HP2C: Health Program Evaluation of Immunization Safety - Essay Example

Immunization Safety Evaluation: Phases and Stakeholders (Your School) Immunization Safety Evaluation: Phases and Stakeholders One of the most important public health interventions is immunization; hence the safety of vaccine products and the adverse events that follow immunization require careful monitoring. This is because vaccines are administered on a large scale on healthy individuals of all ages. Adverse reactions can follow post-immunization period and these concerns should be promptly identified to allow additional research and appropriate action to take place.

This calls for immunization safety evaluation. Immunization Safety Surveillance is one such undertaking of World Health Organization (WHO, 1999). This paper tries to find out the phases involved in such a program and the importance of stakeholders in them. As Powell (2006) notes in his article that evaluation should answer research questions about a program and that they should occur in real world of the program. Some commonly used general evaluation methods according to Powell (2006) are micro- and macro-evaluation, objective and subjective evaluation and formative and summative evaluation.

A large scale research like immunization safety needs combinations of various methods of evaluation. They may be done in different phases as per guidelines from NIS (2008): Phase I: Formative Evaluation: This phase will be done help improve the program strategy while the program is being implemented. Midcourse corrections can be made at this point. Decision makers will get useful suggestions for improvement by this phase. Phase II: Summative Evaluation: This phase will measure the overall impact of the immunization program and list all the outcomes achieved.

Phase III: Logic Model: A graphic depiction of the program components will be made to show the links between the program activities and the outcomes intended. The final outcome is the overall impact of the program as measured quantitatively by the indicators of the object. Logic Model can be applied along with other phases of the study. Phase IV: Performance Measurements: This phase will provide the timeline as to when should the indicators be measured to see the outputs and the initial outcomes of the program (NIS, 2008).

At some point of evaluation, the main questions that will be assessed are: Identification of rare adverse reactions that could have escaped unnoticed during the post-licensure period and notice any increase in the adverse reactions already known Find more risk factors that would augment the already known adverse reactions Check for the consistency in all the lots of vaccines for reactions Identify signals of adverse reaction that need to be studied more thoroughly Study the current immunization recommendations (like timing and spacing) and the degree to which the vaccine is actually reducing the risk of the disease Level of public confidence in the immunization program in question (CDC, 2012).

The first step in evaluation research is to engage stakeholders (CDC, 2007). Stakeholders are people with vested interest in the program and are affected by the evaluation. There are four categories of stakeholders. They are decision makers, implementers, participants, and partners. Decision makers decide and direct the program and use the evaluation findings. In an immunization safety evaluation research, the decision makers could be immunization program director, program manager, health department director, health commissioner or legislators.

The implementers can be program staff and local public health staff. The participants can be physician, parents and community members. The partners can be healthcare and health plan mangers, or community based organizations. Stakeholders are included in the evaluation process to reduce the distrust and to increase the credibility of the evaluation. Their involvement also increases self-awareness of the evaluation process and makes them more prone to adhere to any recommendation made in the end (Metcalfe, Aitken & Gaff, 2008).

The level of involvement of stakeholders depends on the component of the evaluation, but priority is given to those who have authority to make changes to the process, have capacity to advocate changes, and have the authority to fund the program. The following table lists some categories of stakeholders and their interests and role in an immunization evaluation. Table 1: Stakeholder categories, roles and interest Stakeholder (Title) Interest Role/responsibility Program manger Complete evaluation in time, ensure results are useful and utilized to improve program performance With role as a team leader, inspect data collection, write the evaluation plan and utilize its findings Program coordinator Provide useful feedback to providers Stakeholder liaison, data collection and analysis Field staff Provide useful feedback to providers Provider liaison, data collection Clinical staff Interested in receiving constructive feedback to improve immunization delivery Represents provider’s perspective on feedback Adapted from Wortley & Lorick, CDC.

However, categories and level of involvement of stakeholders depend on context and the stage of development of the program component. In some cases developing a draft report and sharing with the stakeholders in the interpretation of the data collected is sufficient and appropriate as a gesture of their involvement in the process. Immunization being an important health intervention, its safety needs to be evaluated from time to time. Immunization Safety Surveillance, by WHO, is one such large undertaking.

It can be done in different phases and with proper involvement of stakeholders. Reference List CDC. (2007). Guide to Immunization Program Evaluation for Grantees. Retrieved from . CDC (2012). Vaccine Safety. The Pink Book: Course Textbook - 12th Ed. 45-59. Retrieved from . Metcalfe, S., Aitken M. & Gaff, C. (2008). The Importance of Program Evaluation: How Can it be Applied to Diverse Genetics Education Settings? J Genet Counsel, 17:170–79. NIS. (2008). Interim Evaluation of the National Immunization Strategy April 2003 to June 2007.

Public Health Agency of Canada. Retrieved from . Powell, R. (2006). Evaluation Research: An Overview. Library Trends, 55(1), 102-20. WHO. (1999). Immunization Safety Surveillance. WPRO/EPI/99.01. Retrieved from . Wortley, P., & Lorick, S. (2003). Immunization Plan Evaluation: Writing an Evaluation Plan. [PowerPoint slides]. CDC. Retrieved from .