Khatiwada Asmita Priyadarshini, Maskey Smriti, Shrestha Nistha, Shrestha Sunil, Khanal Saval, Kc Bhuvan, Paudyal Vibhu
Department of Pharmaceutical and Health Service Research, Nepal Health Research and Innovation Foundation, Lalitpur, Nepal.
University of North Texas Health Science Center, Fort Worth, TX, USA.
J Pharm Policy Pract. 2021 Sep 29;14(1):79. doi: 10.1186/s40545-021-00366-z.
The COVID-19 pandemic has disproportionately affected all essential healthcare services delivery in low-resource settings. This study aimed to explore the challenges and experiences of providers and users of childhood immunisation services in Nepal during the COVID-19 pandemic.
Semi-structured qualitative interviews were conducted with childhood immunisation service providers and users (i.e., parents of children) from Kathmandu valley, Nepal. All interviews were conducted through phone or internet-based tools, such as Zoom, WhatsApp, and messenger. All interviews were audio-recorded, transcribed verbatim, and analysed using theme-based content analysis in an Excel spreadsheet.
A total of 15 participants (n = 7 service providers and n = 8 service users) participated. Six themes were identified, namely: (1) impact of COVID-19 and lockdown on childhood immunisation services; (2) motivation and resilience for childhood immunisation; (3) Biosafety practices and Personal Protective Equipment (PPE) availability during the COVID-19 pandemic; (4) service adjustments and guidelines during pandemic; (5) availability of vaccines; and (6) immunisation program resilience in view of COVID-19. Service providers mentioned facing disruptions in services and some parents had decided to delay scheduled immunisation. However, most service providers showed determinations to deliver the services with high morale, while most service users reported taking their children for immunisation. Families migrating from urban to rural areas during the pandemic led to service providers having no means to confirm complete immunisation of migrating children. Service providers also experienced lack of adequate guidance to deal with the pandemic and personal protective equipment to protect themselves and service users.
Despite experiencing disruptions in childhood immunisation service due to the COVID-19 pandemic, service users and providers were determined to vaccinate the children. There is an urgent need for effective preparedness plans to be in place to address the observed barriers and to ensure resilient immunisation services during ongoing and future pandemics.
新冠疫情对资源匮乏地区所有基本医疗服务的提供造成了不成比例的影响。本研究旨在探讨尼泊尔在新冠疫情期间儿童免疫服务提供者和使用者所面临的挑战及经历。
对尼泊尔加德满都谷地的儿童免疫服务提供者和使用者（即儿童家长）进行了半结构化定性访谈。所有访谈均通过电话或基于互联网的工具进行，如Zoom、WhatsApp和信使。所有访谈均进行了录音，逐字转录，并在Excel电子表格中使用基于主题的内容分析法进行分析。
共有15名参与者（n = 7名服务提供者和n = 8名服务使用者）参与。确定了六个主题，即：（1）新冠疫情和封锁对儿童免疫服务的影响；（2）儿童免疫的动机和恢复力；（3）新冠疫情期间的生物安全措施和个人防护装备（PPE）供应情况；（4）疫情期间的服务调整和指南；（5）疫苗供应情况；以及（6）鉴于新冠疫情的免疫规划恢复力。服务提供者提到服务受到干扰，一些家长决定推迟预定的免疫接种。然而，大多数服务提供者表现出以高昂士气提供服务的决心，而大多数服务使用者报告带孩子进行了免疫接种。疫情期间从城市迁移到农村地区的家庭导致服务提供者无法确认迁移儿童的全程免疫情况。服务提供者还遇到缺乏应对疫情的充分指导以及保护自身和服务使用者的个人防护装备的问题。
尽管新冠疫情导致儿童免疫服务受到干扰，但服务使用者和提供者决心为儿童接种疫苗。迫切需要制定有效的准备计划，以解决所观察到的障碍，并确保在当前和未来疫情期间提供有恢复力的免疫服务。
