Article type
Abstract
"Background: Responsive and inclusive decision-making is an important societal goal, particularly in the context of national health policymaking. Linked to this, there is growing interest in the role of citizens and civil society organizations (CSOs) in health policy decisions, particularly in giving a 'voice-to-the-voiceless'. However, the role of civil society in vaccine policymaking remains underexplored, despite its potential significance for vaccine implementation.
Objectives: To map and critically analyze CSO engagement in decision-making spaces for vaccines and to explore the use of civil society evidence to inform vaccine decisions in Ghana.
Methods: We employed a qualitative case study methodology. Data sources include document analysis, interviews, expert consultations, and observations of meetings of government, development partners, and CSOs engaged in vaccine decision-making at the national level in Ghana. To date, we have included an analysis of 67 documents, observed 4 decision forums, and interviewed 3 key informants.
Results: We identified 382 non-governmental organizations (NGOs) in health, operating within a coalition. Around a third of these focus on vaccine-related issues, primarily involved in vaccine roll-out decisions rather than in contributing evidence to inform decisions on vaccine introduction according to policymakers. CSOs mostly advocate for domestic financing for vaccination initiatives and awareness campaigns for unvaccinated children. Evidence brought to policymaking by civil society is largely experiential, drawn from community reports, personal experiences, social media, and surveys, lacking systematic generation. The capacity to generate, translate, and adapt guidance on vaccine introduction and roll-out appears to be low among CSOs. Decision-makers prefer systematic evidence but are open to, and capable of integrating experiential evidence from CSOs to understand social, cultural, and behavioral contexts. However, the scientific validity of evidence from CSOs may be scrutinized before its use for decisions.
Conclusion: In Ghana, CSOs are mainly involved in roll-out decisions for vaccines, while decisions for vaccine introduction are guided by global and local scientific evidence on epidemiology, disease burden, vaccine financing, safety, and regulations. To improve vaccine decision-making, there's a need for inclusive platforms that can incorporate CSO evidence relevant to their constituencies. Strengthening CSOs' capacity to systematically generate evidence for vaccine decision-making is also crucial.
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Objectives: To map and critically analyze CSO engagement in decision-making spaces for vaccines and to explore the use of civil society evidence to inform vaccine decisions in Ghana.
Methods: We employed a qualitative case study methodology. Data sources include document analysis, interviews, expert consultations, and observations of meetings of government, development partners, and CSOs engaged in vaccine decision-making at the national level in Ghana. To date, we have included an analysis of 67 documents, observed 4 decision forums, and interviewed 3 key informants.
Results: We identified 382 non-governmental organizations (NGOs) in health, operating within a coalition. Around a third of these focus on vaccine-related issues, primarily involved in vaccine roll-out decisions rather than in contributing evidence to inform decisions on vaccine introduction according to policymakers. CSOs mostly advocate for domestic financing for vaccination initiatives and awareness campaigns for unvaccinated children. Evidence brought to policymaking by civil society is largely experiential, drawn from community reports, personal experiences, social media, and surveys, lacking systematic generation. The capacity to generate, translate, and adapt guidance on vaccine introduction and roll-out appears to be low among CSOs. Decision-makers prefer systematic evidence but are open to, and capable of integrating experiential evidence from CSOs to understand social, cultural, and behavioral contexts. However, the scientific validity of evidence from CSOs may be scrutinized before its use for decisions.
Conclusion: In Ghana, CSOs are mainly involved in roll-out decisions for vaccines, while decisions for vaccine introduction are guided by global and local scientific evidence on epidemiology, disease burden, vaccine financing, safety, and regulations. To improve vaccine decision-making, there's a need for inclusive platforms that can incorporate CSO evidence relevant to their constituencies. Strengthening CSOs' capacity to systematically generate evidence for vaccine decision-making is also crucial.
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