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Abstract/Syllabus:

Problem Solving for Immunization Programs

Winter 2004


© 1995 CCP, Courtesy of Photoshare

A health worker immunizes an infant in Nepal.

Course

Instructor

Michael McQuestion

Offered By

Population and Family Health Sciences

Description

Countries around the world - even those at war - are collaborating to ensure that children under the age of five don't die from diseases for which vaccines are available. In the past twenty years, global vaccine coverage has surpassed eighty percent, and a second disease, polio, is nearly eradicated. In the United States, coverage rates are even higher, and vaccine-preventible diseases are now rare. Never have so many resources been focused on immunization - yet problems remain. Additional, highly effective vaccines have been developed but still do not reach the majority of children. More worrisome, currently high immunization rates may be unsustainable for a number of reasons.

This material will cover immunization basics and survey the public health, sociological, and economic literature, identifying and analyzing common problems using a standard problem-solving approach. Topics will span developed and developing countries and will include vaccine-delivery strategies, program management and supervision, epidemiological surveillance, community participation, and disease eradication. Students will analyze actual vaccination data using the U.S. Center for Disease Control's CASA software program. Once you've completed the course, you should have gained the necessary tools to identify and formulate innovative solutions to common problems faced by immunization program managers and policymakers.

Syllabus

Course Description

Countries around the world - even those at war - are collaborating to ensure that children under the age of five don't die from diseases for which vaccines are available. In the past twenty years, global vaccine coverage has surpassed eighty percent, and a second disease, polio, is nearly eradicated. In the United States, coverage rates are even higher, and vaccine-preventible diseases are now rare. Never have so many resources been focused on immunization - yet problems remain. Additional, highly effective vaccines have been developed but still do not reach the majority of children. More worrisome, currently high immunization rates may be unsustainable for a number of reasons.

In this course, we will cover immunization basics and survey the public health, sociological, and economic literature, identifying and analyzing common problems using a standard problem-solving approach. Topics will span developed and developing countries and will include vaccine-delivery strategies, program management and supervision, epidemiological surveillance, community participation, and disease eradication. Students will analyze actual vaccination data using the U.S. Center for Disease Control's CASA software program. Once you've completed the course, you should have gained the necessary tools to identify and formulate innovative solutions to common problems faced by immunization program managers and policymakers.

Course Objectives

This course will provide you with a multidisciplinary perspective on the organization, requirements, and logistics of vaccination programs. After completing this course, you should be able to do the following:

  • Discuss the basic methods of logistics, monitoring, and surveillance
  • Explain how logistics, monitoring, and surveillance are used in disease eradication efforts.
  • Identify and solve program inefficiencies and barriers to program performance.
  • Design and evaluate immunization program problem-solving interventions with the theoretical background you'll receive in this course.

Readings

There is no required textbook. For most lectures, there will be both required and recommended readings drawn from various journals. All articles will be available in PDF format.

Course Topics

The course covers the following topics:

  • The anatomy of an immunization program
  • Surveillance and field measurement tools
  • Methods for improving immunization provider performance
  • Constituents of an eradication strategy: The case of polio
  • Health behavioral models
  • Theories and examples of community action
  • Future directions for immunization

Course Format

The course will consist of:

Lectures: There will be two weekly lectures, each approximately 1.25 hours long. The lectures are organized into modules which correspond to different dimensions of immunization programs. Salient points of the lectures are highlighted in the accompanying slide presentations, as are the corresponding reading assignments. Once the lectures have been posted, you may return to them for review at any point during the course.

Readings: There is no required textbook. For most lectures, there will be both required and recommended readings drawn from various journals. All articles will be available in PDF format.

Practical Exercises: Students will download a software program called CASA, which they will use for the CASA exercises. The exercises will entail analyzing vaccination records from several immunization centers and producing reports.


LiveTalk Sessions: The instructor will lead four online LiveTalk sessions for the purpose of answering questions, reviewing exercises, and moderating the exchanges between students. There also will be an electronic bulletin board in which students may post any course-related messages.

Self-Evaluation Quizzes: Following most lectures, online "quizzes" will be provided to help students assess their progress in understanding the lectures and readings. The quizzes will be graded.

Small Group Exercises: The class will be divided into small groups. Each group is required to complete three exercises and the groups will be graded. Details will be provided during the course.

Final Exam: At the end of the course, students will take an exam which will cover material from the course. Details will be provided during the course.

Course Grades

Students will be expected to submit exercises on time and to participate actively in the LiveTalk sessions and BBS discussions. Grades will be computed as follows:

Participation: 5%
Final exam: 25%
Practical exercises: 70%

  1. CASA: 10%
  2. Quizzes: 30%
  3. Small Group Exercises: 30%

Extra Credit: 6%

The final letter grade will be based on a point system:
A = 90 - 100
B = 80 - 89
C = 70 - 79
P = 70 + (For those taking the course pass/fail)
D = 60 - 69
F = < 59

Schedule

TOPIC ACTIVITIES
Module 1: Problem Solving and Measurement Approaches
Course Introduction Lecture 0
Vaccines and Vaccination Program Essentials Lecture 1
Lecture 1 Readings Quiz 1
Introduce Yourself BBS Assignment
Local Immunization Assessment Exercise 1
Measurement Concepts and Problem-Solving Paradigm Lecture 2
Lecture 2 Readings Quiz 2
Discussing Exercise 1: Problem-Solving Case Studies LiveTalk 1
Module 2: Delivering Vaccines
Delivery Strategies, Cold Chain, and Logistics Lecture 3
Monitoring, Surveillance, and Feedback Lecture 4
Lectures 3 & 4 Readings Quiz 3
WHO Technet Extra Credit #1
Module 3: Improving Provider Performance
Improving Provider Performance Lecture 5
Clinical Assessment Software Application CASA Tutorial
Using CASA to Analyze Provider Data CASA Assignment
Registries, Reminders, and Recalls Lecture 6
Lecture 5 & 6 Readings Quiz 4
Small Group: Analysis of Facility Assessment Data Exercise 2
Small Group: Analysis of Facility Performance Using CASA Exercise 3
U.S. Immunization Program CASA/AFIX Extra Credit #2
Discussion on Provider Inefficiencies LiveTalk 2
Module 4: Creating and Sustaining Vaccine Demand
Quality of Care Lecture 7
Health Behaviors, Social Learning, and Collective Action Lecture 8
Lectures 7 & 8 Readings Quiz 5
Small Group: Analysis of KAP Survey from Local Immunization Coverage Assessment Form Exercise 4
Evaluation of Peers from Small Groups Peer Evaluation
Discussion of Immunization Behaviors and Sustainability LiveTalk 3
Module 5: Disease Eradication and Future Directions
Eradication, Part 1: Polio Lecture 9
Eradication, Part 2: Measles Lecture 10
Sustaining Immunization Supply Lecture 11
Lectures 9 & 10 Readings Quiz 6
GAVI Extra Credit #3
Sustaining Immunization Demand Lecture 12
Course Recap and Projecting to the Future LiveTalk 4
  Final Exam
Course Evaluation
  Course Evaluation



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