Improving Immunization Rates Through Community-Based Participatory Research: Community Health Improvement for Milwaukee’s Children Program

Willis, Earnestine; Sabnis, Svapna; Hamilton, Chelsea; Xiong, Fue; Coleman, Keli; Dellinger, Matt; Watts, Michelle; Cox, Richard J.; Harrell, Janice; Smith, Dorothy E.; Nugent, Melodee; Simpson, Pippa

doi:10.1353/cpr.2016.0017

Cited by 2 publications

(2 citation statements)

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“…Several studies have used PAR successfully in addressing health issues in African countries including Kenya, Zambia and South Africa [ 6 – 9 ], but not specifically for immunization. However, in other contexts, Beauregard et al [ 10 ] used PAR to improve timeliness of vaccination in children, while Willis et al [ 11 ] and Crowley [ 12 ] used PAR to increase immunization rates. Theoretical concepts that led to the emergence of this type of research are broadly based on the principle that complex, persistent or unstructured problems cannot be tackled effectively by a more traditional research approach, which does not adequately address the underlying social, political, economic, cultural and ethical aspects of the problem [ 13 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Using participatory action research to improve immunization utilization in areas with pockets of unimmunized children in Nigeria

Akwataghibe

Ogunsola

Popoola

et al. 2021

Health Res Policy Sys

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Background In 2005, Nigeria adopted the Reaching Every Ward strategy to improve vaccination coverage for children 0–23 months of age. By 2015, Ogun state had full coverage (100%) in 12 of its 20 local government areas, but eight had pockets of unimmunized children, with the highest burden (37%) in Remo North. A participatory action research (PAR) approach was used to facilitate implementation of local solutions to contextual barriers to immunization in Remo North. This article assesses and seeks to explain the outcomes of the PAR implemented in Remo North to understand whether and possibly how it improved immunization utilization. Methods The PAR intervention took place from 2016 to 2017. It involved two (4-month) cycles of dialogue and action between community members, frontline health workers and local government officials in two wards of Remo North, facilitated by the research team. The PAR was assessed using a pre/post-intervention-only design with mixed methods. These included household surveys of caregivers of 215 and 213 children, respectively, 25 semi-structured interviews with stakeholders involved in immunization service delivery and 16 focus group discussions with community members. Data were analysed using the Strategic Advisory Group of Experts (SAGE) vaccine hesitancy framework. Results Collaboration among the three stakeholder groups enabled the development and implementation of solutions to identified problems related to access to and use of immunization services. At endline, assessment by card for children older than 9 months revealed a significant increase in those fully immunized, from 60.7% at baseline to 90.9% (p < .05). A significantly greater number of caregivers visited fixed government health facilities for routine immunization at endline (83.2%) than at baseline (54.2%) (p < .05). The reasons reported by caregivers for improved utilization of routine immunization services were increased community mobilization activities and improved responsiveness of the health workers. Spillover effects into maternal health services enhanced the use of immunization services by caregivers. Spontaneous scale-up of actions occurred across Remo North due to the involvement of local government officials. Conclusion The PAR approach achieved contextual solutions to problems identified by communities. Collection and integration of evidence into discussions/dialogues with stakeholders can lead to change. Leveraging existing structures and resources enhanced effectiveness.

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Section: Introductionmentioning

confidence: 99%

Using participatory action research to improve immunization utilization in areas with pockets of unimmunized children in Nigeria

Akwataghibe

Ogunsola

Popoola

et al. 2021

Health Res Policy Sys

View full text Add to dashboard Cite

show abstract

“…32 , 33 Immunization rates can also be improved with the help of health and public health systems and input from community members. 34 People are known to question the protective effect and relative risk of these vaccines (e.g., tickborne encephalitis) owing to the lack of large-scale epidemiologic investigations. 35 One particular survey in China on general willingness to pay for the seven-valent pneumococcal conjugate vaccine or the influenza vaccine found that economic status and psychosocial factors were the chief barriers to utilization.…”

Section: Discussionmentioning

confidence: 99%

Factors impacting self-pay pediatric vaccine utilization in China: a large-scale maternal survey

Lu²,

et al. 2020

J Int Med Res

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Objectives Utilization of self-pay vaccines worldwide is very low, especially in China; the reasons for this are unclear. We aimed to identify factors that impact the decision among Chinese mothers to utilize self-pay vaccines for their children. Methods Mothers who were hospitalized at two hospitals in Zhanjiang City and who agreed to participate by completing the required questionnaire were eligible for this study. Results In total, 7518 respondents (n = 7592) completed the questionnaire and were included in this survey. The self-pay option was largely elected by mothers with one child, compared with those who had two or more children. Similarly, utilization by workers at government agencies and organizations was higher than that among factory workers or unemployed respondents. Mothers with a college degree or above had higher utilization than those with a high school level education or lower. The main issues affecting maternal decisions to utilize self-pay pediatric vaccines were safety, the protective effect, and the high cost. Conclusion Mothers with higher socioeconomic status were more inclined to self-pay for pediatric vaccines. Steps taken to enhance public awareness about the safety and protective benefits of self-pay vaccines, as well as lowering their cost will likely encourage broader utilization of these vaccines.

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Improving Immunization Rates Through Community-Based Participatory Research: Community Health Improvement for Milwaukee’s Children Program

Cited by 2 publications

References 0 publications

Using participatory action research to improve immunization utilization in areas with pockets of unimmunized children in Nigeria

Using participatory action research to improve immunization utilization in areas with pockets of unimmunized children in Nigeria

Factors impacting self-pay pediatric vaccine utilization in China: a large-scale maternal survey

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