Exploring Factors Influencing Immunization Utilization in Nigeria—A Mixed Methods Study

Akwataghibe, Ngozi; Ogunsola, Elijah A.; Broerse, Jacqueline E. W.; Popoola, Oluwafemi; Agbo, Adanna I.; Dieleman, Marjolein

doi:10.3389/fpubh.2019.00392

Cited by 67 publications

(121 citation statements)

References 20 publications

(25 reference statements)

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“…Forty-eight articles met all inclusion criteria for this study; 28 articles were excluded for various reasons. [See supplementary materials 3] Nine articles employed second-hand data analysis [7,12,18,27,37,40,41,47,42]; thirty-six used crosssectional design [1][2][3]11,[13][14][15][16][17]19,[21][22][23][24][25][26][28][29][30][31][32][33][34][35][36][38][39]42,[45][46][48][49][50][51]53,54] and three used case-control study [20,[43][44]. All described studies were conducted on Africa populations (103,655 adults and 76,327 children).…”

Section: Resultsmentioning

confidence: 99%

“…One critically examined barriers speci c to vaccination doses at birth 0 -1day [18] in the Gambia. Thirty articles reported national immunization coverage [1][2]7,[11][12][13][14][15][16][20][21][22][23][24][25][28][29]32,[34][35][38][39][40][43][44][45][46]49,50,[52][53][54], eighteen did not [3,[17][18][19]22,24,[26][27][30][31]33,[36][37][41][42]47,48,…”

Section: Resultsmentioning

confidence: 99%

“…8 studies examined allparental/caretakers, health systems and providers' barriers [3,11,13,16,43,45,48,52] [18,20]. Misconceptions about childhood immunization were recorded as major hindrance to effective utilization of immunization services in this review [1,2,[11][12][13][14][21][22]29,31,32,48,49] One article [17] reported that some parents believed that the immunity induced by vaccines is less effective than that of the natural disease, and they prefer to endure the diseases than immunization. Some caregivers were reported to believe in the e cacy of traditional medicines as an alternative to immunization and concomitant treatment by traditional healers [31,35].…”

Section: Resultsmentioning

confidence: 99%

“…One study noted that the likelihood of vaccination of a child by day 7 is higher among children residing in rural areas than those in urban and pre-urban settings [18]. Socio-cultural factors and religion were noted to have negatively impacted immunization uptake [12,18,19,22,23,37,48]. Ethnicity and cultural beliefs were reported barriers to vaccine utilization and coverage; certain ethnic groups within the same country were identi ed with low coverage.…”

Section: Resultsmentioning

confidence: 99%

“…We describe health system barriers as inherent factors that obstruct the process of delivering vaccine and vaccine related services to it bene ciaries. These includes broken cold chain, irregular supplies and distribution of vaccines; limited human resource and infrastructures, and long distances separating health facilities from families [1][2][3]11,13,[14][15][16]19,22,23,25,29,32,35,43,44,[47][48][49][50][51][52]. Vaccine shortages at health facility level and di culties of transporting vaccines were commonly reported to signi cantly hinder immunization services [1-174 3,11,14,16,19,22,23,25,33,43,47,48,52,51].…”

Section: Health System Barriersmentioning

confidence: 99%

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Barriers to Childhood Immunization in Sub-Saharan Africa: A Systematic Review

Bangura

Qiu

Ouyang

et al. 2020

Preprint

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Background Immunization to prevent infectious diseases is a core strategy to improve childhood health as well as survival. It remains a challenge for some African countries to attain the required childhood immunization coverage. We aim at identifying individual barriers confronting parents/caretakers, providers, and health systems that hinder childhood immunization coverage in Sub-Saharan Africa. Method This systematic review searched PubMed/MEDLINE, Web of Science and EMBASE. We restricted to published articles in English that focused on childhood immunization barriers in Sub-Saharan Africa from January 1988 to February 2019. We excluded studies if: focused on barriers to immunization for children in other regions of the world, studied adult immunization barriers; studies not available on the university library, they were editorial, reports, reviews, supplement, and bulletins. Study designs included were cross-sectional, second-hand data analysis; and case control. Results Of the 2,538 items identified, 40 met inclusion criteria. Parents/caretakers were the most common subjects. Eight articles were of moderate and 32 were of high methodological quality. Seven studies analyzed secondary data; 30 used cross-sectional designs and three employed case control method. Twenty-five studies reported national immunization coverage of key vaccines for children under one, fifteen did not. When reported, national immunization coverages of childhood vaccines were reported to be low. Parents/caretaker’s barriers included lack of knowledge of immunization, distance to access point, financial deprivation, lack of partners support, and distrust in vaccines and immunization programs. Other associated factors for low vaccine rates included the number of off-springs, life style, migration and occupation. Barriers at health system level cited by healthcare providers included limited human resources and inadequate infrastructures to maintain the cold chain and adequate supply of vaccines. Conclusion In this review we identified more thoroughly the parents/caretakers’ barriers than those of providers and health systems. Factors that influenced decisions to get children vaccinated were mainly their gender, beliefs, socio-economic and socio-culture factors in the communities in which they live. Thus it is vital that immunization programs consider these barriers and address the people and societies in their communities across Sub-Saharan Africa.

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