Power Rosalie, Vakaloloma Unise, Jahan Israt, Perera Sureni, Tuibeqa Ilisapeci, Devi Rachel, Volavola Litiana, May William, Wilson Donald, Tuimabu Lanieta, Khandaker Gulam, Sheel Meru
Translational Health Research Institute, Western Sydney University, New South Wales, Australia.
Fiji Institute of Pacific Health Research, College of Medicine, Nursing & Health Sciences, Fiji National University, Suva, Fiji.
PLOS Glob Public Health. 2025 Jan 8;5(1):e0004132. doi: 10.1371/journal.pgph.0004132. eCollection 2025.
Vaccinating children with disability in low- and middle-income countries, such as Fiji, is a key priority for equity. This study aimed to understand the social and behavioral drivers of vaccine uptake among children with disability in Fiji, from the perspectives of health, disability, and community stakeholders. Five qualitative focus groups were conducted with 22 stakeholders, including healthcare workers, disability service providers and advocates, and community and faith leaders (female n = 17, 77%). Data were collected and analyzed using reflexive thematic analysis and applied the World Health Organization's Behavioral and Social Drivers of Vaccination framework. Numerous drivers were reported to impact vaccination for children with disability. These included (1) Thinking and feeling: lack of reliable information about vaccine benefits and safety for children with disability; (2) Social processes: disability stigma and discrimination impacted families of children with disability engaging with healthcare services; lack of tailored vaccination communication and engagement strategies; and, need for improved disability and health service collaboration; (3) Motivation: lack of awareness and support for parents of children with disability to have their children vaccinated, and religious beliefs negatively impacted motivation; (4) Practical issues: long waiting times and lack of suitable waiting areas for children with disability; financial and time barriers; and, lack of healthcare worker knowledge and confidence in providing vaccines to children with disability, impacted patient-provider trust. The findings from this study can inform strategic actions to overcome barriers to vaccination for children with disability, including strengthening existing vaccination programs, promoting greater equity in vaccination for children with disability in Fiji. This will reduce the burden of vaccine-preventable diseases in this priority group.
在斐济等低收入和中等收入国家，为残疾儿童接种疫苗是实现公平的关键优先事项。本研究旨在从卫生、残疾和社区利益相关者的角度，了解斐济残疾儿童疫苗接种的社会和行为驱动因素。与22名利益相关者进行了5次定性焦点小组讨论，其中包括医护人员、残疾服务提供者和倡导者，以及社区和宗教领袖（女性n = 17，占77%）。使用反思性主题分析收集和分析数据，并应用了世界卫生组织的疫苗接种行为和社会驱动因素框架。据报告，有许多驱动因素影响残疾儿童的疫苗接种。这些因素包括：（1）思维和感受：缺乏关于残疾儿童疫苗益处和安全性的可靠信息；（2）社会过程：残疾污名和歧视影响残疾儿童家庭与医疗服务的接触；缺乏量身定制的疫苗接种沟通和参与策略；以及，需要改善残疾和卫生服务之间的协作；（3）动机：残疾儿童的父母缺乏让孩子接种疫苗的意识和支持，宗教信仰对动机产生负面影响；（4）实际问题：等待时间长，缺乏适合残疾儿童的等候区；经济和时间障碍；以及，医护人员在为残疾儿童提供疫苗方面缺乏知识和信心，影响了医患信任。本研究的结果可为克服残疾儿童疫苗接种障碍的战略行动提供参考，包括加强现有的疫苗接种计划，促进斐济残疾儿童疫苗接种更加公平。这将减轻这一优先群体中疫苗可预防疾病的负担。
