Community perceptions of vaccination among influential stakeholders: qualitative research in rural India

Abstract Background In India and other low- and middle-income countries, multiple family and community members are influential in caregivers’ perceptions of vaccination. Existing literature indicates the primary caregiver, typically the mother, is instrumental in vaccine decision-making, but this ma...

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Autores principales:	Baldeep K. Dhaliwal, Riti Chandrashekhar, Ananya Rattani, Rajeev Seth, Svea Closser, Anika Jain, David E. Bloom, Anita Shet
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Vaccination perceptions Vaccine acceptance Community health workers India Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/8c377f74d4324a6eaaf9a7f69dd838ca
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spelling	oai:doaj.org-article:8c377f74d4324a6eaaf9a7f69dd838ca2021-11-21T12:11:08ZCommunity perceptions of vaccination among influential stakeholders: qualitative research in rural India10.1186/s12889-021-12188-41471-2458https://doaj.org/article/8c377f74d4324a6eaaf9a7f69dd838ca2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12889-021-12188-4https://doaj.org/toc/1471-2458Abstract Background In India and other low- and middle-income countries, multiple family and community members are influential in caregivers’ perceptions of vaccination. Existing literature indicates the primary caregiver, typically the mother, is instrumental in vaccine decision-making, but this may vary in contexts. We investigated the role of stakeholders in India who influence caregivers’ vaccination perceptions, as this is essential to developing strategies to promote vaccine acceptance and improve uptake. Methods This research was conducted in 2019 in Mewat District in Haryana, an area in India with extremely low vaccination coverage. We conducted six focus group discussions with 60 participants in the following categories: fathers of children under-5 years old, expectant mothers, mothers-in-law, community health workers, and community influencers such as locally elected officials and religious leaders. Results Our results highlighted four themes that influence vaccine uptake. First, while caregivers associated vaccination with reductions in specific diseases, they also noted that vaccination services brought broad health gains, including improved nutrition, antenatal guidance, and social support. Second, community health workers critically influenced, positively or negatively, caregivers’ vaccination perceptions. Third, community health workers faced gaps in their education such as limited training on vaccine side-effects, placing them at a disadvantage when dealing with families. Finally, we found that mothers-in-law, fathers, and religious leaders influence caregivers’ perceptions of vaccination. Conclusions Communication of broader benefits of vaccines and vaccination services by community health workers could be impactful in increasing vaccine acceptance. Vaccine uptake could potentially be improved by facilitating community health workers’ ownership over vaccine acceptance and uptake by involving them in the design and implementation of interventions to target mothers and mothers-in-law. A ‘bottom-up’ approach, leveraging community health workers’ knowledge to design interventions, and giving a voice to key members of the household and society beyond mothers alone, may sustain health improvement in low vaccine coverage areas.Baldeep K. DhaliwalRiti ChandrashekharAnanya RattaniRajeev SethSvea ClosserAnika JainDavid E. BloomAnita ShetBMCarticleVaccination perceptionsVaccine acceptanceCommunity health workersIndiaPublic aspects of medicineRA1-1270ENBMC Public Health, Vol 21, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Vaccination perceptions Vaccine acceptance Community health workers India Public aspects of medicine RA1-1270
spellingShingle	Vaccination perceptions Vaccine acceptance Community health workers India Public aspects of medicine RA1-1270 Baldeep K. Dhaliwal Riti Chandrashekhar Ananya Rattani Rajeev Seth Svea Closser Anika Jain David E. Bloom Anita Shet Community perceptions of vaccination among influential stakeholders: qualitative research in rural India
description	Abstract Background In India and other low- and middle-income countries, multiple family and community members are influential in caregivers’ perceptions of vaccination. Existing literature indicates the primary caregiver, typically the mother, is instrumental in vaccine decision-making, but this may vary in contexts. We investigated the role of stakeholders in India who influence caregivers’ vaccination perceptions, as this is essential to developing strategies to promote vaccine acceptance and improve uptake. Methods This research was conducted in 2019 in Mewat District in Haryana, an area in India with extremely low vaccination coverage. We conducted six focus group discussions with 60 participants in the following categories: fathers of children under-5 years old, expectant mothers, mothers-in-law, community health workers, and community influencers such as locally elected officials and religious leaders. Results Our results highlighted four themes that influence vaccine uptake. First, while caregivers associated vaccination with reductions in specific diseases, they also noted that vaccination services brought broad health gains, including improved nutrition, antenatal guidance, and social support. Second, community health workers critically influenced, positively or negatively, caregivers’ vaccination perceptions. Third, community health workers faced gaps in their education such as limited training on vaccine side-effects, placing them at a disadvantage when dealing with families. Finally, we found that mothers-in-law, fathers, and religious leaders influence caregivers’ perceptions of vaccination. Conclusions Communication of broader benefits of vaccines and vaccination services by community health workers could be impactful in increasing vaccine acceptance. Vaccine uptake could potentially be improved by facilitating community health workers’ ownership over vaccine acceptance and uptake by involving them in the design and implementation of interventions to target mothers and mothers-in-law. A ‘bottom-up’ approach, leveraging community health workers’ knowledge to design interventions, and giving a voice to key members of the household and society beyond mothers alone, may sustain health improvement in low vaccine coverage areas.
format	article
author	Baldeep K. Dhaliwal Riti Chandrashekhar Ananya Rattani Rajeev Seth Svea Closser Anika Jain David E. Bloom Anita Shet
author_facet	Baldeep K. Dhaliwal Riti Chandrashekhar Ananya Rattani Rajeev Seth Svea Closser Anika Jain David E. Bloom Anita Shet
author_sort	Baldeep K. Dhaliwal
title	Community perceptions of vaccination among influential stakeholders: qualitative research in rural India
title_short	Community perceptions of vaccination among influential stakeholders: qualitative research in rural India
title_full	Community perceptions of vaccination among influential stakeholders: qualitative research in rural India
title_fullStr	Community perceptions of vaccination among influential stakeholders: qualitative research in rural India
title_full_unstemmed	Community perceptions of vaccination among influential stakeholders: qualitative research in rural India
title_sort	community perceptions of vaccination among influential stakeholders: qualitative research in rural india
publisher	BMC
publishDate	2021
url	https://doaj.org/article/8c377f74d4324a6eaaf9a7f69dd838ca
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Community perceptions of vaccination among influential stakeholders: qualitative research in rural India

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