• Health Policy and Management
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• v.32 no.3
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• pp.272-281
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• 2022

With the outbreak of coronavirus disease 2019 (COVID-19) pandemic, health policymakers are adopting new policies regarding the issue of immunization disparities, especially for children in low-income communities of color who lack awareness and thereby access to vaccines. The purpose of this paper is to propose an evaluation framework using program theory-based evaluation approach and logic model to analyze and evaluate the immunization disparities in children aged 19-35 months. Data is collected from New York City department of Health and the U.S. Census Bureau for Northern Manhattan Start Right Coalition program which consists of 19,800 children, and the community-provider partnership includes 26 practices and 20 groups. Program theory is used to evaluate this community-based initiative with the logic model which is a visual depiction that illustrations the program theory to all stakeholders. The logic model highlights the resources, activities, outputs, outcomes, and impacts of the program to guide to planners and evaluators and to call attention to the inadequacies or flaws in the operational, implementation and service delivery process of the program in offering a new perspective on the program. This framework adds to the literature on evaluations of immunization disparities in determining whether evaluators can definitively attribute positive immunization outcomes in the community to the program and conclude whether it has potential in expanding or duplicating it to other similar settings, especially in other rural areas of the United States, and abroad, where routine immunization equity gaps are wide due to income, racial and ethnic diversity, and language barrier.

• Health Policy and Management
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• v.13 no.2
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• pp.67-84
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• 2003

Immunization has been one of the most effective measures preventing from infectious diseases. However, children routine vaccination rate of Korea was 68.2% and it was not higher than expected. Korean government revised the School Health Law for every primary school children to submit the vaccination certificate record from 2005. It is quite important national Infectious disease prevention policy to keep the immunizations rate high and monitor the immunizations rate continuously. To do this, National Institute of Health introduced the National Immunization Registry(NIR) Program at 2000. Objective : The aims of this study was to evaluate the Immunization Registry program which has been implementing since 2000 at the Public Health Centers(PHC). Methods : The mail survey was done from November 2001 to January 2002. 169 (69%) Public Health Centers among 244 PHC were responded. Results : The respondents of PHC sud the Immunization Registry(IR) program had reduced the workload (18.5%). 69.2% said they inputted the immunization data into the IR program after the shots were given. 86.5% said they hadn´t checked or retrieved the children lists who had missed the scheduled immunization. Only 17.2% said the speed of internet for the R program was good. It showed that 20% of respondents hadn´t written down documents, records on immunization any more. Even there were a lot of negative results, the respondents of PHC thought that the IR program was effective. They especially agreed that the IR program could make the job accurate (81.5%), convenient (71.3%), and reduced the chances of making mistakes (71.3%), increase the service quality (78.5%). And they were well adapting the job process of the IR (79.63%). Bivariate analysis showed that the software program was the important determinants of IR success. The only Bit Computer software program has been evaluated to be less satisfactory than the Integrated (Posdata operating system + Bit software) program. Other variables, such as age, duration of present job, and location of PHC (metropolitan, small city, rural area) were not significantly related. Conclusion : It seemed that the success of NIR might depend on the software program. Because Integrated program, which has been developed from 1994, include not only the general operating and management program for PHC but also IR program. It was natural to prefer Integrated program to Bit software program. So we can suggest that it is essential for the NIR to be successful that not only the immunization software program but also hardware equipments and public health information system should be further improved.

• Journal of agricultural medicine and community health
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• v.29 no.1
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• pp.65-75
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• 2004

Objectives: Immunizations have been one of the most effective measures preventing from infectious diseases. It is quite important national infectious disease prevention policy to keep the immunizations rate high and monitor the immunizations rate continuously. To do this, Korean CDC introduced the National Immunization Registry Program(NIRP) which has been implementing since 2000 at the Public Health Centers(PHC). The National Immunization Registry Program will be near completed after sharing, connecting and transfering vaccination data between public and private sector. The aims of this study was to evaluate the immunization module of non-chart system in private clinic with health information system of public health center(made by POSDATA Co., LTD) and immunization registry program(made by BIT Computer Co., LTD). Methods: The analysis and survey were done by specialists in medical, health field, and health information fields from 2001. November to 2002. January. We made the analysis and recommendation about the immunization module of non-chart system in private clinic. Results and Conclusions: To make improvement on immunization module, the system will be revised on various function like receipt and registration, preliminary medical examination, reference and inquiry, registration of vaccine, print-out various sheet, function of transfer vaccination data, issue function of vaccination certification, function of reminder and recall, function of statistical calculation, and management of vaccine stock. There are needs of an accurate assessment of current immunization module on each private non-chart system. And further studies will be necessary to make it an accurate system under changing health policy related national immunization program. We hope that the result of this study may contribute to establish the National Immunization Registry Program.

• Journal of agricultural medicine and community health
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• v.30 no.2
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• pp.183-204
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• 2005

Objectives: Immunization program is essential public health service under the national responsibility. One of the immunization service of national immunization program is advertising and public relation service, but research for that was rarely conducted. Therefore we conducted the survey for developing advertising strategy of immunization program in 21th century. Methods: Our study subjects were 242 health workers in immunization service department of 169 health centers and 1,193 carers who visited community health center for receiving immunization service of their children. The major questions were general characteristics of the subjects, perceived importance of immunization program, experience of advertising, knowledge and perception about immunization, and items about advertising strategy. Results: Frequently exposed materials in both health workers and carers were TV, community newspapers, and pamphlets. Health workers had high professional knowledges of immunization and carers had high perceptions for need and importance of immunization. Health workers preferred pamphlets and posters as advertising materials and carerers preferred TV and community newspapers. Both health workers and carers preferred green and yellow as advertising posters' color, active and healthy style of immunization advertising, and positive messages of campaign's slogans. Conclusions: Further researches should be conducted for precising long-term immunization advertising strategy in 21th century, and for this we need to develop advertising materials based on public needs and strategy, and evaluate the materials. The national immunization program should be activated throughout more investment of the budgets and human powers.

• Journal of Preventive Medicine and Public Health
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• v.45 no.4
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• pp.267-275
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• 2012

Objectives: This study was conducted to assess the potential health impacts and improve the quality of the free immunization program in Jinju City by maximizing the predicted positive health gains and minimizing the negative health risks. Methods: A steering committee was established in September 2010 to carry out the health impact assessment (HIA) and began the screening and scoping stages. In the appraisal stage, analysis of secondary data, a literature review, case studies, geographic information systems analysis, a questionnaire, and expert consultations were used. The results of the data collection and analyses were discussed during a workshop, after which recommendations were finalized in a written report. Results: Increased access to immunization, comprehensive services provided by physicians, the strengthened role of the public health center in increasing immunization rates and services, and the ripple effect to other neighboring communities were identified as potential positive impacts. On the other hand, the program might be inaccessible to rural regions with no private clinics where there are more at-risk children, vaccine management and quality control at the clinics may be poor, and vaccines may be misused. Recommendations to maximize health gains and minimize risks were separately developed for the public health center and private clinics. Conclusions: The HIA provided an opportunity for stakeholders to comprehensively overview the potential positive and negative impacts of the program before it was implemented. An HIA is a powerful tool that should be used when developing and implementing diverse health-related policies and programs in the community.

• Research in Community and Public Health Nursing
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• v.17 no.2
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• pp.283-294
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• 2006

Purpose: The purpose of this study was to identify the factors influencing childhood immunization. Method: Data were collected by questionnaires from 251 Parents who have 6 months to 7 years old children at public health centers in Seoul and Kyunggi Province. The data were analyzed using descriptive statistics, t-test, ANOVA, and multiple regression. Result: According to general characteristics of the parents and children, there were statistically significant differences in education level of parents, child immunization card, gender, age, and birth order of children. The main factors that affected children's immunization were perceived barriers of action, perceived control, birth order of children, child immunization card, and education level of parents, and these factors explained 49.4%(explanatory power of this model was 49.4%). Conclusion: The results of this study showed strategies for compliance of children immunization. Therefore, when the program are developed for public immunization, these factors need to be considered.

• Health Policy and Management
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• v.18 no.3
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• pp.58-89
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• 2008

The purpose of this study was to evaluate comparatively the content of the Expanded National Immunization Program according to the provision method between 2005 and 2006 in Korea. We assessed the impact of the mutually exclusive vaccination policy using the result reports of the 2005 and 2006 Demonstration Project and the related references by the content analysis. The public health centers paid vaccination fees to the private clinic and hospital in the 2005 Demonstration Project in Daegu metropolitan city and Gunpo city. But, the public health centers directly supplied free vaccination services to the children in the 2006 Demonstration Project in Gangneung city, Yangsan city, and Yeongi-gun. The total budgets of 2005 and 2006 Demonstration Project were 6.57 billion won and 0.65 billion won, respectively. The computerized registration rates and timeliness rates of administration of each vaccination had improved all in the 5 Demonstration Project regions. However, the computerized registration rates of most vaccination in Gunpo city were higher than those in the 2006 Demonstration Project regions except hepatitis B. Especially, the computerized registration rate of BCG was 48.3%, but the BCG coverage rate by the follow-up telephone survey was 99.8% in Daegu metropolitan city. The community parents in all the regions were satisfied because of expanding financial and geographical access to immunization coverage. In conclusions, from the aspect of the main outcomes, the implementation of two different financial immunization aids appears to be widely accepted among these parents and to have had an impact on vaccination coverage. In the future, the government must try to enact that the national immunization policy including under-immunised or incompletely immunised groups would be achieved by the affordable method of the public-private dynamics.

• Journal of Korean Public Health Nursing
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• v.23 no.1
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• pp.113-128
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• 2009

Purpose: To explore the barriers and solutions of immunization programs for children among vulnerable classes in the position of service providers in Community health centers. Method: Data were collected through focus group interviews with 3 groups (17 providers), and were analyzed according to the analytic method of Morgan (1998) and Krueger (1998). Results: The following five categories were identified: difficulties in obtaining a list of children among vulnerable classes, difficulties in first contact with them, difficulties in up-to-date immunization, various difficulties according to the types of vulnerable family and suggestions of solution. These results indicated that there are many difficulties in providing expanded immunization service for children among vulnerable classes in terms of manpower, cooperation of departments in public health centers and linkages between health and welfare. Finally, the characteristics of the types of vulnerable family need to be elucidated. Conclusion: To increase immunization rates among children of vulnerable classes, policies need to be prepared at the public health organization itself and the linkages between health and welfare and need for hiring additional personnel.

• Clinical and Experimental Pediatrics
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• v.59 no.12
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• pp.461-465
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• 2016

This report includes the recommended immunization schedule table for children and adolescents based on the 8th (2015) and revised 7th (2012) Immunization Guidelines released by the Committee on Infectious Diseases of the Korean Pediatric Society (KPS). Notable revised recommendations include: reorganization of the immunization table with a list of vaccines on the vertical axis and the corresponding age on the horizontal axis; reflecting the inclusion of Haemophilus influenzae type b vaccine, pneumococcal conjugate vaccine, and hepatitis A vaccine into the National Immunization Program since 2012; addition of general recommendations for 2 new Japanese encephalitis (JE) vaccines and their interchangeability with existing JE vaccines; addition of general recommendations for quadrivalent meningococcal conjugate vaccines and scope of the recommended targets for vaccination; and emphasizing catch-up immunization of Tdap vaccine. Detailed recommendations for each vaccine may be obtained from the full KPS 8th Immunization Guidelines.

• Journal of Preventive Medicine and Public Health
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• v.55 no.2
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• pp.193-204
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• 2022

Objectives: The primary objective of this study was to examine the effect of women's empowerment on the immunization of Indonesian children. The secondary objective was to examine the effect of wealth as a factor modifying this association. Methods: We utilized data from the 2017 Indonesian Demographic and Health Survey (IDHS). The subjects were married women with children aged 12-23 months (n=3532). Complete immunization was defined using the 2017 IDHS definition. Multiple components of women's empowerment were measured: enabling resources, decision-making involvement, and attitude toward intimate partner violence. The primary analysis was conducted using binomial logistic regression. Model 1 represented only the indicators of women's empowerment and model 2 controlled for socio-demographic variables. Subgroup analyses were conducted for each wealth group. Results: The primary analysis using model 1 identified several empowerment indicators that facilitated complete immunization. The analysis using model 2 found that maternal education and involvement in decision-making processes facilitated complete immunization in children. Subgroup analyses identified that wealth had a modifying effect. The indicators of women's empowerment were strong determinants of complete immunization in lower wealth quintiles but insignificant in middle-income and higher-income quintiles. Conclusions: To our knowledge, this study is the first to explore women's empowerment as a determinant of child immunization in Indonesia. The results indicate that women's empowerment must be considered in Indonesia's child immunization program. Women's empowerment was not found to be a determinant in higher wealth quintiles, which led us to rethink the conceptual framework of the effect of women's empowerment on health outcomes.