TY - JOUR
T1 - Health system quality and COVID-19 vaccination
T2 - a cross-sectional analysis in 14 countries
AU - Arsenault, Catherine
AU - Lewis, Todd P.
AU - Kapoor, Neena R.
AU - Okiro, Emelda A.
AU - Leslie, Hannah H.
AU - Armeni, Patrizio
AU - Jarhyan, Prashant
AU - Doubova, Svetlana V.
AU - Wright, Katherine D.
AU - Aryal, Amit
AU - Kounnavong, Sengchanh
AU - Mohan, Sailesh
AU - Odipo, Emily
AU - Lee, Hwa Young
AU - Shin, Jeonghyun
AU - Ayele, Wondimu
AU - Medina-Ranilla, Jesús
AU - Espinoza-Pajuelo, Laura
AU - Derseh Mebratie, Anagaw
AU - García Elorrio, Ezequiel
AU - Mazzoni, Agustina
AU - Oh, Juhwan
AU - SteelFisher, Gillian K.
AU - Tarricone, Rosanna
AU - Kruk, Margaret E.
N1 - Publisher Copyright:
© 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2024/1
Y1 - 2024/1
N2 - The social and behavioural determinants of COVID-19 vaccination have been described previously. However, little is known about how vaccinated people use and rate their health system. We used surveys conducted in 14 countries to study the health system correlates of COVID-19 vaccination. Country-specific logistic regression models were adjusted for respondent age, education, income, chronic illness, history of COVID-19, urban residence, and minority ethnic, racial, or linguistic group. Estimates were summarised across countries using random effects meta-analysis. Vaccination coverage with at least two or three doses ranged from 29% in India to 85% in Peru. Greater health-care use, having a regular and high-quality provider, and receiving other preventive health services were positively associated with vaccination. Confidence in the health system and government also increased the odds of vaccination. By contrast, having unmet health-care needs or experiencing discrimination or a medical mistake decreased the odds of vaccination. Associations between health system predictors and vaccination tended to be stronger in high-income countries and in countries with the most COVID-19-related deaths. Access to quality health systems might affect vaccine decisions. Building strong primary care systems and ensuring a baseline level of quality that is affordable for all should be central to pandemic preparedness strategies.
AB - The social and behavioural determinants of COVID-19 vaccination have been described previously. However, little is known about how vaccinated people use and rate their health system. We used surveys conducted in 14 countries to study the health system correlates of COVID-19 vaccination. Country-specific logistic regression models were adjusted for respondent age, education, income, chronic illness, history of COVID-19, urban residence, and minority ethnic, racial, or linguistic group. Estimates were summarised across countries using random effects meta-analysis. Vaccination coverage with at least two or three doses ranged from 29% in India to 85% in Peru. Greater health-care use, having a regular and high-quality provider, and receiving other preventive health services were positively associated with vaccination. Confidence in the health system and government also increased the odds of vaccination. By contrast, having unmet health-care needs or experiencing discrimination or a medical mistake decreased the odds of vaccination. Associations between health system predictors and vaccination tended to be stronger in high-income countries and in countries with the most COVID-19-related deaths. Access to quality health systems might affect vaccine decisions. Building strong primary care systems and ensuring a baseline level of quality that is affordable for all should be central to pandemic preparedness strategies.
UR - http://www.scopus.com/inward/record.url?scp=85179764449&partnerID=8YFLogxK
U2 - 10.1016/S2214-109X(23)00490-4
DO - 10.1016/S2214-109X(23)00490-4
M3 - Review article
C2 - 38096888
AN - SCOPUS:85179764449
SN - 2214-109X
VL - 12
SP - e156-e165
JO - The Lancet Global Health
JF - The Lancet Global Health
IS - 1
ER -
