Association of gross domestic product with equitable access to childhood vaccines in 195 countries: a systematic review and meta-analysis

Introduction Gross domestic product (GDP) has been shown to affect government spending on various budget heads including healthcare and the purchase and distribution of vaccines. This vulnerable situation has been exacerbated by the COVID-19 pandemic which disrupted and exposed the fragile nature of...

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Main Authors: Kwabena Obeng Duedu, Yakhya Dieye, Andreas Ateke Njoh, Jerome Nyhalah Dinga, Jones Soladoye Akinbobola, Funmilayo Ibitayo Deborah Afolayan, Tesfaye Kassa, David Dazhia Lazarus, Gezahegne Mamo Kassa, Nefefe Tshifhiwa, Mustapha Oumouna
Format: Article
Language:English
Published: BMJ Publishing Group 2025-01-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/10/1/e015693.full
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author Kwabena Obeng Duedu
Yakhya Dieye
Andreas Ateke Njoh
Jerome Nyhalah Dinga
Jones Soladoye Akinbobola
Funmilayo Ibitayo Deborah Afolayan
Tesfaye Kassa
David Dazhia Lazarus
Gezahegne Mamo Kassa
Nefefe Tshifhiwa
Mustapha Oumouna
author_facet Kwabena Obeng Duedu
Yakhya Dieye
Andreas Ateke Njoh
Jerome Nyhalah Dinga
Jones Soladoye Akinbobola
Funmilayo Ibitayo Deborah Afolayan
Tesfaye Kassa
David Dazhia Lazarus
Gezahegne Mamo Kassa
Nefefe Tshifhiwa
Mustapha Oumouna
author_sort Kwabena Obeng Duedu
collection DOAJ
description Introduction Gross domestic product (GDP) has been shown to affect government spending on various budget heads including healthcare and the purchase and distribution of vaccines. This vulnerable situation has been exacerbated by the COVID-19 pandemic which disrupted and exposed the fragile nature of equitable access to vaccines for childhood immunisation globally. A systematic review and meta-analysis to assess the association of country income status and GDP with vaccination coverage of vaccines for childhood immunisation and other major infectious diseases around the globe will inform global and national policy on equity in living standards and vaccine uptake. This study was carried out to identify factors influenced by GDP that affect access, distribution, and uptake of childhood vaccines around the world using a systematic review and meta-analysis approach.Methods Data were extracted for the burden of major infectious diseases of childhood immunisation programmes, factors affecting access to vaccines, vaccine procurement platforms, vaccination coverage and percentage of GDP used for the procurement of vaccines. Factors influencing the global vaccination coverage rate were also assessed. The protocol was registered on PROSPERO (ID: CRD42022350418) and carried out using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results Data from 195 countries showed that the following infectious diseases had the highest burden; human papillomavirus (HPV), measles, Ebola and yellow fever. Low-income and some lower-middle-income countries (LMICs) used COVAX and UNICEF for vaccine procurement while high-income countries (HICs) preferred national and regional public tenders. Global vaccination coverage for tuberculosis, diphtheria/tetanus/pertussis, hepatitis B, Haemophilus influenzae type b, measles, polio, meningitis and HPV had a significantly higher coverage than COVID-19. Being an HIC and having coverage data collected from 1985 to 2015 as the most current data were associated with high vaccination coverage. The percentage of GDP spent on vaccine procurement did not influence vaccination coverage.Conclusion Low-income countries and LMICs should prioritise vaccine research and improve on development capacity. Countries worldwide should share data on vaccine expenditure, vaccination coverage, and the development and introduction of new vaccines and technologies to facilitate equitable vaccine access.
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spelling doaj-art-76b5d9419d5f4f27919b0f1a604897662025-02-01T00:50:10ZengBMJ Publishing GroupBMJ Global Health2059-79082025-01-0110110.1136/bmjgh-2024-015693Association of gross domestic product with equitable access to childhood vaccines in 195 countries: a systematic review and meta-analysisKwabena Obeng Duedu0Yakhya Dieye1Andreas Ateke Njoh2Jerome Nyhalah Dinga3Jones Soladoye Akinbobola4Funmilayo Ibitayo Deborah Afolayan5Tesfaye Kassa6David Dazhia Lazarus7Gezahegne Mamo Kassa8Nefefe Tshifhiwa9Mustapha Oumouna10Birmingham City University, Birmingham, UKAfrican Vaccinology Network, Buea, CameroonExpanded Program on Immunization, Ministry of Public Health, Yaounde, CameroonMichael Gahnyam Gbeugvat Foundation, Buea, CameroonUniversity of Abuja, Abuja, NigeriaAfrican Vaccinology Network, Buea, CameroonAfrican Vaccinology Network, Buea, CameroonAfrican Vaccinology Network, Buea, CameroonAfrican Vaccinology Network, Buea, CameroonAfrican Vaccinology Network, Buea, CameroonAfrican Vaccinology Network, Buea, CameroonIntroduction Gross domestic product (GDP) has been shown to affect government spending on various budget heads including healthcare and the purchase and distribution of vaccines. This vulnerable situation has been exacerbated by the COVID-19 pandemic which disrupted and exposed the fragile nature of equitable access to vaccines for childhood immunisation globally. A systematic review and meta-analysis to assess the association of country income status and GDP with vaccination coverage of vaccines for childhood immunisation and other major infectious diseases around the globe will inform global and national policy on equity in living standards and vaccine uptake. This study was carried out to identify factors influenced by GDP that affect access, distribution, and uptake of childhood vaccines around the world using a systematic review and meta-analysis approach.Methods Data were extracted for the burden of major infectious diseases of childhood immunisation programmes, factors affecting access to vaccines, vaccine procurement platforms, vaccination coverage and percentage of GDP used for the procurement of vaccines. Factors influencing the global vaccination coverage rate were also assessed. The protocol was registered on PROSPERO (ID: CRD42022350418) and carried out using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results Data from 195 countries showed that the following infectious diseases had the highest burden; human papillomavirus (HPV), measles, Ebola and yellow fever. Low-income and some lower-middle-income countries (LMICs) used COVAX and UNICEF for vaccine procurement while high-income countries (HICs) preferred national and regional public tenders. Global vaccination coverage for tuberculosis, diphtheria/tetanus/pertussis, hepatitis B, Haemophilus influenzae type b, measles, polio, meningitis and HPV had a significantly higher coverage than COVID-19. Being an HIC and having coverage data collected from 1985 to 2015 as the most current data were associated with high vaccination coverage. The percentage of GDP spent on vaccine procurement did not influence vaccination coverage.Conclusion Low-income countries and LMICs should prioritise vaccine research and improve on development capacity. Countries worldwide should share data on vaccine expenditure, vaccination coverage, and the development and introduction of new vaccines and technologies to facilitate equitable vaccine access.https://gh.bmj.com/content/10/1/e015693.full
spellingShingle Kwabena Obeng Duedu
Yakhya Dieye
Andreas Ateke Njoh
Jerome Nyhalah Dinga
Jones Soladoye Akinbobola
Funmilayo Ibitayo Deborah Afolayan
Tesfaye Kassa
David Dazhia Lazarus
Gezahegne Mamo Kassa
Nefefe Tshifhiwa
Mustapha Oumouna
Association of gross domestic product with equitable access to childhood vaccines in 195 countries: a systematic review and meta-analysis
BMJ Global Health
title Association of gross domestic product with equitable access to childhood vaccines in 195 countries: a systematic review and meta-analysis
title_full Association of gross domestic product with equitable access to childhood vaccines in 195 countries: a systematic review and meta-analysis
title_fullStr Association of gross domestic product with equitable access to childhood vaccines in 195 countries: a systematic review and meta-analysis
title_full_unstemmed Association of gross domestic product with equitable access to childhood vaccines in 195 countries: a systematic review and meta-analysis
title_short Association of gross domestic product with equitable access to childhood vaccines in 195 countries: a systematic review and meta-analysis
title_sort association of gross domestic product with equitable access to childhood vaccines in 195 countries a systematic review and meta analysis
url https://gh.bmj.com/content/10/1/e015693.full
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