Saleh Sara, Chedid Pia
Department of Nursing, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
Department of Medical Laboratory Technology, Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon.
PLoS One. 2025 May 8;20(5):e0322205. doi: 10.1371/journal.pone.0322205. eCollection 2025.
Barriers to childhood immunization in Lebanon are multifaceted. While Lebanon has historically maintained high immunization coverage, recent socio-economic challenges and recurrent political crisis have strained the healthcare system, leading to decreased vaccination rates. The knowledge, attitudes, and practices (KAP) of mothers play a key role in determining whether their children receive recommended immunizations. The aim of this study was to assess the KAP of Lebanese mothers regarding childhood immunization and to identify potential barriers to vaccination in children.
A cross-sectional study was conducted among Lebanese mothers with children aged between zero days to 5 years old. A stratified random sampling method was used and a structured questionnaire was administered to collect data on KAP regarding childhood immunization. Descriptive statistics were performed. Chi-square test and linear regression were used to assess the association between KAP and sociodemographic factors with significance set at p < 0.05.
Most mothers demonstrated good knowledge (86.3%) and positive attitudes (94.8%) toward vaccination. However, only 43.3% exhibited good vaccination practices. Significant disparities were observed in rural regions such as Beqaa, where mothers had the lowest education levels, the highest rates of poor knowledge (11.9%), and the lowest vaccination practice scores (32.7%). Employment was significantly associated with higher knowledge scores (p = 0.002, 95% CI: -1.42 to -0.33), while household income was significantly associated with attitudes (p = 0.009, 95% CI: -0.96 to -0.13) and vaccination practices (p = 0.002, 95% CI: -0.48 to -0.11). Vaccine unavailability and cost were frequently cited as barriers, particularly in rural regions.
Discrepancy between knowledge and attitude v/s practice suggests that a number of barriers prevent mothers from translating their good knowledge and positive attitude into action. Significant regional disparities exist, with rural areas like Beqaa facing the greatest challenges. Strengthening vaccine accessibility, implementing targeted educational interventions, and increasing governmental support are critical to improving immunization coverage nationwide.
黎巴嫩儿童免疫接种面临多方面的障碍。尽管黎巴嫩历来保持着较高的免疫接种覆盖率，但近期的社会经济挑战和反复出现的政治危机给医疗系统带来了压力，导致疫苗接种率下降。母亲们的知识、态度和行为在决定其子女是否接受推荐的免疫接种方面起着关键作用。本研究的目的是评估黎巴嫩母亲对儿童免疫接种的知识、态度和行为，并确定儿童疫苗接种的潜在障碍。
对有0天至5岁子女的黎巴嫩母亲进行了一项横断面研究。采用分层随机抽样方法，并使用结构化问卷收集有关儿童免疫接种的知识、态度和行为的数据。进行了描述性统计。卡方检验和线性回归用于评估知识、态度和行为与社会人口学因素之间的关联，显著性设定为p < 0.05。
大多数母亲对疫苗接种表现出良好的知识（86.3%）和积极的态度（94.8%）。然而，只有43.3%的母亲表现出良好的疫苗接种行为。在贝卡等农村地区观察到显著差异，那里的母亲教育水平最低，知识水平差的比例最高（11.9%），疫苗接种行为得分最低（32.7%）。就业与较高的知识得分显著相关（p = 0.002，95%置信区间：-1.42至-0.33），而家庭收入与态度（p = 0.009，95%置信区间：-0.96至-0.13）和疫苗接种行为（p = 0.002，95%置信区间：-0.48至-0.11）显著相关。疫苗供应不足和成本经常被列为障碍，特别是在农村地区。
知识与态度和行为之间的差异表明，一些障碍阻碍了母亲们将她们良好的知识和积极的态度转化为行动。存在显著的地区差异，像贝卡这样的农村地区面临着最大的挑战。加强疫苗可及性、实施有针对性的教育干预措施以及增加政府支持对于提高全国免疫接种覆盖率至关重要。
