Julita Gil Cuesta1,2, Katherine Whitehouse1,2, Salimou Kaba3, Kassi Nanan-N'Zeth3, Benoit Haba3, Catherine Bachy2, Isabella Panunzi2, Emilie Venables1,2,4. 1. Luxembourg Operational Research Unit, Médecins Sans Frontières, 68 Rue de Gasperich, L-1617, Luxembourg. 2. Medical Department, Médecins Sans Frontières,46 Arbre Benit, 1050, Brussels, Belgium. 3. Médecins Sans Frontières, Coléah Abattoir, Corniche Sud, Commune de Matam, BP3523, Conakry, Republic of Guinea. 4. Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, South Africa.
Abstract
BACKGROUND: Recurrent measles outbreaks followed by mass vaccination campaigns (MVCs) occur in urban settings in sub-Saharan countries. An understanding of the reasons for this is needed to improve future vaccination strategies. The 2017 measles outbreak in Guinea provided an opportunity to qualitatively explore suboptimal vaccination coverage within an MVC among participants through their perceptions, experiences and challenges. METHODS: We conducted focus group discussions with caregivers (n=68) and key informant interviews (n=13) with health professionals and religious and community leaders in Conakry. Data were audio-recorded, transcribed verbatim from Susu and French, coded and thematically analysed. RESULTS: Vaccinations were widely regarded positively and their preventive benefits noted. Vaccine side effects and the subsequent cost of treatment were commonly reported concerns, with further knowledge requested. Community health workers (CHWs) play a pivotal role in MVCs. Caregivers suggested recruiting CHWs from local neighbourhoods and improving their attitude, knowledge and skills to provide information about vaccinations. Lack of trust in vaccines, CHWs and the healthcare system, particularly after the 2014-2016 Ebola epidemic, were also reported. CONCLUSIONS: Improving caregivers' knowledge of vaccines, potential side effects and their management are essential to increase MVC coverage in urban settings. Strengthening CHWs' capacities and appropriate recruitment are key to improving trust through a community involvement approach.
BACKGROUND: Recurrent measles outbreaks followed by mass vaccination campaigns (MVCs) occur in urban settings in sub-Saharan countries. An understanding of the reasons for this is needed to improve future vaccination strategies. The 2017 measles outbreak in Guinea provided an opportunity to qualitatively explore suboptimal vaccination coverage within an MVC among participants through their perceptions, experiences and challenges. METHODS: We conducted focus group discussions with caregivers (n=68) and key informant interviews (n=13) with health professionals and religious and community leaders in Conakry. Data were audio-recorded, transcribed verbatim from Susu and French, coded and thematically analysed. RESULTS: Vaccinations were widely regarded positively and their preventive benefits noted. Vaccine side effects and the subsequent cost of treatment were commonly reported concerns, with further knowledge requested. Community health workers (CHWs) play a pivotal role in MVCs. Caregivers suggested recruiting CHWs from local neighbourhoods and improving their attitude, knowledge and skills to provide information about vaccinations. Lack of trust in vaccines, CHWs and the healthcare system, particularly after the 2014-2016 Ebola epidemic, were also reported. CONCLUSIONS: Improving caregivers' knowledge of vaccines, potential side effects and their management are essential to increase MVC coverage in urban settings. Strengthening CHWs' capacities and appropriate recruitment are key to improving trust through a community involvement approach.
Authors: Norbert G Schwarz; Marjolein Gysels; Christopher Pell; Julian Gabor; Meike Schlie; Saadou Issifou; Bertrand Lell; Peter G Kremsner; Martin P Grobusch; Robert Pool Journal: Vaccine Date: 2009-07-17 Impact factor: 3.641
Authors: Sara Cooper; Bey-Marrié Schmidt; Evanson Z Sambala; Alison Swartz; Christopher J Colvin; Natalie Leon; Charles S Wiysonge Journal: Cochrane Database Syst Rev Date: 2021-10-27