Question

Question:..Utilising McConnell’s (2010) framework for determining policy success, assess the successes or failings of Australia’s more recent iterations of childhood vaccination reform.

I must need the References and evidence of research and the incorporation of such into responses without this i can not submit this assignment. referencing is most important for this assignment. please provide..thank you

Answer 1

Policy protagonists are keen to claim that policy is successful while opponents are more likely to frame policies as failures. The reality, according to Alan Mcconell, is that policy outcomes are often somewhere in between these extremes. Considering the multidimensional aspect of policy, often succeeding in some respects but not in others, according to facts and their interpretation- The Marsh and McConnell Framework helps analyse how successful a policy has been or can be.

Ref: http://web.pdx.edu/~nwallace/PATF/McConnell.pdf

(Ref: https://www.governanceinstitute.edu.au/magma/media/upload/ckeditor/files/Policy%20success%20(Marsh%20and%20Lewis).docx)

Recent Reforms in Chilhood Immunisation in Australia

As a part of the National Immunisation Program, Childhood immunisation coverage has increased greatly in the last couple of years

Ref: https://www.health.gov.au/sites/default/files/national-immunisation-strategy-for-australia-2019-2024_0.docx

According to a Government Report, The current NIP consists of a schedule (the NIP Schedule) of recommended vaccines by age group and/or medical risk, made available free of charge to Australians in those age groups and risk groups. To date, the NIP Schedule includes vaccines against 17 diseases: hepatitis B, diphtheria, tetanus, pertussis (whooping cough), Haemophilus influenzae type b (Hib) disease, polio, pneumococcal, rotavirus, measles, mumps, rubella, meningococcal, varicella (chickenpox), hepatitis A, human papillomavirus (HPV), influenza and herpes zoster, As a result of the success of the NIP, many diseases – such as rubella, tetanus, diphtheria, Hib and measles – are now extremely rare in Australia. However, the lack of visibility of these diseases in the community has its own challenges – it can lead to complacency among consumers and healthcare providers.

The current governance arrangements for the NIP reflect the collaborative, whole-of-government approach between the Australian, state and territory governments that has characterised the program since its introduction in 1997

Strategic priorities

The consultation process identified the following eight strategic priorities for inclusion in the strategy:

• Improve immunisation coverage.
• Ensure effective governance of the National Immunisation Program.
• Ensure secure vaccine supply and efficient use of vaccines for the National Immunisation Program.
• Continue to enhance vaccine safety monitoring systems.
• Maintain and ensure community confidence in the National Immunisation Program through effective communication strategies.
• Strengthen monitoring and evaluation of the National Immunisation Program through assessment and analysis of immunisation register data and vaccine-preventable disease surveillance.
• Ensure an adequately skilled immunisation workforce through promoting effective training for immunisation providers.
• Maintain Australia’s strong contribution to the region.

Some Key Achievements

Significant gains were made during the period of the National Immunisation Strategy 2013–2018. Immunisation coverage is now above 90% for all monitored age groups, and 94.6% among 5-year-old children. Aboriginal and Torres Strait Islander children were the first to achieve the 95% coverage target, an important gain that will generate improved health outcomes for years to come. HPV vaccination rates are now higher than ever, with 80.2% of females turning 15 in 2017 and 75.9% of males turning 15 in 2017 fully vaccinated.

New vaccines have been made available through the NIP, including HPV vaccine for boys, herpes zoster (shingles) vaccine for 70–79-year-olds, pertussis vaccines for pregnant women and meningococcal ACWY vaccines for infants and adolescents. In July 2017, the NIP was expanded to enable catch-up for all individuals up to the age of 19 years, and refugees and humanitarian entrants of all ages. Some states have also introduced vaccines for influenza for young children.

Australia was one of the first countries in the world to implement a whole-of-life immunisation register when the Australian Immunisation Register was implemented in September 2016.

A new NPEV commenced in July 2017, introducing stronger incentives for states to achieve higher immunisation coverage rates, and to support program sustainability through targets for wastage (loss of vaccines due to cold chain breach or other damage) and leakage (unauthorised use of vaccines).

The Australian Health Protection Principal Committee maintained oversight of immunisation, including through the Communicable Diseases Network Australia, the NIC and Jurisdictional Immunisation Coordinators.

Centralised procurement for essential vaccines has now been embedded in the NIP, to support efficiencies in administration and value for money. The Australian Government works closely with states and territories, and pharmaceutical companies to support continuous supply of essential vaccines for Australia.

In addition to implementing the vaccine safety recommendations in Professor John Horvath’s review of the management of adverse events associated with the influenza vaccines Panvax and Fluvax, the Australian Government has funded the establishment of the AusVaxSafety national surveillance network. AusVaxSafety is a world-leading active monitoring system that enables near real-time tracking of vaccine adverse events in Australians. The Advisory Committee on Vaccines plays an integral role by providing advice to support the registration of vaccines and their introduction into the Australian market, and providing advice on ongoing monitoring of, and technical input into, investigations of adverse events following immunisation. All stakeholders continue to play an important role in monitoring for adverse events and reporting them to the Therapeutic Goods Administration (TGA).

From 2017, the ‘Get the facts about immunisation’ campaign was the first national immunisation campaign in more than 20 years, providing parents with evidence-based information to support decision making on vaccination. States and territories also implement a range of innovative campaigns, including 'Immunise to 95' and 'Save the date to vaccinate'.

The Australian Government’s No Jab, No Pay policy, and No Jab, No Play policies implemented in some states, have supported vaccination uptake and improved immunisation coverage rates.

The Australian Health Protection Principal Committee endorsed the National Immunisation Education Framework for Health Professionals in October 2017 and was tasked by the Council of Australian Governments’ Health Council with its implementation.

Australia was verified by WHO as having eliminated endemic measles in 2014. In 2018, WHO declared that rubella had been eliminated in Australia, according to its official threshold. Rubella remains endemic in many other countries, meaning that the virus can still be imported by travellers from these countries. Therefore, we will continue to work to maintain this elimination status in Australian and the region. In addition, Australia has maintained its poliomyelitis (polio)-free status, and works closely with the WPRO and WHO headquarters towards achieving the global eradication of polio. Australia also actively supports other National Immunisation Technical Advisory Groups (NITAGs) through its own NITAG: ATAGI.

This progress however, also has multiple critics, with the emphasis on making Vaccines necessary.

n Australia, No Jab, No Pay legislation was introduced nationally on 1 January 2016. It removed an exemption, which previously allowed parents whose children were not fully vaccinated, to remain eligible for family assistance payments if a health practitioner certified that they were conscientious objectors to vaccination. The requirement to be fully immunised for age to retain eligibility for family assistance payments commenced in the late 1990s.2 At state level, No Jab, No Play legislation, which requires children attending childcare centres to be immunised, has been tightened in New South Wales and passed in Queensland and Victoria. Victoria has the strictest requirements, with full immunisation necessary for attendance, unless the child has an approved medical exemption or is on a recognised catch-up schedule. NSW continues to allow a written exemption for children of vaccine-refusing parents, and Queensland allows facilities discretion over whether to apply the requirements. In California, recent school entry legislation has removed all non-medical exemptions to mandatory school immunisation requirements, leaving home schooling as the only option for vaccine-refusing parents.

(Ref: https://www.mja.com.au/journal/2017/206/9/no-jab-no-pay-and-vaccine-refusal-australia-jury-out)

After both literary support and criticism of the policy reforms, one needs to check these through the lenses of the process, programme and political dimension to correctly estimate how successful the entire endeavour has actually been.