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Padjadjaran of Nursing Journal

Original

Vol. 10 No. 3 (2022): Jurnal Keperawatan Padjadjaran

Barriers felt by nurses related to childhood basic immunisation in East Nusa Tenggara: A phenomenological study

DOI
https://doi.org/10.24198/jkp.v10i3.2164
Submitted
November 6, 2022
Published
2022-12-31

Abstract

Background: Immunisation barriers can increase morbidity and mortality associated with vaccine-preventable diseases. Understanding barriers to childhood vaccination is critical to informing effective interventions to maximise coverage.

Purpose: This study aims to explore the experiences of nurses involved in immunisation related to the obstacles they experience in immunisation activities.

Methods: This research is qualitative research with a phenomenological approach. Nurse participants who manage immunisation activities at the public health centre were recruited using a purposive sampling technique. In-depth interviews were conducted with 15 nurses who work in immunisation activities. Inclusion criteria are nurses who directly provide immunisation services and have managed the immunisation program for more than one year. Exclusion criteria were nurses who were on leave. The study was conducted from August to September 2022, and face-to-face interviews were conducted. Interview transcripts were analysed using the thematic analysis method.

Results: Three major themes were generated in this study, namely: 1) barriers to immunisation governance systems, 2) barriers to vaccine recipients, and 3) policy barriers.

Conclusions: Interventions to overcome barriers to immunisation need to be carried out comprehensively at various levels, such as promoting the benefits of vaccines for the community, strengthening the capacity of officers' competence, reducing political bias, and funding supporting facilities for immunisation programs.

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References

  1. Al-Salihi, L., Aakef, I., Al-Shuwaili, S., & Zaki Hadi, W. (2019). Primary health-care staff barriers to immunization. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine, 44(3), 256. https://doi.org/10.4103/IJCM.IJCM_14_19
  2. Atkinson, C. L., & Atkinson, A. M. (2021). Vaccine hesitancy and administrative burden in the Australian National Immunization Program: An analysis of twitter discourse. Knowledge, 1(1), 25-39. https://doi.org/10.3390/KNOWLEDGE1010004
  3. Atkinson, K. M., Mithani, S. S., Bell, C., Rubens-Augustson, T., & Wilson, K. (2020). The digital immunization system of the future: Imagining a patient-centric, interoperable immunization information system. Therapeutic Advances in Vaccines and Immunotherapy, 8.
  4. https://doi.org/10.1177/2515135520967203/ASSET/IMAGES/LARGE/10.1177_2515135520967203-FIG1.JPEG
  5. Bajnok, I. R., Shamian, J., Catton, H. R., Hons, E., Skinner, T., & Pavlovic, T. (2018). The role of nurses in immunization. International Council of Nurses. Retrieved form: www.icn.ch
  6. Bangura, J. B., Xiao, S., Qiu, D., Ouyang, F., & Chen, L. (2020). Barriers to childhood immunization in Sub-Saharan Africa: A systematic review. BMC Public Health, 20(1), 1-15. https://doi.org/10.1186/S12889-020-09169-4/TABLES/1
  7. Borg, K., Sutton, K., Beasley, M., Tull, F., Faulkner, N., Halliday, J., Knott, C., & Bragge, P. (2018). Communication-based interventions for increasing influenza vaccination rates among aboriginal children: A randomised controlled trial. Vaccine, 36(45), 6790-6795. https://doi.org/10.1016/J.VACCINE.2018.09.020
  8. Central Bureau of Statistics East Nusa Tenggara. (2021). East Nusa Tenggara Province in 2021 profile. In Central Bureau of Statistics East Nusa Tenggara. Central Bureau of Statistics East Nusa Tenggara. https://ntt.bps.go.id/publication/2021/02/26/28a3d01a29a82489c3f95190/provinsi-nusa-tenggara-timur-dalam-angka-2021.html
  9. East Nusa Tenggara Provincial Health Office. (2022). Evaluation of complete basic immunization (IDL) coverage in East Nusa Tenggara Province. In East Nusa Tenggara Provincial Health Office.
  10. Epaulard, O., Harboe, Z. B., Khaliq, A., Ashraf Elahi, A., Zahid, A., & Lassi, Z. S. (2022). A survey exploring reasons behind immunization refusal among the parents and caregivers of children under two years living in urban slums of Karachi, Pakistan. International Journal of Environmental Research and Public Health, 19(18), 11631. https://doi.org/10.3390/IJERPH191811631
  11. Feyisa, D., Ejeta, F., Aferu, T., & Kebede, O. (2022). Adherence to who vaccine storage codes and vaccine cold chain management practices at primary healthcare facilities in Dalocha District of Silt’e Zone, Ethiopia. Tropical Diseases, Travel Medicine and Vaccines, 8(1), 1-13. https://doi.org/10.1186/S40794-022-00167-5/TABLES/7
  12. Gooding, E., Spiliotopoulou, E., & Yadav, P. (2019). Impact of vaccine stockouts on immunization coverage in Nigeria. Vaccine, 37(35), 5104-5110. https://doi.org/10.1016/J.VACCINE.2019.06.006
  13. Grandahl, M., Paek, S. C., Grisurapong, S., Sherer, P., Tydén, T., & Lundberg, P. (2018). Parents’ knowledge, beliefs, and acceptance of the HPV vaccination in relation to their socio demographics and religious beliefs: A cross-sectional study in Thailand. PLOS ONE, 13(2), e0193054. https://doi.org/10.1371/JOURNAL.PONE.0193054
  14. Hirani, J. C., & Wüst, M. (2022). Nurses and infant vaccination coverage. Journal of Economic Behavior & Organization, 196, 402-428. https://doi.org/10.1016/J.JEBO.2022.01.030
  15. Hussain, S. F., Boyle, P., Patel, P., & Sullivan, R. (2016). Eradicating polio in Pakistan: An analysis of the challenges and solutions to this security and health issue. Globalization and health, 12(1), 1-9. https://doi.org/10.1186/S12992-016-0195-3
  16. Janusz, C. B., Frye, M., Mutua, M. K., Wagner, A. L., Banerjee, M., & Boulton, M. L. (2021). Vaccine delay and its association with under vaccination in children in Sub-Saharan Africa. American Journal of Preventive Medicine, 60(1), S53-S64. https://doi.org/10.1016/J.AMEPRE.2020.10.003
  17. Malande, O. O., Munube, D., Afaayo, R. N., Annet, K., Bodo, B., Bakainaga, A., Ayebare, E., Njunwamukama, S., Mworozi, E. A., & Musyoki, A. M. (2019). Barriers to effective uptake and provision of immunization in a rural district in Uganda. PLOS ONE, 14(2), e0212270. https://doi.org/10.1371/JOURNAL.PONE.0212270
  18. Ministry of Health Republic of Indonesia. (2020). Technical instructions for immunization services during the COVID-19 pandemic. https://infeksiemerging.kemkes.go.id/download/Final_Juknis_Pelayanan_Imunisasi_pada_Masa_Pandemi_COVID-19.pdf
  19. Ministry of Health Republic of Indonesia. (2022). Review and evaluation of immunization program achievements in East Nusa Tenggara Province. In Ministry of Health of the Republic of Indonesia.
  20. Navin, M. C., Kozak, A. T., & Deem, M. J. (2020). Perspectives of public health nurses on the ethics of mandated vaccine education. Nursing Outlook, 68(1), 62-72. https://doi.org/10.1016/J.OUTLOOK.2019.06.014
  21. Neubauer, B. E., Witkop, C. T., & Varpio, L. (2019). How phenomenology can help us learn from the experiences of others. Perspectives on Medical Education, 8(2), 90-97. https://doi.org/10.1007/S40037-019-0509-2
  22. Nicol, E., Turawa, E., & Bonsu, G. (2019). Pre- and in service training of health care workers on immunization data management in LMICs: A scoping review. Human Resources for Health, 17(1), 1-14. https://doi.org/10.1186/S12960-019-0437-6/TABLES/3
  23. Ogboghodo, E. O., Omuemu, V. O., Odijie, O., & Odaman, O. J. (2018). Cold chain management: An assessment of knowledge and attitude of health workers in primary health care facilities in Edo State Nigeria. Sahel Medical Journal, 21(2), 75. https://doi.org/10.4103/SMJ.SMJ_45_17
  24. Padmawati, R. S., Heywood, A., Sitaresmi, M. N., Atthobari, J., MacIntyre, C. R., Soenarto, Y., & Seale, H. (2019). Religious and community leaders’ acceptance of rotavirus vaccine introduction in Yogyakarta, Indonesia: A qualitative study. BMC Public Health, 19(1), 1-6. https://doi.org/10.1186/S12889-019-6706-4/PEER-REVIEW
  25. Porth, J. M., Wagner, A. L., Teklie, H., Abeje, Y., Moges, B., & Boulton, M. L. (2019). Vaccine non-receipt and refusal in Ethiopia: The expanded program on immunization coverage survey, 2012. Vaccine, 37(15), 2106-2121. https://doi.org/10.1016/J.VACCINE.2019.02.045
  26. Ropero Alvarez, A. M., Vilajeliu, A., Magariños, M., Jauregui, B., Guzmán, L., Whittembury, A., Cain, E., Garcia, O., Montesanos, R., & Ruiz Matus, C. (2021). Enablers and barriers of maternal and neonatal immunization programs in Latin America. Vaccine, 39, B34-B43. https://doi.org/10.1016/J.VACCINE.2020.07.051
  27. Rosen, B., Waitzberg, R., Israeli, A., Hartal, M., & Davidovitch, N. (2021). Addressing vaccine hesitancy and access barriers to achieve persistent progress in Israel’s COVID-19 Vaccination Program. Israel Journal of Health Policy Research, 10(1), 1-20. https://doi.org/10.1186/S13584-021-00481-X/TABLES/6
  28. Sahito, A., Ahmed, S., & Fatmi, Z. (2020). Covering the last mile for vaccination: Feasibility and acceptability of traditional birth attendant-based referral system in hard-to-reach areas in Rural Pakistan. Journal of Global Health, 10(2), 1-9. https://doi.org/10.7189/JOGH.10.021303
  29. Sandelowski, M. (1986). The problem of rigor in qualitative research. ANS. Advances in Nursing Science, 8(3), 27-37. https://doi.org/10.1097/00012272-198604000-00005
  30. Sawitri, A. A. S., Yuliyatni, P. C. D., Ariawan, M. D., Kartika Sari, K. A., Susanti, R., & Sutarsa, I, N. (2021). Limitations of immunization registers at community health centers for measuring immunization coverage: A case study of the japanese encephalitis mass immunization program in Bali Province, Indonesia. Osong Public Health and Research Perspectives, 12(3), 158. https://doi.org/10.24171/J.PHRP.2020.0241
  31. Silva, B. S., de Azevedo Guimarães, E. A., de Oliveira, V. C., Cavalcante, R. B., Pinheiro, M. M. E. K., Gontijo, T. L., Rodrigues, S. B., Ferreira, A. P., de Oliveira Quites, H. F., & Pinto, I. C. (2020). National immunization program information system: Implementation context assessment. BMC Health Services Research, 20(1), 1-10. https://doi.org/10.1186/S12913-020-05175-9/TABLES/3
  32. Singh, S., Sahu, D., Agrawal, A., & Vashi, M. D. (2019). Barriers and opportunities for improving childhood immunization coverage in slums: A qualitative study. Preventive Medicine Reports, 14, 100858. https://doi.org/10.1016/J.PMEDR.2019.100858
  33. Sundler, A. J., Lindberg, E., Nilsson, C., & Palmér, L. (2019). Qualitative thematic analysis based on descriptive phenomenology. Nursing Open, 6(3), 733. https://doi.org/10.1002/NOP2.275
  34. Wade, G. H. (2014). Nurses as primary advocates for immunization adherence. MCN The American Journal of Maternal/ Child Nursing, 39(6), 351-356. https://doi.org/10.1097/NMC.0000000000000083
  35. World Health Organization. (2021, July 15). Immunization coverage. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/immunization-coverage
  36. Yufika, A., Wagner, A. L., Nawawi, Y., Wahyuniati, N., Anwar, S., Yusri, F., Haryanti, N., Wijayanti, N. P., Rizal, R., Fitriani, D., Maulida, N. F., Syahriza, M., Ikram, I., Fandoko, T. P., Syahadah, M., Asrizal, F. W., Aletta, A., Haryanto, S., Jamil, K. F., … Harapan, H. (2020). Parents’ hesitancy towards vaccination in Indonesia: A cross-sectional study in Indonesia. Vaccine, 38(11), 2592-2599. https://doi.org/10.1016/J.VACCINE.2020.01.072
  37. Zhu, X., Weigel, P., Baloh, J., Nataliansyah, M., Gunn, N., & Mueller, K. (2019). Mobilising cross-sector collaborations to improve population health in US rural communities: A qualitative study. BMJ Open, 9(11), 30983. https://doi.org/10.1136/BMJOPEN-2019-030983