Burnett James Michael, Myende Nqobile, Africa Algernon, Kamupira Mercy, Sharkey Alyssa, Simon-Meyer Janine, Bamford Lesley, Guo Sufang, Padarath Ashnie
Research and Implementation Science Unit, Health Systems Trust, Durban 4001, South Africa.
Health and Nutrition Section, United Nations International Children's Emergency Fund South Africa, Pretoria 0011, South Africa.
Vaccines (Basel). 2024 Sep 10;12(9):1035. doi: 10.3390/vaccines12091035.
In South Africa over the past 20 years, immunisation has saved countless lives as well as prevented illnesses and disabilities. Despite this, vaccine-preventable illnesses remain a danger. The demand for and uptake of immunisation services are shaped by a variety of factors that can either act as barriers or facilitators to immunisation uptake. The aim of this project was to identify the supply and demand barriers and develop local strategies to improve childhood immunisation in four zero-dose districts in South Africa. This study used a mixed-method approach. In each of these four districts, 15 in-depth key informant interviews with health workers and local health managers and four focus group discussions (10 participants per focus group discussion) with community members and caregivers were held over a three-month period. Transcribed interviews were thematically analysed using qualitative analysis software (Nvivo) into 10 factors as identified as important in influencing immunisation demand and uptake in previous studies. A further four were identified during the data analysis process. Despite the varying role of factors affecting demand and uptake of immunisation services, three consistent findings stand out as major barriers across all districts. The first is . This clearly highlights the crucial role that the interactions between patients and staff play in shaping perceptions and behaviours related to immunisation services. The second is the overall . This emphasises the role that patient experience of services plays in perceptions and behaviours related to immunisation services. The third is . This highlights the important role family dynamics play in shaping individuals' decisions regarding immunisation uptake as well as the impact it has on the ability of people to access health services. The role played by the different factors in the demand and uptake of immunisation services varied across the four districts examined in this study. Each of the districts presents a unique landscape where different factors have varying degrees of importance in affecting the utilisation of immunisation services. In some districts, certain factors are major barriers, clearly hindering the demand and uptake of immunisation services, while in others, these same factors might be a relatively minor barrier. This discrepancy highlights the unique nature of healthcare challenges across the districts and the need for tailored strategy recommendations to address them effectively.
在过去20年里，南非的免疫接种挽救了无数生命，预防了疾病和残疾。尽管如此，疫苗可预防疾病仍然构成威胁。免疫接种服务的需求和接受情况受到多种因素的影响，这些因素既可能成为免疫接种的障碍，也可能起到促进作用。本项目的目的是确定供应和需求方面的障碍，并制定地方战略，以改善南非四个零剂量区的儿童免疫接种情况。 本研究采用了混合方法。在这四个区中的每个区，在三个月的时间里，对卫生工作者和当地卫生管理人员进行了15次深入的关键信息人访谈，并与社区成员和照顾者进行了四次焦点小组讨论（每个焦点小组讨论有10名参与者）。使用定性分析软件（Nvivo）对转录的访谈进行主题分析，归纳出10个在以往研究中被认为对影响免疫接种需求和接受情况很重要的因素。在数据分析过程中又确定了另外4个因素。 尽管影响免疫接种服务需求和接受情况的因素作用各不相同，但有三个一致的发现成为所有区的主要障碍。第一个是 。这清楚地凸显了患者与工作人员之间的互动在塑造与免疫接种服务相关的观念和行为方面所起的关键作用。第二个是整体的 。这强调了患者的服务体验在与免疫接种服务相关的观念和行为中所起的作用。第三个是 。这凸显了家庭动态在塑造个人关于接受免疫接种的决定方面所起的重要作用，以及它对人们获得卫生服务能力的影响。 在本研究考察的四个区中，不同因素在免疫接种服务需求和接受情况中所起的作用各不相同。每个区都呈现出独特的情况，不同因素在影响免疫接种服务利用方面的重要程度各不相同。在一些区，某些因素是主要障碍，明显阻碍了免疫接种服务的需求和接受，而在其他区，这些相同的因素可能只是相对较小的障碍。这种差异凸显了各区医疗保健挑战的独特性质，以及需要制定针对性的战略建议来有效应对这些挑战。
