scholarly journals “Saint Google, now we have information!”: a qualitative study on narratives of trust and attitudes towards maternal vaccination in Mexico City and Toluca

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Clarissa Simas ◽  
Heidi J. Larson ◽  
Pauline Paterson
Keyword(s):  
Qualitative Study ◽  
Pregnant Women ◽  
Digital Media ◽  
Mexico City ◽  
Immunization Coverage ◽  
Childhood Immunization ◽  
Maternal Healthcare ◽  
Middle Income ◽  
Maternal Immunization ◽  
Maternal Vaccination

Abstract Background Maternal vaccination is key to decreasing maternal and infant mortality globally. Yet perceptions about maternal vaccines and immunization among pregnant women are often understudied, particularly in low- and middle- income countries. This qualitative study explored trust, views, and attitudes towards maternal immunization among pregnant women in Mexico. A total of 54 women from Mexico City and Toluca participated in the in-depth interviews and focus groups. We explored participants’ experiences with maternal vaccination, as well as how they navigated the health system, searched for information, and made decisions around maternal immunization. Results Our findings point to issues around access and quality of maternal healthcare, including immunizations services. While healthcare professionals were recognized for their expertise, participants reported not receiving enough information to make informed decisions and used online search engines and digital media to obtain more information about maternal healthcare. Some participants held strong doubts over the benefits of vaccination and were hesitant about the safety and efficacy of maternal vaccines. These concerns were also shared by pregnant women who had been vaccinated. Some participants disclosed low levels of trust in government and vaccination campaigns. Conclusion Pregnant women, soon to be parents and making vaccination decisions for their child, constitute an important target group for policymakers seeking optimal maternal as well as childhood immunization coverage. Our findings highlight the importance of targeted communication, trust-building and engagement strategies to strengthen confidence in immunization amongst this group.

scholarly journals Every child on the map: A theory of change framework for improving childhood immunization coverage and equity using geospatial data and technologies (Preprint)

2021 ◽  
Author(s):  
Sarah Cunard Chaney ◽  
Patricia Mechael ◽  
Nay Myo Thu ◽  
Mamadou S Diallo ◽  
Carine Gachen
Keyword(s):  
Positive Impact ◽  
Immunization Coverage ◽  
Service Planning ◽  
Geospatial Data ◽  
Health System Strengthening ◽  
Theory Of Change ◽  
Immunization Programs ◽  
Childhood Immunization ◽  
Middle Income ◽  
Effective Use

UNSTRUCTURED The effective use of geospatial data and technologies to collect, manage, analyze, model and visualize geographic data has great potential to improve data driven decision-making for immunization programs. This article presents A Theory of Change for the use of geospatial technologies for immunization programming, a framework to illustrate the ways that geospatial data and technologies can contribute to improved immunization outcomes and have a positive impact on childhood immunization coverage rates in low- and middle-income countries. The Theory of Change is the result of a review of the state of the evidence and literature, consultation with implementers, donors, immunization and geospatial technology experts and a review of country implementation experiences. The framework illustrates how the effective use of geospatial data and technologies can help immunization programs realize improvements in the number of children immunized by producing reliable estimates of target populations, identifying chronically missed settlements and locations with the highest number of zero-dose and under-immunized children and guiding immunization managers with solutions to optimize resource distribution and location of health services. Through these direct effects on service delivery, geospatial data and technologies can contribute to overall health system strengthening with equity in immunization coverage. The Theory of Change presented here may serve as a guide for country program managers, implementers, donors and other stakeholders to better understand how geospatial tools can support immunization programs and facilitate integrated service planning and equitable delivery through the unifying role of geography and geospatial data.

scholarly journals Antenatal care providers’ attitudes and beliefs towards maternal vaccination in Kenya

2021 ◽  
Vol 4 ◽  
pp. 19
Author(s):  
Subhash Chander ◽  
Ines Gonzalez-Casanova ◽  
Sandra S. Chaves ◽  
Nancy A. Otieno ◽  
Marc-Alain Widdowson ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Critical Role ◽  
Healthcare Providers ◽  
Attitudes And Beliefs ◽  
Care Providers ◽  
Middle Income ◽  
Maternal Immunization ◽  
Maternal Vaccination ◽  
Vaccine Recommendations ◽  
And Behavior

Background: Maternal immunization is known to be one of the best strategies to protect both mothers and their infants from infectious diseases. Studies have shown that healthcare providers play a critical role in implementation of maternal immunization. However, little is known about providers’ attitudes and beliefs towards vaccination that can influence their vaccine recommendations, specifically in low to middle income countries (LMIC). Methods: A self-administrated knowledge, attitude and behavior (KAB) survey was provided to 150 antenatal care providers across four different regions (Nairobi, Mombasa, Marsabit, and Siaya counties) of Kenya. The research staff visited the 150 clinics and hospitals and distributed a quantitative KAB survey. Results: Nearly all of the antenatal care providers (99%) recommended tetanus maternal vaccination. Similarly, 99% of the providers agreed that they would agree to provide additional vaccinations for pregnant women and reported that they always advise their patients to get vaccinated. Between 80 and 90% of the providers reported that religious beliefs, ethnicity, cultural background and political leaders do not affect their attitude or beliefs towards recommending vaccines. Conclusions: Considering the positive responses of healthcare providers towards vaccine acceptance and recommendation, these results highlight an opportunity to work in partnership with these providers to improve coverage of maternal vaccination and to introduce additional vaccines (such as influenza). In order to achieve this, logistical barriers that have affected the coverage of the currently recommended vaccines, should be addressed as part of this partnership.

scholarly journals Antenatal care providers’ attitudes and beliefs towards maternal vaccination in Kenya

2020 ◽  
Vol 4 ◽  
pp. 19
Author(s):  
Subhash Chander ◽  
Ines Gonzalez-Casanova ◽  
Sandra S. Chaves ◽  
Nancy A. Otieno ◽  
Marc-Alain Widdowson ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Critical Role ◽  
Healthcare Providers ◽  
Attitudes And Beliefs ◽  
Care Providers ◽  
Middle Income ◽  
Maternal Immunization ◽  
Maternal Vaccination ◽  
Vaccine Recommendations ◽  
And Behavior

Background: Maternal immunization is known to be one of the best strategies to protect both mothers and their infants from infectious diseases. Studies have shown that healthcare providers play a critical role in implementation of maternal immunization. However, little is known about providers’ attitudes and beliefs towards vaccination that can influence their vaccine recommendations, specifically in low to middle income countries (LMIC). Methods: A self-administrated knowledge, attitude and behavior (KAB) survey was provided to 150 antenatal care providers across four different regions (Nairobi, Mombasa, Marsabit, and Siaya counties) of Kenya. The research staff visited the 150 clinics and hospitals and distributed a quantitative KAB survey. Results: Nearly all of the antenatal care providers (99%) recommended tetanus maternal vaccination. Similarly, 99% of the providers agreed that they would agree to provide additional vaccinations for pregnant women and reported that they always advise their patients to get vaccinated. Between 80 and 90% of the providers reported that religious beliefs, ethnicity, cultural background and political leaders do not affect their attitude or beliefs towards recommending vaccines. Conclusions: Considering the positive responses of healthcare providers towards vaccine acceptance and recommendation, these results highlight an opportunity to work in partnership with these providers to improve coverage of maternal vaccination and to introduce additional vaccines (such as influenza). In order to achieve this, logistical barriers that have affected the coverage of the currently recommended vaccines, should be addressed as part of this partnership.

scholarly journals Maternal healthcare utilization and full immunization coverage among 12–23 months children in Benin: a cross sectional study using population-based data

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Eugene Budu ◽  
Abdul-Aziz Seidu ◽  
Ebenezer Agbaglo ◽  
Ebenezer Kwesi Armah-Ansah ◽  
Kwamena Sekyi Dickson ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Healthcare Utilization ◽  
Postnatal Care ◽  
Immunization Coverage ◽  
Traditional Birth Attendants ◽  
Odds Ratios ◽  
Maternal Healthcare ◽  
Birth Attendants ◽  
Full Immunization

Abstract Background Maternal and child health are important issues for global health policy, and the past three decades have seen a significant progress in maternal and child healthcare worldwide. Immunization is a critical, efficient, and cost-effective public health intervention for newborns. However, studies on these health-promoting indicators in low-income and middle-income countries, especially in sub-Sahara Africa are sparse. We investigated the association between maternal healthcare utilization and complete vaccination in the Republic of Benin. Methods We analysed data from the 2018 Benin Demographic and Health Survey (BDHS). Specifically, the children’s recode file was used for the study. The outcome variable used was complete vaccination. Number of antenatal care visits, assistance during delivery, and postnatal check-up visits were the key explanatory variables. Bivariate and multilevel logistic regression analyses were carried out. The results were presented as unadjusted odds ratios (uOR) and adjusted odds ratios (aOR), with their corresponding 95% confidence intervals (CIs) signifying their level of precision. Statistical significance was declared at p < 0.05. Results The prevalence of full immunization coverage in Benin was 85.4%. The likelihood of full immunization was lower among children whose mothers had no antenatal care visits, compared to those whose mothers had 1–3 visits [aOR = 0.11, 95% CI: 0.08–0.15], those who got assistance from Traditional Birth Attendants/other during delivery, compared to those who had assistance from Skilled Birth Attendants/health professionals [aOR = 0.55, 95% CI: 0.40–0.77], and mothers who had no postnatal care check-up visit, compared to those who had postnatal care check-up < 24 h after delivery [aOR = 0.49, 95% CI: 0.36–0.67]. With the covariates, religion, partner’s level of education, parity, wealth quintile, and place of residence also showed significant associations with full immunization. Conclusion The study has demonstrated strong association between full immunization and antenatal care, skilled attendance at birth, and postnatal care check-up visit. We found that full immunization decreases among women with no antenatal care visits, those who receive assistance from Traditional Birth Attendants during delivery, and those who do not go for postnatal care visits. To help achieve full immunization, it is prudent that the government of Benin collaborates with international organisations such as WHO and UNICEF to provide education to pregnant women on the importance of immunization after delivery. Such education can be embedded in the antenatal care, delivery and postnatal care services offered to pregnant women during pregnancy, delivery, and after delivery.

scholarly journals A missed opportunity: birth registration coverage is lagging behind Bacillus Calmette–Guérin (BCG) immunization coverage and maternal health services utilization in low- and lower middle-income countries

2019 ◽  
Vol 38 (S1) ◽  
Author(s):  
M. Hafizur Rahman ◽  
Amber Bickford Cox ◽  
Samuel L. Mills
Keyword(s):  
Maternal Health ◽  
Health Services ◽  
Democratic Republic ◽  
Democratic Republic Of Congo ◽  
Immunization Coverage ◽  
Maternal Health Services ◽  
Birth Registration ◽  
Childhood Immunization ◽  
Middle Income ◽  
Middle Income Countries

Abstract Background Civil registration and vital statistics (CRVS) systems lay the foundation for good governance by increasing the effectiveness and delivery of public services, providing vital statistics for the planning and monitoring of national development, and protecting fundamental human rights. Birth registration provides legal rights and facilitates access to essential public services such as health care and education. However, more than 110 low- and middle-income countries (LMICs) have deficient CRVS systems, and national birth registration rates continue to fall behind childhood immunization rates. Using Demographic and Health Survey (DHS) and Multiple Indicator Cluster Survey (MICS) data in 72 LMICs, the objectives are to (a) explore the status of birth registration, routine childhood immunization, and maternal health services utilization; (b) analyze indicators of birth registration, routine childhood immunization, and maternal health services utilization; and (c) identify missed opportunities for strengthening birth registration systems in countries with strong childhood immunization and maternal health services by measuring the absolute differences between the birth registration rates and these childhood and maternal health service indicators. Methods We constructed a database using DHS and MICS data from 2000 to 2017, containing information on birth registration, immunization coverage, and maternal health service indicators. Seventy-three countries including 34 low-income countries and 38 lower middle-income countries were included in this exploratory analysis. Results Among the 14 countries with disparity between birth registration and BCG vaccination of more than 50%, nine were from sub-Saharan Africa (Tanzania, Uganda, Gambia, Mozambique, Djibouti, Eswatini, Zambia, Democratic Republic of Congo, Ghana), two were from South Asia (Bangladesh, Nepal), one from East Asia and the Pacific (Vanuatu) one from Latin America and the Caribbean (Bolivia), and one from Europe and Central Asia (Moldova). Countries with a 50% or above absolute difference between birth registration and antenatal care coverage include Democratic Republic of Congo, Gambia, Mozambique, Nepal, Tanzania, and Uganda, in low-income countries. Among lower middle-income countries, this includes Eswatini, Ghana, Moldova, Timor-Leste, Vanuatu, and Zambia. Countries with a 50% or above absolute difference between birth registration and facility delivery care coverage include Democratic Republic of Congo, Djibouti, Moldova, and Zambia. Conclusion The gap between birth registration and immunization coverage in low- and lower middle-income countries suggests the potential for leveraging immunization programs to increase birth registration rates. Engaging health providers during the antenatal, delivery, and postpartum periods to increase birth registration may be a useful strategy in countries with access to skilled providers.

scholarly journals Childhood Immunization in Ethiopia: Accuracy of Maternal Recall Compared to Vaccination Cards

Vaccines ◽  
2019 ◽  
Vol 7 (2) ◽  
pp. 48 ◽  
Author(s):  
Julia M. Porth ◽  
Abram L. Wagner ◽  
Yemesrach A. Tefera ◽  
Matthew L. Boulton
Keyword(s):  
Predictive Value ◽  
Immunization Coverage ◽  
Cross Sectional Study ◽  
Vaccination Status ◽  
Childhood Vaccination ◽  
Childhood Immunization ◽  
Cross Sectional ◽  
Middle Income ◽  
Vaccination Card ◽  
Maternal Recall

Health surveys conducted in low- and middle-income countries typically estimate childhood vaccination status based on written vaccination cards, maternal recall (when cards are not available), or a combination of both. This analysis aimed to assess the accuracy of maternal recall of a child’s vaccination status in Ethiopia. Data came from a 2016 cross-sectional study conducted in the Southern Nations, Nationalities, and Peoples’ (SNNP) Region of Ethiopia. Vaccine doses received by a given 12–23-month-old child were recorded from both a vaccination card and based on maternal recall and then compared. Concordance, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Cohen’s Kappa were calculated. Estimates of full immunization coverage were similar when collected via vaccination card (75%) and maternal recall (74%). For fully vaccinated children, comparison of maternal recall versus vaccination card showed high concordance (96%), sensitivity (97%), specificity (93%), PPV (98%), NPV (92%), and Kappa (90%). Accuracy of maternal recall of a child’s vaccination status is high in the SNNP region of Ethiopia. Although determination of vaccination status via vaccination card is preferred since it constitutes a written record, maternal recall can also be used with confidence when vaccination cards are not available.

scholarly journals Street Food Stand Availability, Density, and Distribution Across Income Levels in Mexico City

2021 ◽  
Vol 18 (8) ◽  
pp. 3953
Author(s):  
Jose B. Rosales Chavez ◽  
Meg Bruening ◽  
Punam Ohri-Vachaspati ◽  
Rebecca E. Lee ◽  
Megan Jehn
Keyword(s):  
Mexico City ◽  
Food Environment ◽  
Local School ◽  
Middle Income ◽  
Street Food ◽  
Income Levels ◽  
Rigorous Approach ◽  
Ground Truthing ◽  
Document Relationships ◽  
Street Segments

Street food stands (SFS) are an understudied element of the food environment. Previous SFS studies have not used a rigorous approach to document the availability, density, and distribution of SFS across neighborhood income levels and points of access in Mexico City. A random sample (n = 761) of street segments representing 20 low-, middle-, and high-income neighborhoods were assessed using geographic information system (GIS) and ground-truthing methods. All three income levels contained SFS. However, SFS availability and density were higher in middle-income neighborhoods. The distribution of SFS showed that SFS were most often found near homes, transportation centers, and worksites. SFS availability near schools may have been limited by local school policies. Additional studies are needed to further document relationships between SFS availability, density, and distribution, and current structures and processes.

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