Factors contributing to the uptake of childhood vaccination in Galkayo District, Puntland, Somalia

Abstract

Background: As in many Sub-Saharan African countries, the health system in Somalia is not operating at the capacity needed to lift childhood vaccination coverage to ninety percent or above, as recommended by United Nations Children's Fund. Current national estimates of coverage for the six major vaccine preventable childhood diseases range from thirty to sixty percent. Infectious disease outbreaks continue to pose significant challenges for the country's health authorities. Objective: This important qualitative study, conducted in Galkayo District, Somalia, investigates limiting factors associated with childhood vaccination uptake from the perspective of both communities and health care workers. Methods: Qualitative information was collected through six focus group discussions with parents (n = 48) and five one-to-one interviews with health workers (n = 15) between March and May 2017, in three settings in the Galkayo District-Galkayo city, Bayra and Bacadwayn. Results: From a health system perspective, the factors are: awareness raising, hard to reach areas, negative attitudes and perceived knowledge of health workers, inadequate supplies and infrastructure, and missed vaccination opportunities. From the perspective of individuals and communities the factors are: low trust in vaccines, misinterpretation of religious beliefs, vaccine refusals, Somalia's patriarchal system and rumours and misinformation. Parents mostly received immunization information from social mobilizers and health facilities. Fathers, who are typically family decision-makers, were poorly informed. The findings highlight the need for in-service training to enable health workers to improve communication with parents, particularly fathers, peripheral communities and local religious leaders. Conclusions: Enhancing knowledge and awareness of vaccination among parents is crucial. Fathers' involvement is lacking. This may be boosted by highlighting fathers' obligation to protect their children's health through vaccination. It is also important that men engage with the wider community in decision-making and advance towards the global vaccination targets.

Vaccine hesitancy among parents and its influencing factors: a cross-sectional study in Guangzhou, China

“…With all other variables adjusted, multivariate analysis revealed that parental mistrust of domestic vaccines was one of the main risk factors for vaccine hesitancy in Guangzhou. A study on the factors affecting childhood vaccination in Galkayo District, Puntland, Somalia showed that parents’ low trust in vaccines could not be ignored, 31 while vaccine safety was one of the main factors that affected parents’ trust in vaccines. From 2016 to 2018, the reported vaccine safety incidents attracted significant attention in China.…”

Childhood vaccine uptake in Africa: threats, challenges, and opportunities

“…This disrupts vaccination programs and prevents children from being fully vaccinated. 19 Restoration of routine immunizations takes long because of the destruction of health care facilities during wars. For example, DRC Congo continues experiencing conflicts between the armed militia groups, FDLR and Mai Mai militia.…”

The attitudes of obstetric caregivers towards labor pain relief methods and associated factors at public health centers of East Gojjam zone, Amhara Region, Ethiopia: Institutional based cross-sectional study

“…Thus, labour pain is perceived as a normal life journey by most women and midwives [ 3 , 4 ]. Labour pain is caused by uterine muscle contractions and pressure exerted by presenting part of the fetus against the maternal pelvis, urinary bladder, and bowel during the passage of the fetus through the birth canal [ 5 , 6 ]. Loneliness, ignorance, unkind or insensitive treatment during labour, along with unresolved past psychological or physical distress, increases the chance that the woman will suffer.…”