The Socioecological Model as a Framework for Exploring Factors Influencing Childhood Immunization Uptake in Lagos State, Nigeria

Abstract Background Nigeria is one of the ten countries globally that accounts for 62% of under- and unvaccinated children worldwide. Despite several governmental and non-governmental agencies' interventions, Nigeria has yet to achieve significant gains in childhood immunization coverage. This study identifies intrapersonal, interpersonal, organizational, community, and policy-level factors that influence childhood immunization uptake from various stakeholders' perspectives using the Socioecological Model (SEM). Methods Using the Socioecological Model as a guiding framework, we conducted ten focus group sessions with mothers/caregivers and community leaders residing in Lagos state and nine semi-structured interviews with healthcare workers who provide routine immunization services in Lagos state primary healthcare facilities. We performed a qualitative analysis of focus groups and semi-structured interviews using deductive coding methods. Results The study sample included 44 mothers/caregivers and 24 community leaders residing in Lagos State, Nigeria, and 18 healthcare workers (routine immunization focal persons) working in the primary healthcare setting in Lagos state. Study participants discussed factors at the each level of the SEM that influence childhood immunization uptake, including intrapersonal (caregivers’ immunization knowledge, caregivers’ welfare and love of child/ren), interpersonal (role of individual relationships and social networks), organizational (geographical and financial access to health facilities, health facilities attributes, staff coverage, and healthcare worker attributes), community (community outreaches and community resources), and policy-level (free immunization services and provision of child immunization cards) that influence childhood immunization uptake. Several factors were intertwined, such as healthcare workers’ education of caregivers on immunization and caregivers' knowledge of vaccination. Conclusions The reciprocity of the findings from the different Socioecological Model levels emphasizes the importance of developing multi-pronged interventions that operate at multiple levels of the SEM. Our results can inform the design of culturally appropriate and effective interventions to address Nigeria's suboptimal immunization coverage.

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Pro-and Anti-vaccination among Mothers in Deciding Children’s Immunization: A Qualitative Study

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6113 ◽

2021 ◽

Vol 9 (B) ◽

pp. 385-391

Author(s):

Aisyah Nur Izzati ◽

Retno Indarwati ◽

Makhfudli Makhfudli ◽

Budi Utomo ◽

Eka Mishbahatul M. Has ◽

...

Keyword(s):

Social Media ◽

Healthcare Workers ◽

Immunization Coverage ◽

Mutual Trust ◽

Analysis Method ◽

Structured Interviews ◽

Immunization Program ◽

Positive Communication ◽

Vaccine Confidence ◽

Media Forum

BACKGROUND: Society participation in the mandatory basic immunization program has declined in the last 2 years in Indonesia. One of the causes is the widespread of anti-vaccine issue, which has recently been debated on social media. This study aimed to explore the perspectives, backgrounds, experiences, and aspects that underlie the mother’s confidence in anti-vaccine and pro-vaccine groups who join the Facebook social media forum. METHODS: A phenomenology qualitative design was undertaken. The data were collected from June to August 2020. We conducted in-depth structured interviews with 5 anti-vaccine participants and 5 pro-vaccine participants. We obtained saturation data with ten participants. The data managed by NVIVO 12 software and analyzed using the thematic analysis method. RESULTS: We obtained 4 themes, including social media values, perceptions of immunization, immunization barriers, and knowledge about immunization. Anti-vaccine parents were firm not to immunize their children even though they knew the purpose of immunization and were perceived that there were no barriers to taking immunization. Pro-vaccine parents were determined to take basic immunization despite experiencing various barriers. CONCLUSION: This study showed that social media, perceptions, knowledge, and barrier about immunization affect mothers in considering the decision to give immunization to their children. Nurses and other healthcare workers should be provided positive communication and mutual trust between parents and health services are required to develop parental vaccine confidence so that basic immunization coverage can increase.

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Assessing the contributions of private health facilities in a pioneer private-public partnership in childhood immunization in Nigeria

Journal of Public Health in Africa ◽

10.4081/jphia.2014.297 ◽

2014 ◽

Vol 5 (1) ◽

Cited By ~ 2

Author(s):

Chukwuemeka Oluoha ◽

Chukwuemeka Umeh ◽

Hycienth Ahaneku

Keyword(s):

Public Health ◽

Retrospective Study ◽

Local Governments ◽

Immunization Coverage ◽

Health Facilities ◽

Childhood Immunization ◽

Immunization Program ◽

Public Health Facilities ◽

Modest Contribution ◽

Immunization Services

The vision of Nigeria’s immunization program is to reach and sustain routine immunization coverage of greater than 90% for all vaccines by 2020. In order to achieve this, Abia state embarked on a unique private-public partnership (PPP) between private health facilities and the Abia state ministry of health. The aim of this partnership was to collaborate with private health facilities to provide free childhood immunization services in the state - the first of its kind in Nigeria. This is a retrospective study of the 2011 Abia state, Nigeria monthly immunization data. In the 4 local governments operating the PPP, 45% (79/175) of the health facilities that offered immunization services in 2011 were private health facilities and 55% (96/175) were public health facilities. However, 21% of the immunization services took place in private health facilities while 79% took place in public health facilities. Private health facilities were shown to have a modest contribution to immunization in the 4 local governments involved in the PPP. Efforts should be made to expand PPP in immunization nationally to improve immunization services in Nigeria.

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Community-identified recommendations to enhance cancer survivorship for Aboriginal and Torres Strait Islander people

Australian Journal of Primary Health ◽

10.1071/py17127 ◽

2018 ◽

Vol 24 (3) ◽

pp. 233 ◽

Cited By ~ 2

Author(s):

Judith A. Meiklejohn ◽

Brian Arley ◽

Ross Bailie ◽

Jon Adams ◽

Gail Garvey ◽

...

Keyword(s):

Cancer Survivors ◽

Cancer Survivorship ◽

Primary Healthcare ◽

Healthcare Workers ◽

System Development ◽

Survival Rates ◽

Patient Navigator ◽

Indigenous Australians ◽

Structured Interviews ◽

Care Plans

Indigenous Australians diagnosed with cancer experience higher mortality and lower survival rates compared to non-Indigenous Australians. Reasons are multifaceted and complex. Knowledge about Indigenous cancer survivors’ perspectives of positive cancer survivorship is a gap in research evidence. The study explored cancer survivorship perspectives of Indigenous cancer survivors, their support people and healthcare workers with a view to developing recommendations for cancer survivorship. Indigenous Australians who completed cancer treatment in the previous 6 months to 5 years, their support people and primary healthcare workers were recruited from primary healthcare centres and a large tertiary Queensland hospital. Semi-structured interviews and focus groups were conducted with written and informed consent obtained prior. Participants emphasised key action areas and recommendations to enhance cancer survivorship, namely: establishing a community cancer advocate and peer support program, availability and use of a cancer-specific Indigenous primary healthcare worker and hospital-based Indigenous patient navigator, as well as adoption of question prompt lists and cancer survivorship care plans. Existing research suggests significant benefits from implementing the key recommendations identified in this study. Greater support and commitment across health sectors and funding bodies is needed to promote institutional change and health system development.

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Utah Health Status Update: Childhood Immunization Coverage in Utah

PsycEXTRA Dataset ◽

10.1037/e559252009-001 ◽

2008 ◽

Cited By ~ 1

Keyword(s):

Health Status ◽

Immunization Coverage ◽

Childhood Immunization

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Information Obtained During Consultations by Primary Healthcare Workers to Aid Safe Prescribing in Low- and Lower-Middle-Income Countries: A Systematic Review

SSRN Electronic Journal ◽

10.2139/ssrn.3460648 ◽

2019 ◽

Author(s):

Christopher Smith ◽

Michelle Helena van Velthoven ◽

Nguyen Duc Truong ◽

Nguyen Hai Nam ◽

Phan Anh Vũ ◽

...

Keyword(s):

Systematic Review ◽

Primary Healthcare ◽

Healthcare Workers ◽

Middle Income ◽

Middle Income Countries

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Encountering suicide in primary healthcare rehabilitation: the experiences of physiotherapists

BMC Psychiatry ◽

10.1186/s12888-020-03004-1 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Åse Lundin ◽

Anna Bergenheim

Keyword(s):

At Risk ◽

Healthcare System ◽

Primary Healthcare ◽

Qualitative Content Analysis ◽

Western Hemisphere ◽

Mental Wellbeing ◽

Healthcare Personnel ◽

Public Health Issue ◽

Structured Interviews ◽

Patients At Risk

Abstract Background Suicide is a serious public health issue and one of the most common causes of death globally. Suicide has long-lasting impact on personal, relational, community and societal levels. Research has shown that patients often seek help in the primary healthcare system preceding a suicide. Studies exploring the experiences of encountering patients at risk for suicide have been performed among various categories of healthcare personnel, such as nurses and psychiatry residents as well as emergency room staff. There is a lack of research regarding primary healthcare rehabilitation staff, despite the fact that physiotherapists are the third largest health profession in the Western hemisphere and often work with patients experiencing mental health symptoms. The aim of this study was to explore the experiences of encountering patients at risk for suicide among physiotherapists working in a primary healthcare rehabilitation setting. Methods Semi-structured interviews were conducted with 13 physiotherapists working in primary healthcare rehabilitation clinics in the Gothenburg area, Sweden. The interviews were recorded on audio and transcribed into written text. A qualitative content analysis was performed on the material collected. Results The analysis of the material revealed an overarching theme, Through barriers and taboos – the physiotherapist finds a way, with five main categories: possibilities for identification, obstacles in meeting suicide, workplace environment matters, where does the patient belong? and education and experience are keys. Conclusions The present study indicates that physiotherapists in the primary healthcare system encounter patients experiencing suicidality, and they expressed a strong desire to care for both the physical and mental wellbeing of the patients. Despite reporting many barriers, the physiotherapists often found a way to form a meaningful therapeutic alliance with the patient and to ask about possible suicidality in their clinical practice. The result suggests that physiotherapists could play a larger role in working with patients experiencing suicidality in a primary healthcare setting and that they could be viewed as possible gatekeepers in identification as well as referral of these patients into other parts of the healthcare system.

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Yellow fever childhood immunization coverage in Jos North Local Government area, North Central Nigeria: 2015–2017

International Journal of Infectious Diseases ◽

10.1016/j.ijid.2020.09.1323 ◽

2020 ◽

Vol 101 ◽

pp. 509-510

Author(s):

A. Omololu ◽

N. Shehu ◽

D. Shwe ◽

A. Onukak ◽

G. Andrew ◽

...

Keyword(s):

Local Government ◽

Yellow Fever ◽

Immunization Coverage ◽

Local Government Area ◽

Childhood Immunization ◽

North Central ◽

Area North

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‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa

BMJ Global Health ◽

10.1136/bmjgh-2020-004360 ◽

2021 ◽

Vol 6 (4) ◽

pp. e004360

Author(s):

Dumisani MacDonald Hompashe ◽

Ulf-G Gerdtham ◽

Carmen S Christian ◽

Anja Smith ◽

Ronelle Burger

Keyword(s):

Health Systems ◽

Primary Healthcare ◽

Healthcare Workers ◽

Quality Care ◽

Public Healthcare ◽

Health Coverage ◽

Access To Health Services ◽

Healthcare Provision ◽

Healthcare Facilities ◽

Patients Experience

Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction. Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions. Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions. Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.

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Views and experiences of family physicians about Syrian refugee patients in Turkey: a qualitative research

Primary Health Care Research & Development ◽

10.1017/s1463423621000190 ◽

2021 ◽

Vol 22 ◽

Author(s):

Duygu Ayhan Baser ◽

Özge Mıhcı ◽

Meltem Tugce Direk ◽

Mustafa Cankurtaran

Keyword(s):

Primary Healthcare ◽

Asylum Seekers ◽

Health Care Services ◽

Qualitative Methodology ◽

Healthcare Delivery ◽

Family Physicians ◽

Healthcare Services ◽

Free Access ◽

Structured Interviews ◽

Syrian Refugee

Abstract Aim: The aim of this study was to describe the attitudes, views and solution proposals of family physicians (FPs) about primary healthcare problems of Syrian refugee patients. This study would be the very first study for Turkey that evaluates the attitudes, views and solution proposals of FPs about primary healthcare problems of Syrian refugee patients. Background: Following the anti-regime demonstrations that started in March 2011, the developments in Syria created one of the biggest humanitarian crises in the world and the largest number of asylum seekers continue to be hosted in Turkey. There are some studies evaluating asylum seekers’ access to healthcare services in Europe, and the common result is that refugees have free access to primary healthcare services in most countries; however, they face many obstacles when accessing primary healthcare services. While there are studies in the literature evaluating the situation of access to primary healthcare services from the perspective of asylum seekers; there are few studies evaluating the opinions/views of FPs. Methods: A qualitative methodology informed by the grounded theory was used to guide the research. A total of 20 FPs were interviewed face to face through semi-structured interviews, using 12 questions about their lived experience and views caring of refugee population. Interviews were analysed thematically. Finding: The following themes were revealed: Benefiting from Primary Health Care Services, Benefiting from Rights, Differences Between the Approach/Attitudes of Turkish Citizens and Refugees, Barriers to Healthcare Delivery, Training Needs of Physicians, Solution proposals. FPs reported that there is a need for support in primary care and a need for training them and refugees in this regard and they specified refugee healthcare centres are the best healthcare centres for refugees; however, the number of these and provided services should be increased.

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