Knowledge and attitudes of community pharmacists on vaccination, barriers and willingness to implement community pharmacy-based vaccination services in Ethiopia

Abstract

This study aimed to evaluate the knowledge and attitudes of community pharmacists (CPs) on vaccination and assess the barriers and willingness to implement community pharmacy-based vaccination services (CPBVS) in Ethiopia. An online cross-sectional study was conducted on 423 CPs in Ethiopia, and questionnaires were distributed to CPs through the Ethiopian Pharmaceutical Association telegram group and e-mail invitations. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 27. Most CPs (92%) had good knowledge of vaccination, and 43.5% strongly agreed that the population’s immunization rates would rise if CPs were authorized to provide vaccinations. The overall mean attitude score (±SD) toward vaccination was 35.95 (±4.11) out of a total score of 45, with 187 (44.2%) scoring below the mean. The most common barriers were lack of authorization (94.1%), costs and time associated with professional development and training (71.4%), time requirements for professional development (70%), and insufficient staff or resources for implementation (70%). Two hundred thirty CPs (54.4%) expressed a willingness to implement CPBVS. Educational qualifications were significantly associated with knowledge of CPs regarding vaccination. Those with inadequate knowledge had about 2.5 times (AOR = 2.51, 95% CI: 1.19, 5.31, p = .016) a poorer attitude toward vaccination services compared with those with adequate knowledge. Those study participants who had a good attitude toward vaccination services were nearly seven (AOR = 6.80, 95% CI: 4.36–10.59, p = .0001) times more willing to provide CPBVS when compared with their counterparts. Implementing CPBVS in Ethiopia requires overcoming barriers and providing professional development opportunities.

Pharmacists’ Willingness to Offer Vaccination Services: A Systematic Review and Meta-Analysis

“…The 34 studies selected for this review were conducted in 19 countries across 5 WHO regions ( Table 2 ). The selected literature included eight studies from the United States [ 3 , 27 , 28 , 30 , 34 , 40 , 51 , 52 ]; five from Canada [ 29 , 35 , 36 , 37 , 53 ]; three from Jordan [ 41 , 54 , 55 ]; three from Nigeria [ 56 , 57 , 58 ]; two each from Lebanon [ 38 , 59 ], Malaysia [ 60 , 61 ] and Indonesia [ 62 , 63 ]; and one each from Estonia [ 64 ], France [ 65 ], Italy [ 66 ], Austria [ 33 ], Serbia [ 31 ], Bulgaria [ 31 ], Albania [ 31 ], Saudi Arabia [ 32 ], Romania [ 31 ], Poland [ 39 ], Ethiopia [ 67 ] and Thailand [ 68 ]. The study by Turcu-Stiolica et al reported research conducted in four countries: Romania, Serbia, Albania and Bulgaria [ 31 ].…”

“…Quality assessment conducted across nine domains showed most (n = 21, 61.8%) of the included studies with an overall low risk of bias (quality score = 7–8) [ 3 , 27 , 28 , 32 , 33 , 35 , 36 , 37 , 38 , 40 , 52 , 53 , 54 , 55 , 56 , 59 , 60 , 61 , 66 , 67 , 68 ]. About a third (n = 13, 38.2%) of the studies had a moderate risk of bias (quality score = 6) [ 29 , 30 , 31 , 34 , 39 , 41 , 51 , 57 , 58 , 62 , 63 , 64 , 65 ], while none showed a high risk of bias.…”

“…Disparities in willingness were observed within and across countries, as well as across the respective WHO regions ( Table 3 ). Willingness across the WHO regions ranged from 45 to 90.8% across the nine European countries represented [ 31 , 33 , 39 , 64 , 65 , 66 ]; 64.5–82.6% in countries represented in the EMR [ 38 , 41 , 54 , 55 , 59 ]; 47.70–74% in the countries in Africa [ 56 , 57 , 58 , 67 ] and 42.2–89.2% in the Southeast Asia countries [ 60 , 61 , 62 , 63 , 68 ]. Willingness was at least 75% or more in 9 of the 13 studies included from the Americas [ 3 , 28 , 29 , 30 , 34 , 35 , 36 , 37 , 52 ].…”

Assessment of community pharmacists’ knowledge, attitudes and their willingness to provide vaccination services in Saudi Arabia

“…This is a concerning finding as other studies have reported varied levels of knowledge in their sample. Studies from Lebanon and Ethiopia reported contrasting results wherein more than 90% of the pharmacists in their sample had good knowledge of vaccines [ 16 , 27 ]. Another study from Malaysia reported moderate knowledge level among half of the participating pharmacists [ 28 ].…”

“…As in our study, many other have reported legal liability as the most critical barrier in provision of immunization service at community pharmacies [ 20 , 32 – 34 ]. However, other studies from Ethiopia and Jordan have reported lack of authorization as the most common barrier for providing vaccination service at community pharmacies [ 27 , 35 ]. Therefore, it important to review and update the regulations in Saudi Arabia in regard to authorizing pharmacists to administer vaccines.…”