To guide evidence-based decision making, the advisory group also

To guide evidence-based decision making, the advisory group also has recommended national disease burden surveys in children for Hib (2004–2005), rotavirus gastroentritis (2009) and nasopharyngeal carriage of Streptococcus pneumoniae (2009). The agenda for NITAG meetings is adopted by the advisory group in line with the needs of the country or

according to specific proposals from medical universities, MOHME, or WHO. To check details develop technical recommendations and guidelines, the NITAG uses as sources of expert information scientific textbooks, results of local research projects, WHO position statements, and information posted on the websites of WHO, the US Centers for Disease Control and Prevention, and other reputable organizations. In addition, the following criteria

are important for making technical recommendations: the pattern of disease morbidity and mortality in the country, hospitalization rates, disability adjusted life years (DALYs) or quality adjusted life years (QALYs), epidemic potential of the disease, international commitment to disease eradication or elimination, or equity issues. In addition, the NITAG considers economic issues including vaccine cost, overall Epacadostat chemical structure programme costs, results from different economic evaluations (cost-effectiveness, cost-benefit, cost-utility, and others), affordability, and financial sustainability. Whenever the advisory group requires an economic evaluation for its recommendations, the CCDC is asked to conduct an economic survey or study to obtain the relevant information. The advisory group’s recommendations are primarily based on local evidence but regional data also are used if necessary. Recommendations of the advisory group are almost always made by consensus but on rare occasions when members do

not agree, open voting is used to obtain the majority’s decision. When recommendations are finalized, the CCDC is responsible for their dissemination Oxymatrine to the decision makers. Recommendations are then published in a guideline booklet and distributed to public health personnel and medical professionals. The EPI manager and the Director General of CCDC are members of the NITAG and the recommendations are addressed to them. The Director General of CCDC in turn informs the MOHME for implementation of recommendations. Implementation is then considered an obligation since the EPI programme already has government approval. The minutes of meetings are prepared and distributed to the members of the NITAG for their information. The recommendations are also disseminated to the relevant authorities and responsible decision-making bodies for their information and necessary action.

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