क्लिनिकल और सेलुलर इम्यूनोलॉजी जर्नल
खुला एक्सेस

अमूर्त

Assessing the Fidelity of the Malaria Vaccine Implementation in Malawi

Parth K. Patel*, Linda Alinane Nyondo-Mipando, Noel Kalanga

Globally, remarkable progress has been made in the fight against malaria over the last two decades, yet the rate of reduction of malaria case incidence and mortality seems stalled. Globally, malaria case incidence (i.e., cases per 1000 population at risk) reduced from 80 to 58 and only to 57 in 2019. Mosquirix (RTS, S/AS01), a four-dose malaria vaccine with an effectiveness of 39%, was piloted by the WHO in three countries including Malawi where it was integrated into the EPI as a regular schedule dose. Fidelity was assessed to evaluate the degree of adherence to the planned protocol for the roll out of the program. This is a qualitative study that used the implementation fidelity framework where 12 healthcare workers were interviewed, 47 parents attended 2 focused group discussions, and a non-participatory observation checklist determined the status of vaccine storage and administration, in 2 separate health centers serving as immunization clinics. Framework approach analysis was used in this study. 59 participants were interviewed in this study. 12 health workers that were interviewed, 2 (17%) were female and 10 (83%) were male whereas all 47 (100%) parents were female. The average age of HCWs was 38 years while for the parents it was 29 years. The study demonstrated fidelity to the malaria vaccine protocol but to a much lesser extent. It has to some extent been implemented with fidelity and there is demonstrable adherence to the vaccine protocol, nevertheless, numerous gaps still exist.