Maternal Vaccination in Uganda: Exploring Pregnant Women, Community Leaders and Healthcare Workers’ Perceptions

Nalubega, Phiona; Karafillakis, Emilie; Atuhaire, Lydia; Akite, Pamela; Zalwango, Flavia; Chantler, Tracey; Cochet, Madeleine; Seeley, Janet; Doaré, Kirsty Le

doi:10.3390/vaccines9060552

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…The women we spoke to were concerned about the safety of their baby and this is one reason why they valued the detailed information given to them and referred to the information documents given to them at the time of consent. Similar concerns about safety of the baby have been reported in other studies [ 11 , 21 ].…”

Section: Discussionsupporting

confidence: 84%

“…Although some women mentioned that they made their own decision to join for the clinical trial, the majority of the women joined the trial after consulting the male partners who were the fathers of the children to be born. Involving men in the information sharing process remains critical for retention during maternal vaccine clinical trials and creating an environment at the hospitals that would encourage their involvement has been suggested in other studies conducted in Uganda [ 11 , 19 ]. Most cultures in Uganda follow a patrilineal system and most households are headed by men, and this impacts on how health decisions maybe made by some women [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…We have recently shown that in Uganda, vaccine uptake in pregnant women was influenced by the awareness of the vaccine, disease severity and susceptibility, vaccine benefits, side effects and risk of harm during pregnancy, history of previous vaccination, and recommendation from healthcare professionals [ 11 ]. We found that there was a need to include the wider community in vaccine discussions to increase confidence in existing vaccines.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the consent process among pregnant and breastfeeding women taking part in a maternal vaccine clinical trial in Kampala, Uganda: a qualitative study

Ssali,

Namugumya,

Nalubega

et al. 2024

BMC Med Ethics

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Background The involvement of pregnant women in vaccine clinical trials presents unique challenges for the informed consent process. We explored the expectations and experiences of the pregnant women, spouses/partners, health workers and stakeholders of the consent process during a Group B Streptococcus maternal vaccine trial. Methods We interviewed 56 participants including pregnant women taking part in the trial, women not in the trial, health workers handling the trial procedures, spouses, and community stakeholders. We conducted 13 in-depth interviews and focus group discussions with 23 women in the trial, in-depth interviews with 5 spouses, and 5 women not in the trial, key informant interviews with 5 health workers and 5 other stakeholders were undertaken. Results Decision-making by a pregnant woman to join a trial was done in consultation with spouse, parents, siblings, or trusted health workers. Written study information was appreciated by all but they suggested the use of audio and visual presentation to enhance understanding. Women stressed the need to ensure that their male partners received study information before their pregnant partners joined a clinical trial. Confidentiality in research was emphasised differently by individual participants; while some emphasised it for self, others were keen to protect their family members from being exposed, for allowing them to be involved in research. However, others wanted their community participation to be acknowledged. Conclusion We found that pregnant women make decisions to join a clinical trial after consulting with close family. Our findings suggest the need for an information strategy which informs not only the pregnant woman, but also her family about the research she is invited to engage in.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring the consent process among pregnant and breastfeeding women taking part in a maternal vaccine clinical trial in Kampala, Uganda: a qualitative study

Ssali,

Namugumya,

Nalubega

et al. 2024

BMC Med Ethics

Self Cite

View full text Add to dashboard Cite

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“…Therefore, she must rst have a good understanding of the services or activities implemented by the health center, in order to adhere to them and be able to support them, otherwise she herself may be a hindrance to the success of the intervention. In addition to this, she has a view of the way in which the care is provided, one of the elements for assessing the effectiveness of the care, as mentioned by certain authors (32)(33)(34).…”

Section: Discussionmentioning

confidence: 99%

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo.

Kasongo

Molima

Makali

et al. 2023

Preprint

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Background: The concept of biopsychosocial care is one of the approaches recommended in the health system by the WHO. Although efforts are being made on the provider side to implement it, community involvement is needed to enable its integration into the health sector. For this to happen, the community must first have an understanding of the approach, as a stakeholder and direct beneficiary. The objective of this study is to understand the community's views on the concept of integrated health care according to the biopsychosocial approach (BPS) at the Health Center of a Health District. Methods: We conducted a qualitative study based on individual semi-directive interviews with members of the Health Development Committees of six Health Areas belonging to four Health Districts as well as with some patients met in health facilities. A total of 15 interviews were conducted. The adapted NoMAD tool, derived from the Theory of the Normalization Process of Complex Interventions, allowed us to collect data from November 2017 to February 2018, and then from November 2018 to February 2019. After data extraction and synthesis, we conducted a thematic analysis using the NoMAD tool to build a thematic framework. Results: Initially, community perceptions were diverse in relation to the BPS approach of integrated care in the Health Centre; but later, the concept became clearer with the implementation of the approach, even for the providers with the change in their way of working (interprofessional collaboration, sharing of responsibilities...). Certain practices were encouraged to help the approach, notably the development of financial autonomy and mutual support. According to the community, the BPS model has further strengthened the performance of health workers and should be expanded and sustained. Stakeholders throughout the country were called upon to support the BPS concept in its implementation. Conclusions: The results of our study should encourage the involvement of community participation in any process of integrating the biopsychosocial model of person-centred health care, even at higher levels of care. However, the barriers and enablers to the BPS mechanism identified in our study should be taken into consideration.

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“…This perception may lead them either to adhere to these interventions and be able to support them, or, if not, itself constitute a brake on the success of the intervention. In addition to this, she has a view of the way in which the care is provided, one of the elements for assessing the effectiveness of the care, as mentioned by certain authors [ 35 – 37 ].…”

Section: Discussionmentioning

confidence: 99%

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo

Kasongo,

Mukalay,

Molima

et al. 2023

BMC Health Serv Res

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Summary Background Biopsychosocial care is one of the approaches recommended in the health system by the WHO. Although efforts are being made on the provider side to implement it and integrate it into the health system, the community dynamic also remains to be taken into account for its support. The objective of this study is to understand the community's perceptions of the concept of integrated health care management according to the biopsychosocial approach (BPS) at the Health Center of a Health District and its evaluation in its implementation. Methods This cross-sectional study was done in six Health Areas belonging to four Health Districts in South Kivu, DRC. We conducted 15 semi-directive individual interviews with 9 respondents selected by convenience, including 6 members of the Development Committees of the Health Areas, with whom we conducted 12 interviews and 3 patients met in the health centers. The adapted Normalization MeAsure Development (NoMAD) tool, derived from the Theory of the Normalization Process of Complex Interventions, allowed us to collect data from November 2017 to February 2018, and then from November 2018 to February 2019. After data extraction and synthesis, we conducted a thematic analysis using the NoMAD tool to build a thematic framework. Six themes were grouped into three categories. Results Initially, community reports that the BPS approach of integrated care in the Health Centre is understood differently by providers; but then, through collective coordination and integrated leadership within the health care team, the approach becomes clearer. The community encouraged some practices identified as catalysts to help the approach, notably the development of financial autonomy and mutual support, to the detriment of those identified as barriers. According to the community, the BPS model has further strengthened the performance of health workers and should be expanded and sustained. Conclusions The results of our study show the importance of community dynamics in the care of biopsychosocial situations by providers. The barriers and catalysts to the mechanism, both community-based and professional, identified in our study should be considered in the process of integrating the biopsychosocial model of person-centered health care.

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Maternal Vaccination in Uganda: Exploring Pregnant Women, Community Leaders and Healthcare Workers’ Perceptions

Cited by 6 publications

References 20 publications

Exploring the consent process among pregnant and breastfeeding women taking part in a maternal vaccine clinical trial in Kampala, Uganda: a qualitative study

Exploring the consent process among pregnant and breastfeeding women taking part in a maternal vaccine clinical trial in Kampala, Uganda: a qualitative study

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo.

Community perceptions of a biopsychosocial model of integrated care in the health center: the case of 4 health districts in South Kivu, Democratic Republic of Congo

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