Vaccines | Free Full-Text | Sustainable Dengue Prevention and Management: Integrating Dengue Vaccination Strategies with Population Perspectives
Four key themes surfaced from the analysis of the expert discussions, which identified the drivers and barriers for a successful dengue prevention and management program. These included the need for health systems to (1) continuously prioritize dengue on the national health agenda, (2) ensure collaboration and coordination among all stakeholders, (3) incorporate population views into educational programs to elicit behavioral change, and (4) design these programs for sustainability. These findings served as an additional perspective for dengue prevention and management programs in general and were not specific to a particular strategy or country. However, where mentioned by experts, relevant country-specific examples were used to support each theme.
4.1. Continuously Prioritize Dengue on the National Health Agenda
This theme delves into (a) where dengue currently stands in national health agendas, (b) the hidden impact of dengue, (c) the barriers to prioritizing dengue, (d) the strategies to overcome these barriers, and (e) how the agenda can be effectively disseminated to the population.
4.2. Ensure Collaboration and Coordination among All Stakeholders
4.3. Incorporate Population Views to Elicit Behavioral Change
Knowledge: There is a lack of awareness of the risk of dengue re-infection, the existence of a dengue vaccine, and a lack of understanding of the safety and efficacy of a vaccine. Education programs can specifically fill these pre-identified knowledge gaps to empower populations to proactively safeguard their health. Additionally, vaccination campaigns should first aim to raise awareness about the severity of dengue and introduce vaccines as one of the solutions to minimize the risk of infections for improved uptake and adherence.
Attitude: The overall sentiment regarding the importance of vaccines is positive. However, some individuals express skepticism towards trying a new vaccine due to concerns about potential side effects. Perceptions on the effectiveness of vector control were positive, however confidence in the government’s ability to combat dengue was low. For vaccine education programs, enhancing the understanding of the characteristics and potential side effects of the new dengue vaccine can contribute to a more positive attitude towards it. Governments can initiate and promote vector control and vaccination programs to instill confidence in their ability to combat dengue, which in turn will further increase the practice of prevention.
Practice: Common vector control measures, such as discarding standing water and wearing long sleeves, are generally practiced. However, to maximize their full effect, strict adherence is necessary. Regarding a willingness to be vaccinated, inducing behavior change can involve offering incentives for compliance with country regulations and strategically locating vaccine centers in convenient and accessible locations.
4.4. Design for a Sustainable Health Program
There are some limitations to this study. Firstly, the sample of six experts interviewed may not be fully representative of the diverse APAC and LATAM health systems. Therefore, future research should consider a more comprehensive sample of experts across various geographies and expertise. Secondly, the experts interviewed were also authors of this commentary, potentially introducing bias in the narrative. To minimize bias, the commentary was supported by the published literature, where applicable. Thirdly, the use of the CFIR was limited to only the discussion guide development. Future studies on dengue prevention program implementation should consider fully leveraging the CFIR to identify implementation drivers and barriers specific to their contexts of interest.
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