a potential moderator of the relationship between racial discrimination and mental health, specifically stress and suicidality, in adulthood.</div></div><div><h3>Study design</h3><div>Secondary data analysis.</div></div><div><h3>Methods</h3><div>We performed a secondary data analysis using data from waves I (grades 7–12), IV (ages 24–32), and V (ages 32–42) of the National Longitudinal Study of Adolescent to Adult Health (N = 1523).</div></div><div><h3>Results</h3><div>Univariate logistic regression models showed that racial discrimination was significantly associated with an increased likelihood of suicidality in adulthood (Odds Ratio = 12.94, 95 % Confidence Interval = [4.69, 35.73]). Multivariate models showed similar findings. Racial discrimination was also significantly associated with increased stress scores in adulthood, though with a small effect. Maternal, paternal, and overall parental support in adolescence did not moderate these relationships. This remained true in racial and ethnic subgroup analyses.</div></div><div><h3>Conclusions</h3><div>Parental support includes a variety of behaviors that may not have been fully captured in the measures used in this study. Potential moderating effects should be evaluated using alternative measures of parental support that may better capture these behaviors.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"237 ","pages":"Pages 276-281"},"PeriodicalIF":3.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residual loneliness in the Netherlands after the COVID-19 pandemic: An application of the single interrupted time series design with pre-, peri- and post-pandemic observations","authors":"Theo G. van Tilburg","doi":"10.1016/j.puhe.2024.10.023","DOIUrl":"10.1016/j.puhe.2024.10.023","url":null,"abstract":"<div><h3>Objectives</h3><div>During the COVID-19 pandemic, many countries implemented policies to physically separate citizens. As a consequence, an increased prevalence of loneliness was observed. This article examined whether the prevalence of loneliness in the Netherlands has returned to pre-pandemic levels after the restrictive policy was ended. We studied age differences in the course of loneliness.</div></div><div><h3>Study design</h3><div>Single interrupted time series design.</div></div><div><h3>Methods</h3><div>Data were from the Longitudinal Internet Studies for the Social Sciences (age range 16–102 years) and the Longitudinal Aging Study Amsterdam (age range 65–101 years). Both studies included respondents sampled from the Dutch population registers. Data collected relatively soon and later after the pandemic outbreak (nine and five observations in 2020–2023, respectively) were compared to extrapolated trend data based on a long period of time before the outbreak (since 2008 and 1992, respectively).</div></div><div><h3>Results</h3><div>With two exceptions, the results of the two studies including five age categories and three types of loneliness measurement instruments showed that after an increased prevalence during the pandemic, prevalence at the last observation was at or below the level of the extrapolated trend.</div></div><div><h3>Conclusions</h3><div>It is highly likely that the pandemic was indeed an interruption and not a fundamental trend change in loneliness. This shows individuals’ resilience and the ability to reactivate social ties after the interruptive pandemic.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"237 ","pages":"Pages 238-244"},"PeriodicalIF":3.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of local tobacco control policies on the prevalence of smoke-free sports clubs","authors":"Heike H. Garritsen ,&nbsp;Andrea D. Rozema ,&nbsp;Rixt A. Smit ,&nbsp;Ien AM. van de Goor ,&nbsp;Mara van Dooremaal ,&nbsp;Jessica Baars ,&nbsp;Anton E. Kunst","doi":"10.1016/j.puhe.2024.10.025","DOIUrl":"10.1016/j.puhe.2024.10.025","url":null,"abstract":"<div><h3>Objectives</h3><div>In absence of national legislation, local governments may stimulate outdoor sports clubs to become smoke-free. However, it is unknown whether and to what extent such efforts are effective in encouraging sports clubs to adopt a smoke-free policy (SFP). The aim of this study was to assess the association between tobacco control policies of municipalities and the prevalence of SFPs among outdoor sports clubs.</div></div><div><h3>Study design</h3><div>Retrospective, cross-sectional.</div></div><div><h3>Methods</h3><div>Information on Dutch sports clubs (N = 3068) was linked to information on tobacco control policies of municipalities (i.e., “smoking prevention policies”, “smoke-free environment policies”, and “smoke-free sports policies”) (N = 218). Multilevel logistic regression models examined the association between municipal tobacco control policies and the prevalence of SFPs among outdoor sports clubs, while controlling for sports clubs’ characteristics.</div></div><div><h3>Results</h3><div>We found a positive, dose-response association between tobacco control policies of municipalities and the prevalence of SFPs among outdoor sports clubs. The odds of having an SFP in place was significantly higher for sports clubs in municipalities with moderate “smoking prevention policies” (OR = 1.85, 95%CI = 1.18–2.89), strong “smoke-free environment policies” (OR = 1.95, 95%CI = 1.19–3.20), and strong “smoke-free sports policies” (OR = 1.66, 95%CI = 1.02–2.24) compared to sports clubs in municipalities with no/weak policies.</div></div><div><h3>Conclusions</h3><div>The results suggest that local tobacco control policies can increase the prevalence of SFPs among outdoor sports clubs. In order to create maximum effect, local policies need to be comprehensive and widely implemented.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"237 ","pages":"Pages 270-275"},"PeriodicalIF":3.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimation of HIV prevalence at the ZIP code-level in Atlanta, Georgia: Bayesian prediction modeling using passive surveillance data and social determinants of disease spreading","authors":"Enrique M. Saldarriaga,&nbsp;Anirban Basu","doi":"10.1016/j.puhe.2024.10.019","DOIUrl":"10.1016/j.puhe.2024.10.019","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to predict the number of undiagnosed HIV cases at the ZIP Code-level in Atlanta, Georgia, based on publicly available information.</div></div><div><h3>Study design</h3><div>Statistical modeling.</div></div><div><h3>Methods</h3><div>We fitted a Bayesian hierarchical Binomial model to county-level estimates of the passive-surveillance-system. The denominator was the true total HIV cases arising from a Negative Binomial distribution. The trial probability, known as ascertainment probability, depended on socio-economic determinants of HIV, retained via feature-selection algorithms. Data were obtained from CDC's HIV report for End of the HIV Epidemic and the American Community Survey. The prediction model was assessed out-of-sample in Georgia counties. We combined socio-economic data with the posterior predictive distribution of the coefficients to predict the mean ascertainment probability and total HIV cases at the ZIP Code-level. These estimates were spatially smoothed and aggregated at the county-level for secondary validations.</div></div><div><h3>Results</h3><div>The county-level model showed good mixing properties and predictive accuracy. The mean ascertainment probability calibrated to the ZIP Code-level varied from 78.4% (95% credible interval: 24.4%–99.3%) to 93.8% (95%CI: 80.6%–99.8%). Further, the predicted undiagnosed HIV cases ranged between 12 (95%CI: 6–19; ZIP Code 30322) to 1603 (95%CI 1209–1968; ZIP Code 30318).</div></div><div><h3>Conclusions</h3><div>Our findings provide a more complete picture of the relative burden of HIV across ZIP codes. Such information can be used by Local Health Departments to identify underserved areas and allocate resources accordingly. Furthermore, our methodological approach can be applied to complement the information obtained from passive surveillance, especially when more resource-intensive approaches are not available or are unfeasible to employ.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"237 ","pages":"Pages 282-290"},"PeriodicalIF":3.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating vaccine procurement and financing challenges in Cameroon: Insights and recommendations from a mixed-methods study (2015–2020)","authors":"Yauba Saidu ,&nbsp;Budzi Michael Ngenge ,&nbsp;Sangwe Clovis Nchinjoh ,&nbsp;Adidja Amani ,&nbsp;Nnang Nadege Edwidge ,&nbsp;Nkwain Jude Muteh ,&nbsp;Marius Zambou Vouking ,&nbsp;Clarence Mbanga ,&nbsp;Valirie Ndip Agbor ,&nbsp;Diaby Ousmane ,&nbsp;Andreas Ateke Njoh ,&nbsp;Owens Wiwa ,&nbsp;Emmanuele Montomoli ,&nbsp;Sue Ann Costa Clemens ,&nbsp;Ralf Clemens","doi":"10.1016/j.puhe.2024.10.001","DOIUrl":"10.1016/j.puhe.2024.10.001","url":null,"abstract":"<div><h3>Objectives</h3><div>Vaccine stockouts at the national level has been recognized as a critical challenge in ensuring sustained and equitable immunization coverage. These stockouts often arise from inherent issues within countries, including delays in government funding, suboptimal forecasting and stock management practices, and inefficiencies in the procurement process amongst others. Understanding the complexities and barriers within vaccine procurement and financing systems is crucial for developing effective strategies to enhance vaccine availability and strengthen immunization programs. This is particularly relevant in the context of reaching zero dose children and transitioning from Gavi. This study aimed to comprehensively assess the vaccine procurement and financing landscape in Cameroon from 2015 to 2020.</div></div><div><h3>Study design</h3><div>This was a descriptive cross-sectional study.</div></div><div><h3>Methods</h3><div>Employing a mixed-methods approach, we conducted a desk review of pertinent documents and engaged in in-depth interviews with key stakeholders involved in the procurement and funding mobilization processes. Through data collection and analysis using Microsoft Excel 365 and Dedoose software, we delineated the intricacies of the procurement process and pinpointed specific barriers that have contributed to vaccine stockouts.</div></div><div><h3>Results</h3><div>The mapping of vaccine procurement processes revealed complexity, protracted timelines, and the involvement of multiple stakeholders. The Expanded Program on Immunization (EPI) faced a USD 4 million funding deficit for vaccine procurement between 2016 and 2019. Consequently, the program experienced delays in acquiring 20 million vaccine doses, leading to 41 months of stockout for at least one antigen. Major bottlenecks identified by key stakeholders in vaccine procurement and financing encompassed delayed fund mobilization, inefficient and lengthy processes for fund mobilization and disbursement, poor data utilization, and discrepancies between forecasted, allocated, and mobilized funds.</div></div><div><h3>Conclusion</h3><div>The findings of this research hold significant implications for many EPIs. By elucidating procurement and financing challenges, we can formulate evidence-based recommendations aimed at optimizing resource allocation, streamlining procurement processes, and bolstering vaccine availability. These insights are essential for fostering collaboration between government agencies, technical partners, and financial partners to achieve sustainable vaccine access in Cameroon. Establishing a joint procurement working group could streamline processes, potentially reducing stockouts and improving vaccine coverage.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"237 ","pages":"Pages 261-269"},"PeriodicalIF":3.9,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}