More support for mothers: a qualitative study on factors affecting immunisation behaviour in Kampala, Uganda

Abstract

BackgroundThe proportion of Ugandan children who are fully vaccinated has varied over the years. Understanding vaccination behaviour is important for the success of the immunisation programme. This study examined influences on immunisation behaviour using the attitude-social influence-self efficacy model.MethodsWe conducted nine focus group discussions (FGDs) with mothers and fathers. Eight key informant interviews (KIIs) were held with those in charge of community mobilisation for immunisation, fathers and mothers. Data was analysed using content analysis.ResultsInfluences on the mother's immunisation behaviour ranged from the non-supportive role of male partners sometimes resulting into intimate partner violence, lack of presentable clothing which made mothers vulnerable to bullying, inconvenient schedules and time constraints, to suspicion against immunisation such as vaccines cause physical disability and/or death.ConclusionsImmunisation programmes should position themselves to address social contexts. A community programme that empowers women economically and helps men recognise the role of women in decision making for child health is needed. Increasing male involvement and knowledge of immunisation concepts among caretakers could improve immunisation.

Exposing concerns about vaccination in low- and middle-income countries: a systematic review

“…Several issues were reported regarding vaccines being expired (Babirye et al 2011;Braka et al 2012), weak cold chain (Braka et al 2012;Fowler et al 2007;Khowaja et al 2012) or health workers reusing syringes (Dasgupta et al 2008). Concerns with vaccines purchased by the government were reported in Kazakhstan and Uganda.…”

“…Some mothers feared going to the health facility for vaccination if they did not have a good enough ''baby shawl'' to carry the baby. They have reported being harassed by nurses as a consequence of that (Babirye et al 2011). Sheikh et al reported that 2.4 % and 7.9 % of people surveyed reported poor previous experience with physicians as the first and second reasons for not vaccinating their children, respectively (Sheikh et al 2013).…”

“…As one participant in a FGD explained: ''At one time our neighbour in a 'rural geographical area' immunised a child in the morning and by 5.00 p.m. the child was dead. From that time I fear taking children for immunisation and all my children are not immunised'' (Babirye et al 2011). In another case: ''Sometimes after immunisation children get fever and spend the whole night crying so the health worker must tell the mother in advance what will happen to the baby, that the baby might become weak, or get a fever or the injection is painful so he will cry a lot'' (Babirye et al 2011).…”

Role of male partners in the prevention of mother-to-child HIV transmission

“…30 Finally, male partner education and engagement on infant breastfeeding has been associated with improvements in initiation, exclusivity, and continuation of breastfeeding, even in non-HIV-infected populations, 58 and spousal support has been associated with better infant immunization practices in some parts of sub-Saharan Africa. 59 Based on these encouraging results in non-HIV settings, additional programs and studies should be promoted that will implement and evaluate benefits of male involvement in PMTCT that extend beyond HIV prevention.…”

Antenatal immunisation intentions of expectant parents: Relationship to immunisation timeliness during infancy

“…In comparison, our knowledge of the immunisation decisions made by partners during the pregnancy is minimal [6,7], and the extent to which mothers and their partners intentions differ is not known.…”