Mutyoba Joan Nankya, Surkan Pamela J, Makumbi Fredrick, Aizire Jim, Kirk Gregory D, Ocama Ponsiano, Atuyambe Lynn M
Department of Epidemiology & Biostatistics, School of Public Health, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
J Virus Erad. 2021 Apr 30;7(2):100039. doi: 10.1016/j.jve.2021.100039. eCollection 2021 Jun.
Sub-Saharan Africa continues with very low hepatitis B (HBV) birth dose vaccination coverage. To guide policy on HBV vaccine for newborns, we explored perceptions, barriers and preferences of pregnant women regarding HBV and the HBV birth dose vaccination.
We conducted eight focus groups discussions (FGDs) among 70 pregnant women, stratified by rural-urban residence, age and education level, using a structured focus group discussion guide to explore birth dose awareness, perceptions, barriers and preferences. Data were transcribed, coded and analysed using framework analysis.
Perceptions related to HBV and liver cancer causes and prevention were diverse; most FGD participants did not perceive illnesses as distinctly different. Older women-groups, both urban and rural, had never heard about HBV, but were aware of liver cancer, viewing the disease as fatal. No FGD participants were aware of HBV birth dose. Concerns included vaccine safety, its availability to women who deliver outside the health system and mistrust in health-care worker (HCWs) when handling newborns. Rural-dwelling groups perceived absence of HBV services, while FGDs with young participants believed vaccine side-effects hampered birth dose planning. Most women-groups preferred (i) oral to injectable vaccines; (ii) receiving birth dose education during antenatal, to media-based education; (iii) that newborns receive the birth dose immediately after delivery in the mother's presence.
Although the birth dose is acceptable among pregnant women, planners need to continuously engage them as key stakeholders during planning to address concerns, in order to raise confidence, maximize uptake and strengthen HBV eradication efforts.
撒哈拉以南非洲地区的乙肝（HBV）首剂疫苗接种覆盖率仍然很低。为指导新生儿乙肝疫苗接种政策，我们探讨了孕妇对乙肝病毒及乙肝首剂疫苗接种的认知、障碍和偏好。
我们对70名孕妇进行了8次焦点小组讨论（FGD），根据城乡居住地、年龄和教育水平进行分层，使用结构化的焦点小组讨论指南来探讨首剂疫苗接种的知晓情况、认知、障碍和偏好。数据进行转录、编码，并使用框架分析法进行分析。
对乙肝病毒以及肝癌病因和预防的认知各不相同；大多数焦点小组讨论参与者并未认为这些疾病有明显差异。城市和农村的老年女性群体从未听说过乙肝病毒，但知晓肝癌，认为这种疾病是致命的。没有焦点小组讨论参与者知晓乙肝首剂疫苗。担忧包括疫苗安全性、在卫生系统外分娩的妇女能否获得疫苗，以及对医护人员在处理新生儿时的不信任。农村居住群体认为缺乏乙肝服务，而年轻参与者所在的焦点小组讨论认为疫苗副作用阻碍了首剂疫苗接种计划。大多数女性群体更喜欢：（i）口服疫苗而非注射疫苗；（ii）在产前接受首剂疫苗接种教育，而非基于媒体的教育；（iii）新生儿在母亲在场的情况下出生后立即接种首剂疫苗。
尽管首剂疫苗接种在孕妇中是可接受的，但规划者在规划过程中需要持续将她们作为关键利益相关者来参与，以解决她们的担忧，从而提高信心、最大化疫苗接种率并加强乙肝消除工作。
