Qualitative insights into reasons for missed opportunities for vaccination in Kenyan health facilities

Abstract

Background In 2016, Kenya conducted a study of missed opportunities for vaccination (MOV)-when eligible children have contact with the health system but are not fully vaccinated-to explore some of the reasons for persistent low vaccination coverage. This paper details the qualitative findings from that assessment. Methods Using the World Health Organization MOV methodology, teams conducted focus group discussions among caregivers and health workers and in-depth interviews of key informants in 10 counties in Kenya. Caregivers of children <24 months of age visiting the selected health facilities on the day of the assessment were requested to participate in focus group discussions. Health workers were purposively sampled to capture a broad range of perspectives. Key informants were selected based on their perceived insight on immunization services at the county, sub-county, or health facility level. Results Six focus group discussions with caregivers, eight focus group discussions with health workers, and 35 in-depth interviews with key informants were completed. In general, caregivers had positive attitudes toward healthcare and vaccination services, but expressed a desire for increased education surrounding vaccination. In order to standardize vaccination checks at all health facility visits, health workers and key informants emphasized the need for additional trainings for all staff members on immunization. Health workers and key informants

Assessment of missed opportunities for vaccination (MOV) in Burkina Faso using the World Health Organization’s revised MOV strategy: Findings and strategic considerations to improve routine childhood immunization coverage

“…Our findings share certain similarities with recent MOV assessments in other countries [13] , [9] , [10] , [11] , indicating their potential relevance for countries with no formal MOV assessment. In such settings, immunization managers could consider skipping the assessment step and summarizing evidence from published studies and proceed to brainstorming, action-planning, and implementation of MOV-reduction activities, as recently proposed by WHO [31] .…”

“…Reducing MOV requires contextual evidence regarding the prevalence of MOV and its contributing factors. Several studies have investigated MOV elsewhere [10] , [11] , [12] , [13] , [14] , [15] , [16] , but to our knowledge there have been none to date in Burkina Faso.…”

Assessment of missed opportunities for vaccination in Kenyan health facilities, 2016

“…The quantitative component of the WHO MOV methodology, described in this paper, included exit interviews with caregivers of children <24 months and anonymous self-administered health worker knowledge, attitude and practices (KAP) surveys. The WHO guides on the MOV strategy and past MOV assessments provide more detailed information on the general process and expected outcomes [2,7,8,[25][26][27][28].…”

“…Recent studies in Chad, Malawi and Timor Leste using the updated WHO methodology showed that between 41-66% of eligible children had made contact with the health system and were not vaccinated with all the vaccines for which they were eligible [8,29]. In November 2016, to better understand the reasons for under-vaccination and to prioritize needed interventions, the Kenya NVIP conducted a MOV assessment using the updated WHO methodology [28]. This paper details the findings from the quantitative component of the MOV assessment.…”

“…This paper details the findings from the quantitative component of the MOV assessment. The results of the qualitative component of the Kenya MOV assessment have been described in detail in a separate manuscript [28].…”