Community perceptions of malaria and vaccines in the South Coast and Busia regions of Kenya.
Community perceptions of malaria and vaccines in the South Coast and Busia regions of Kenya.
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DOI：
10.1186/1475-2875-10-147
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发表时间：
2011-05-30
期刊：
影响因子：
3
通讯作者：
Bingham, Allison
中科院分区：
文献类型：
--
作者：
Ojakaa, David I;Ofware, Peter;Bingham, Allison
背景：疟疾是肯尼亚5岁以下儿童发病和死亡的主要原因。在规划的背景下，与现有的疟疾控制方法一起使用的疫苗，本研究探讨了社会文化和健康的沟通问题，个人谁负责或影响儿童疫苗接种的决定在社区一级。方法：这是一项定性研究进行了两个疟疾流行的地区，肯尼亚-南海岸和布西亚。参与者的选择是有目的和标准的。共有20个焦点小组讨论，22个深入访谈，和18个退出interview were carried.RESULTS：与会者了解，疟疾是一个严重的问题，没有一个单一的工具可以打败。社区将欢迎疟疾疫苗，尽管他们对干预措施有疑问和担忧。虽然存在对当地儿童免疫计划的支持，但年轻人和老年人，特别是男性，对疫苗及其作用的了解有限。即使当父母不给孩子接种疫苗时，卫生保健提供者也感到沮丧，但一些父母对疫苗接种服务的获得和质量感到担忧。一些妇女，包括年长母亲和经济条件较差的妇女，认为自己是保健工作者对其养育子女的选择或其子女的外表所作负面评论的焦点。一般来说，父母和照顾者在决定是否给孩子接种疫苗时会权衡几个因素，如个人机会成本、资源限制和感知的好处，而且这一决定通常会受到包括社区领导人和卫生工作者在内的人群网络的影响。该研究提出的问题应能为宣传战略提供信息，并指导肯尼亚最终采用疟疾疫苗的政策决定。与目前的做法不同的是，关于儿童福利和免疫接种的保健教育侧重于妇女，宣传战略应以适合男女的方式平等地针对男女。它应该让有影响力的社区成员参与进来，并提供有关免疫接种的必要信息和保证。还应努力解决对免疫服务质量的关切-包括卫生工作者的人际沟通技能。
BACKGROUND: Malaria is a leading cause of morbidity and mortality in children younger than 5 years in Kenya. Within the context of planning for a vaccine to be used alongside existing malaria control methods, this study explores sociocultural and health communications issues among individuals who are responsible for or influence decisions on childhood vaccination at the community level.METHODS: This qualitative study was conducted in two malaria-endemic regions of Kenya--South Coast and Busia. Participant selection was purposive and criterion based. A total of 20 focus group discussions, 22 in-depth interviews, and 18 exit interviews were conducted.RESULTS: Participants understand that malaria is a serious problem that no single tool can defeat. Communities would welcome a malaria vaccine, although they would have questions and concerns about the intervention. While support for local child immunization programs exists, limited understanding about vaccines and what they do is evident among younger and older people, particularly men. Even as health care providers are frustrated when parents do not have their children vaccinated, some parents have concerns about access to and the quality of vaccination services. Some women, including older mothers and those less economically privileged, see themselves as the focus of health workers' negative comments associated with either their parenting choices or their children's appearance. In general, parents and caregivers weigh several factors--such as personal opportunity costs, resource constraints, and perceived benefits--when deciding whether or not to have their children vaccinated, and the decision often is influenced by a network of people, including community leaders and health workers.CONCLUSIONS: The study raises issues that should inform a communications strategy and guide policy decisions within Kenya on eventual malaria vaccine introduction. Unlike the current practice, where health education on child welfare and immunization focuses on women, the communications strategy should equally target men and women in ways that are appropriate for each gender. It should involve influential community members and provide needed information and reassurances about immunization. Efforts also should be made to address concerns about the quality of immunization services--including health workers' interpersonal communication skills.