Enablers and barriers towards ensuring routine immunization services during the COVID-19 pandemic: findings from a qualitative study across five different states in India

Abstract

Background The coronavirus disease 2019 (COVID-19) pandemic has led to disruption in delivering routine healthcare services including routine immunization (RI) worldwide. Understanding the enablers and barriers for RI services during a pandemic is critically important to develop context-appropriate strategies to ensure uninterrupted routine services. Methods A community-based, cross-sectional descriptive study was conducted in five different states of India, nested within an ongoing multicentric study on RI. Telephone in-depth interviews among 56 health workers were carried out and the data were analyzed using a content analysis method. Results During the COVID-19 pandemic, healthcare providers encountered many challenges at the health system, community and individual level when rendering RI services. Challenges like the limited availability of personal protective equipment and vaccines, deployment for COVID-19 duty at system level, the difficulty in mobilizing people in the community, fear among people at community level, mobility restrictions and limited family support, as well as the stress and stigma at individual level, were barriers to providing RI services. By contrast, the issuing of identification cards to health staff, engaging community volunteers, the support given to health workers by their families and training on COVID-19, were factors that enabled health workers to maintain RI services during the pandemic. Conclusions When addressing the COVID-19–related public health emergency, we should not lose sight of the importance of services like RI.

A Study on Community needs, perceptions and demand regarding the use of the health services during COVID-19 pandemic in district Kathua, J and K

“…[ 12 13 ] Routine immunization both at the rural and urban areas were affected with similar findings observed in other studies also. [ 14 ] Other services which were reported to be disrupted were planned elective surgeries, Non Communicable disease (NCD) services, mental health services, and long-term palliative care. These findings of our study were consistent with other studies also.…”

Pandemic disruptions in vaccine uptake in a low-income setting: a qualitative inquiry

“…Lockdowns imposed by the government significantly impacted attendance at CRI facilities, and caregivers experienced transportation challenges in rural and peri-urban regions. These lockdowns coincided with the global drop in the number of children immunized by routine immunization programs, specifically, in the Central African Republic (CAR), Ghana, Guinea, and Senegal [ 25 , 26 ]. However, despite the hurdles posed by the pandemic to regular childhood and COVID-19 vaccination programs, both caregivers and healthcare providers were motivated to vaccinate the children.…”

The Challenges for Implementation of Policies Causing A Delay in Mass Immunization Against Covid-19: A Cross Sectional Qualitative Study

“…However, ensuring the proper implementation of these rules is a challenge (5,7,9,11). The results indicate that common hurdles especially illiteracy, overcrowded and poorly organized vaccine centers and less number of available vaccines are the main challenges in mass immunization of Covid 19 (16,19).…”

“…In order to solve this problem, supply of scientifically proven more efficient vaccines that are accepted internationally should be increased. Vaccines which are widely accepted and desired should be made more accessible in order to increase the rate of vaccination (17,19,20,23).…”

“…Sino-pharm, Sino-vac, CanSino Bio, AstraZeneca, Pfizer-BioNTech, Moderna, and Sputnik V are the vaccinations given in Pakistan (National Command Operation Center, n.d.) (4,7,11,13) The Pakistani government has put into place a number of policies and preventative measures to enhance the country's governance framework, scenario, and COVID-19 outbreak situation. Even though the government has taken prompt and sufficient action to combat the pandemic, there are numerous implementation, legislative, and policy barriers preventing effective mass immunization (5,20,21).This is despite the fact that many vaccination centers across the nation are operating at full capacity to achieve the results (6,19).…”