Lewtak Katarzyna, Nitsch-Osuch Aneta, Dzielska Anna, Maciejewski Tomasz, Atif Nurzynska Anastasiia, Sochoń-Latuszek Agnieszka, Kukuła Katarzyna, Kleszczewska Dorota Wiktoria
Medical University of Warsaw, Warsaw, Poland (Department of Social Medicine and Public Health).
Institute of Mother and Child, Warsaw, Poland (Department of Child and Adolescent Health).
Int J Occup Med Environ Health. 2024 Dec 18;37(6):602-616. doi: 10.13075/ijomeh.1896.02478. Epub 2024 Dec 12.
The aim of this qualitative research study was to explore the barriers encountered by Ukrainian war migrants and refugees in accessing vaccinations in Poland and the challenges related to delivering vaccinations observed by healthcare professionals (HCPs).
The study was based on an analysis of data from 18 in-depth interviews with HCPs working with Ukrainian refugees conducted in Poland in July and August 2023. The authors analyzed the data using the UNICEF Journey to Health and Immunization (JHI) framework in order to identify bottlenecks and possible interventions that could solve existing problems in preventive healthcare for migrants.
This qualitative study revealed that at each stage of the JHI, there were challenges related to vaccinating Ukrainian children in Poland, which were similar to those experienced in other countries - gaps in routine immunizations and the need to fill these gaps by ensuring refugee populations are fully included in routine immunization in the host country. The work environment, training, and communication with the Ukrainian mothers contribute to HCPs' engagement in increasing vaccine uptake among their patients. The HCPs' attitudes, skills, and experiences impacted their interactions with patients and participation in the immunization process. Healthcare professionals observed that the mother's journey was influenced by vaccine literacy level, competing priorities, individual barriers of access (e.g., language barrier, costs), as well as feelings associated with the decision to vaccinate a child, including worries about vaccine safety. The surrounding cultural norms, social support, and past experiences with the Ukrainian health system also influenced decisions on vaccinations.
Overcoming barriers related to vaccinations requires a comprehensive approach, starting with expanding HCPs' knowledge about migrants' rights to health services, including vaccinations, improving communication between patients and HCPs, building vaccine literacy/trust in vaccinations, and achieving vaccination coverage through tailored and flexible systemic solutions. Int J Occup Med Environ Health. 2024;37(6):602-16.
本定性研究旨在探讨乌克兰战争移民和难民在波兰接种疫苗时遇到的障碍,以及医疗保健专业人员(HCPs)在提供疫苗接种方面所观察到的挑战。
该研究基于对2023年7月和8月在波兰对与乌克兰难民合作的HCPs进行的18次深入访谈的数据进行分析。作者使用联合国儿童基金会健康与免疫之旅(JHI)框架对数据进行分析,以确定瓶颈以及可解决移民预防性医疗保健中现有问题的可能干预措施。
这项定性研究表明,在JHI的每个阶段,在波兰为乌克兰儿童接种疫苗都存在挑战,这些挑战与其他国家所经历的类似——常规免疫存在缺口,需要通过确保难民群体充分纳入东道国的常规免疫来填补这些缺口。工作环境、培训以及与乌克兰母亲的沟通有助于HCPs致力于提高患者的疫苗接种率。HCPs的态度、技能和经验影响了他们与患者的互动以及在免疫过程中的参与度。医疗保健专业人员观察到,母亲的就医过程受到疫苗知识水平、相互竞争的优先事项、个体获取障碍(如语言障碍、费用)以及与为孩子接种疫苗的决定相关的感受(包括对疫苗安全性的担忧)的影响。周围的文化规范、社会支持以及过去与乌克兰卫生系统的经历也影响了疫苗接种的决策。
克服与疫苗接种相关的障碍需要一种全面的方法,首先要扩大HCPs对移民获得包括疫苗接种在内的卫生服务权利的了解,改善患者与HCPs之间的沟通,建立疫苗知识/对疫苗接种的信任,并通过量身定制和灵活的系统解决方案实现疫苗接种覆盖率。《国际职业医学与环境卫生杂志》。2024年;37(6):602 - 16。