Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Department of Community Medicine, University College Hospital, Ibadan, Nigeria.
BMC Health Serv Res. 2024 Oct 21;24(1):1262. doi: 10.1186/s12913-024-11623-7.
In Nigeria, COVID-19 vaccines were delivered through outreach activities, as well as integrated within routine immunisation. However, evaluations of integrated approaches for novel vaccines are scarce. We aimed to understand the perceived benefits and challenges of integrating the COVID-19 vaccine within routine immunisation in Nigeria, and identify ways to strengthen this approach.
We conducted 30 semi-structured interviews with community members and healthcare workers in primary healthcare facilities (PHCs) in Jigawa (n = 16) and Oyo (n = 14) states, Nigeria from 08 August to 13 September 2022. Participants were selected purposively from PHCs. We obtained information on participants' perception about routine immunisation, and perceived benefits and challenges associated with integrated COVID-19 vaccine delivery. Healthcare worker and community interviews were analysed separately following a thematic analysis approach.
We identified four themes that describe the community and healthcare workers' responses, perceived impact, and the health system adaptions to the challenges associated with the integrated vaccine delivery approach. Community members expressed concern that children might be given COVID-19 vaccines instead of routine immunisations, while others appreciated the integrated approach due to their trust in the efficacy of COVID-19 vaccines, government, and healthcare providers. Healthcare providers perceived the integrated approach as improving vaccination coverage and awareness but noted additional problems of increased workload, vaccine scarcity, and prolonged clinic visits. Insufficient resources were subsisting barriers to effective integration in both states, but the provider's gender was also a challenge in Jigawa state. Additionally, the use of incentives to generate demand had ambiguous effects in Jigawa state.
Taking an integrated approach to deliver COVID-19 vaccines was acceptable by healthcare providers but community members expressed concerns. Given existing vaccination programmes have persistent challenges, it is pertinent to address these barriers to enhance effectiveness of an integrated approach.
在尼日利亚，通过外展活动以及常规免疫规划来提供 COVID-19 疫苗。然而，对于新型疫苗的综合方法评估却很少。本研究旨在了解在尼日利亚将 COVID-19 疫苗纳入常规免疫规划中的益处和挑战，并确定加强这种方法的途径。
我们于 2022 年 8 月 8 日至 9 月 13 日在尼日利亚吉加瓦州（n=16）和奥约州（n=14）的基层医疗设施（PHC）中进行了 30 次半结构化访谈，访谈对象包括社区成员和医疗保健工作者。参与者是从 PHC 中通过目的性抽样方法选择的。我们获得了有关参与者对常规免疫规划的看法以及与整合 COVID-19 疫苗接种相关的益处和挑战的信息。医疗保健工作者和社区访谈分别按照主题分析方法进行分析。
我们确定了四个主题，这些主题描述了社区和医疗保健工作者的反应、感知影响以及与整合疫苗接种方法相关的卫生系统适应。社区成员担心儿童可能会接种 COVID-19 疫苗而不是常规免疫接种，而其他人则因为信任 COVID-19 疫苗的有效性、政府和医疗保健提供者而赞赏这种整合方法。医疗保健提供者认为整合方法提高了疫苗接种覆盖率和意识，但也注意到了工作量增加、疫苗短缺和就诊时间延长等额外问题。资源不足是两个州有效整合的障碍，但在吉加瓦州，提供者的性别也是一个挑战。此外，在吉加瓦州，激励措施的使用对需求的产生产生了不确定的影响。
向医疗保健提供者提供综合方法来提供 COVID-19 疫苗是可以接受的，但社区成员表示担忧。鉴于现有疫苗接种计划仍存在挑战，有必要解决这些障碍，以提高综合方法的效果。
