Salleh Hazeqa, Avoi Richard, Abdul Karim Haryati, Osman Suhaila, Dhanaraj Prabakaran, Ab Rahman Mohd Ali 'Imran
Department of Public Health Medicine, Faculty of Medicine and Health Sciences, University Malaysia, Kota Kinabalu 88400, Sabah, Malaysia.
Communications Programme, Faculty of Social Sciences and Humanities, University Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia.
Vaccines (Basel). 2023 Jun 2;11(6):1056. doi: 10.3390/vaccines11061056.
The development of the measles-containing vaccine (MCV) has rendered measles a largely preventable disease. In the state of Sabah in Malaysia, a complete course of measles immunisation for infants involves vaccinations at the ages of six, nine, and twelve months. However, it is difficult for marginalised populations to receive a complete course of measles immunisation. This present study used behavioural theory (BT) to examine the beliefs and perceptions of a marginalised population towards community volunteering as a method of increasing the immunisation coverage of measles. Marginalised populations living in Kota Kinabalu, Sabah, more specifically, Malaysian citizens living in urban slums and squatter areas, as well as legal and illegal migrants, were extensively interviewed in person for this qualitative study. The 40 respondents were either the parents or primary caregivers of at least one child under the age of five. The components of the Health Belief Model were then used to examine the collected data. The respondents had poor awareness of the measles disease and perceived the disease as not severe, with some even refusing immunisation. The perceived barriers to receiving vaccinations included a nomadic lifestyle; issues with finances, citizenship status, language, and weather; failing to remember immunisation schedules; a fear of health care personnel; having too many children; and a lack of female autonomy in vaccine decision-making. However, the respondents were receptive towards community-based programmes and many welcomed a recall or reminder system, especially when the volunteers were family members or neighbours who spoke the same language and knew their village well. A few, however, found it awkward to have volunteers assisting them. Evidence-based decision making may increase measles immunisation coverage in marginalised populations. The components of the Health Belief Model validated that the respondents lacked awareness of the measles disease and viewed it and its effects as not severe. Therefore, future volunteer programmes should prioritise increasing the receptivity and self-control of marginalised populations to overcome barriers that hinder community involvement. A community-based volunteer programme is highly recommended to increase measles immunisation coverage.
含麻疹疫苗（MCV）的研发使麻疹成为一种基本可预防的疾病。在马来西亚沙巴州，婴儿的完整麻疹免疫程序包括在6个月、9个月和12个月时接种疫苗。然而，边缘化人群很难接受完整的麻疹免疫程序。本研究运用行为理论（BT）来考察边缘化人群对社区志愿服务的信念和看法，将其作为提高麻疹免疫覆盖率的一种方法。在这项定性研究中，对居住在沙巴州哥打基纳巴卢的边缘化人群，更具体地说，是居住在城市贫民窟和棚户区的马来西亚公民以及合法和非法移民进行了广泛的个人访谈。40名受访者均为至少一名5岁以下儿童的父母或主要照顾者。然后运用健康信念模型的组成部分来分析所收集的数据。受访者对麻疹疾病的认识较差，认为该疾病不严重，有些人甚至拒绝接种疫苗。接种疫苗的感知障碍包括游牧生活方式；财务、公民身份、语言和天气问题；记不住免疫接种时间表；害怕医护人员；孩子太多；以及在疫苗决策中缺乏女性自主权。然而，受访者对基于社区的项目持接受态度，许多人欢迎召回或提醒系统，特别是当志愿者是说同一种语言且熟悉他们村庄的家庭成员或邻居时。然而，有少数人觉得有志愿者协助他们很尴尬。基于证据的决策可能会提高边缘化人群的麻疹免疫覆盖率。健康信念模型的组成部分证实，受访者对麻疹疾病缺乏认识，认为其及其影响不严重。因此，未来的志愿者项目应优先提高边缘化人群的接受度和自我控制能力，以克服阻碍社区参与的障碍。强烈建议开展基于社区的志愿者项目以提高麻疹免疫覆盖率。
