CIHR Catalyst Grant: Health Equity

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Health Interventions for Equity: The rollout of the new Meningococcal A vaccine in sub Saharan Africa [Pending funding]

Total amount requested: $74,998.00

 Principal Investigator:

• Dr. Janice E. Graham

Co-Applicants:

• Dr. Alexander Borda-Rodriguez
• Dr. Sylvie Fortin
• Dr. Scott Halperin

A new meningococcal serogroup A conjugate vaccine, MenAfriVac, is the first vaccine developed, manufactured and to be licensed in the global south for use in developing countries, it is scheduled for introduction in the west African country of Burkina Faso in April-May, 2010.

This pilot project will examine the actors and activities involved in the planning and actual implementation of MenAfriVac in Burkina Faso. The manner in which decision-makers and citizens develop, plan for the implementation, respond, accommodate or resist a new vaccine intervention requires baseline evaluation and subsequent attentive monitoring and analysis. The rollout of MenAfriVac across Burkina Faso, vaccinating the entire population aged 1 to 29 years of age, offers a unique opportunity to gather and analyse essential historical, socio-cultural, economic, political, environmental and epidemiological events related to the vaccine development and country-wide intervention. We will collect qualitative data through ethnographic methods, and collate with quantitative data from the district of Nouna, Burkina Faso. The data collected in this study will be analysed towards the goal of developing an analytical decision-making model applicable for vaccines and other health technologies in developing countries. To this end, we have brought together a team of partnered collaborators that include WHO, the Program for Appropriate Technologies in Health/Meningitis Vaccine Project (PATH/MVP), the MultiDisease Surveillance Centre in Ouagadougou, Ministry of Health of Burkina Faso, and the Centre de Recherche en Santé de Nouna (CRSN). The roles and interconnections of local, national and international organizations, as well as multi-dimensional on-the-ground socio-cultural, historical, economic, and political factors that lead to differential health concerns and responses will be studied, with attention to lessons learned and improvement on vaccine decisionmaking models for the future.

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 Equity issues in vaccine coverane and triage for crtitical care: Key lessons from H1N1.09 [Pending funding]

Total amount requested: $74,932.00

 Principal Investigator:

• Dr. Janice E. Graham

Co-Applicants:

• Dr. Amrita Mishra

This catalyst application will address key social, ethical and policy issues pertaining to equity issues in vaccine coverage and triage in the H1N1 influenza pandemic. The research will assess the policies and practices for vaccine coverage in Nova Scotia in order to suggest ways to improve vaccine coverage for vulnerable populations, including First Nations and rural communities in Nova Scotia. Improved vaccine coverage for vulnerable populations, including First Nations and rural communities, may reduce the pressure on healthcare resources. Such pressure is related to triage, the process of assessing patients for the urgency of their access to critical care resources such as ventilators. Thus the research will also examine the infrastructure and practices for performing triage in the second wave of H1N1/09. The research will be conducted by medical anthropologists based at the Technoscience and Regulation Research Unit, in the Faculty of Medicine, Dalhousie University. The methods are primarily qualitative, including documentary review and analysis, primary on-site observational data collection, and interviews and focus groups of patients and health care professionals. The ethnographic sites include the Queen Elizabeth II Health Sciences Centre for tertiary care and the IWK Health Centre for paediatric care facilities at Halifax, Nova Scotia.