Barriers to vaccination service delivery within general practice: opportunity to make a sustainable difference in Aboriginal child health?

Carman, Rebecca; Andrew, Lesley; Devine, Amanda; Oosthuizen, Jacques

doi:10.1111/1753-6405.12937

Cited by 3 publications

(5 citation statements)

References 24 publications

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“…Inadequate awareness of community vaccination needs can contribute to barriers in vaccine service provision for Indigenous people [69]. Although Indigenous healthcare workers reported feeling insufficiently informed to be the sole HPV vaccine educators of their community, they did seek knowledge for themselves; support from the media for vaccine messaging, especially in remote communities, might alleviate some of this pressure.…”

Section: Indigenous Healthcare Worker Perspectivesmentioning

confidence: 99%

Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review

MacDonald

Kenzie

Letendre

et al. 2023

PLOS Glob Public Health

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Despite the availability of effective and safe human papillomavirus (HPV) vaccines that reduce the incidence and impact of cervical cancer and other cancers, HPV vaccine coverage rates remain persistently low and the cervical cancer burden disproportionately high among Indigenous people globally. This study aimed to systematically identify, appraise, and summarize the literature on documented barriers and supports to HPV vaccination in Indigenous populations internationally. Forty-three studies were included and an inductive, qualitative, thematic synthesis was applied. We report on 10 barrier themes and 7 support themes to vaccine uptake, and provide a quantitative summary of metrics. Focusing on Indigenous perspectives reported in the literature, we propose recommendations on community-research collaboration, culturally safe intergenerational and gender-equitable community HPV vaccine education, as well as multi-level transparency to ensure informed consent is secured in the context of reciprocal relationships. Although the voices of key informant groups (e.g., HPV-vaccine eligible youth and community Elders) are underrepresented in the literature, the identification of barriers and supports to HPV vaccination in a global Indigenous context might help inform researchers and health policy makers who aim to improve HPV vaccine uptake in Indigenous populations.

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Section: Indigenous Healthcare Worker Perspectivesmentioning

confidence: 99%

Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review

MacDonald

Kenzie

Letendre

et al. 2023

PLOS Glob Public Health

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“…McBain-Rigg and Veitch [10] offer alternate reasons and suggest that ante-natal engagement is impacted by transportation issues, access affordability and cultural and language barriers. The national and international literature is consistent in terms of the perceived views held by midwives on the utility of vaccines [1,6,17]. Midwives are collectively described as being supportive of their application and use.…”

Section: Discussionmentioning

confidence: 76%

“…For Aboriginal families, it also improves the accessibility and acceptability of the available services [10,18,19]. From the provider perspective, it offers insight into past trauma and colonisation [17]. Cultural safety also provides a greater understanding of kinship and relationships in Aboriginal families, the women's responsibility to her family, and her positioning with the land, country, and environment.…”

Section: Discussionmentioning

confidence: 99%

The knowledge, attitudes and beliefs of midwives on the vaccination coverage rates in Perth’s Aboriginal children

2021

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Background Midwives are well placed to promote vaccination awareness throughout a women’s pregnancy and strengthen childhood vaccination demand following hospital discharge. In Perth, Western Australia, Aboriginal children experience some of the lowest vaccination coverage rates across the nation. To identify factors preventing greater vaccination uptake amongst the target population, a theory-based study was conducted with midwives across two Perth maternity hospitals to explore behavioural attributes, knowledge, attitudes and beliefs surrounding vaccination provision and the vaccines administered to Aboriginal children. Methods A purpose-designed questionnaire was distributed to midwives working in two Perth public maternity hospitals. The proximal constructs of The Theory of Planned Behavior were used to frame the questionnaire to enable the barriers to greater vaccination coverage to be identified and behaviourally situated. Descriptive statistics described the demographics of the study sample. Chi-square and the Fisher’s exact test were used to identify associations between midwife characteristics and awareness of the coverage rates. Significance was set at α = 0.05. Results Of the 58 midwives who completed the study questionnaire, 77.2% were unaware of the sub-optimal vaccination coverage in Perth’s Aboriginal children. Level of education (p = 0.53) and years worked as a practising midwife (p = 0.47) were not found to be associated with an awareness of the coverage rates. Approximately, 50% of midwives reported some concern over the efficacy of childhood vaccines, 44.4% did not feel confident with their knowledge of vaccines, while 33.3% do not routinely discuss childhood vaccinations with parents prior to hospital discharge. Conclusions Key findings in the study identified that a range of educational, leadership and system-based issues are affecting midwives’ capacity to play a more substantial role in influencing vaccination coverage in Perth’s Aboriginal children.

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“…The overall characteristics of included studies are summarized in each section of the key attributes of good PHC delivery [19]. Of 112 studies included, methodologically, 29 were qualitative studies [17,, 20 were cross-sectional [52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69][70][71], 15 were mixed-method studies [72][73][74][75][76][77][78][79][80][81][82][83][84][85][86], 10 were national / state based surveys / census [87][88][89][90][91][92][93][94][95][96], nine were retrospective / prospective cohort [97][98]…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…, in our scoping review, 36 studies[17,25,30,34,36,44,45,50,53,54,61,65,67,71,72,74,75,79,83,85,90,93,95,96,98- 102,116,122,127,128,131-133] assessed various indicators of access to PHC. Of these studies, 15 studies reported service access[36,45,53,54,71,72,74,83,85,90,99,100,102,122,132), three reported acceptability[44,65,75] and the rest of the studies assessed explanatory factors, barriers and challenges of access and coverage of PHC[17,25,30,34,50,61,67,79,93,95,96,98,101,116,127,128,131,133] (Table…”

mentioning

confidence: 99%

Successes and challenges of primary health care in Australia: A scoping review and comparative analysis

et al. 2023

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Introduction Australia has achieved universal health insurance for its population since 1975 -a major step forward for increasing access to primary care (PC). Nevertheless, there are reports of several multi-layered challenges, including inequity, that persist. This analysis aims to undertake a scoping review of the success, explanatory factors, and challenges of Primary Health Care (PHC) in Australia guided by the World Health Organization (WHO)-defined key characteristics of good PC. MethodsWe searched PubMed, Embase, Scopus and Web of Science using key terms related to PHC principles, attributes, system functioning and health care delivery modalities. We also used key PC terminologies used to assess key characteristics of good PC developed by WHO and key terms and attributes from Australia's health care landscape. We then integrated our search terms with the PHC Search Filters developed by Brown, L., et al. (2014). We restricted the search from 2013 to 2021. Two authors independently assessed study eligibility and performed a quality check on the extracted data. We presented findings according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. ResultsWe identified 112 articles on primary health care (PHC), represented from all Australian states and territories. Overall, Australian PHC has achieved comprehensiveness, access and coverage, quality of care, patient / person centeredness and service coordination indicators with exemplary evidence-base practice/ knowledge translation and clinical decision-making practices at the PC settings. Yet, we identified complex and multilayered barriers including geographic and socio-economic berries and inequality, staff dissatisfaction/turn over, low adoption of person-centred care, inadequate sectoral collaboration, and inadequate infrastructure in rural and remote primary care units. ConclusionPrimary health care in Australia, which has evolved through major reforms, has been adapting to the complex health care needs of the socio-culturally diversified nation, and has achieved many of the PC attributes, including service diversity, accessibility, acceptability, and quality of care. Yet, there are persistent gaps in service delivery to socio-economically disadvantaged populations, including indigenous people, culturally and linguistically diverse (CALD) populations, and rural-and remote-residents. These challenges could be mitigated through system-wide and targeted policy-level intervention to further improve service delivery through effective and functional local health service coordination, sectoral integration, and improving health care providers' cultural competence.

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Barriers to vaccination service delivery within general practice: opportunity to make a sustainable difference in Aboriginal child health?

Cited by 3 publications

References 24 publications

Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review

Barriers and supports for uptake of human papillomavirus vaccination in Indigenous people globally: A systematic review

The knowledge, attitudes and beliefs of midwives on the vaccination coverage rates in Perth’s Aboriginal children

Successes and challenges of primary health care in Australia: A scoping review and comparative analysis

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