Provider perspectives on demand creation for maternal vaccines in Kenya

Abstract

Background . Expansion of maternal immunization, which offers some of the most effective protection against morbidity and mortality in pregnant women and neonates, requires broad acceptance by healthcare providers and their patients. We aimed to describe issues surrounding acceptance and demand creation for maternal vaccines in Kenya from a provider perspective. Methods . Nurses and clinical officers were recruited for semi-structured interviews covering resources for vaccine delivery, patient education, knowledge and attitudes surrounding maternal vaccines, and opportunities for demand creation for new vaccines. Interviews were conducted in English and Swahili, transcribed verbatim from audio recordings, and analyzed using codes developed from interview guide questions and emergent themes. Results . Providers expressed favorable attitudes about currently available maternal immunizations and introduction of additional vaccines, viewing themselves as primarily responsible for vaccine promotion and patient education. The importance of educational resources for both patients and providers to maintain high levels of maternal immunization coverage was a common theme. Most identified barriers to vaccine acceptance and delivery were cultural and systematic in nature. Suggestions for improvement included improved patient and provider education, including material resources, and community engagement through religious and cultural leaders. Conclusions . The distribution of standardized, evidence-based print materials for patient education may reduce provider overwork and facilitate in-clinic efforts to inform women about maternal vaccines. Continuing education for providers should address communication surrounding current vaccines and those under consideration for introduction into routine schedules. Engagement of religious and community leaders, as well as male decision-makers in the household, will enhance future acceptance of maternal vaccines.

Views and experiences of maternal healthcare providers regarding influenza vaccine during pregnancy globally: A systematic review and qualitative evidence synthesis

“…The studies represented different contexts and locations, including high-, middle- and low-income countries. Three articles were from Australia [ 24 , 41 , 42 ], and one from the USA [ 43 ], Kenya [ 44 ], El Salvador [ 45 ], the UK [ 46 ] and China [ 47 ]. Articles were published between 2014 and 2019.…”

“…All eight studies provided a clear statement of aims and used appropriate qualitative methods. The research design was explicitly justified in all but two studies [ 44 , 47 ]. Recruitment strategy was discussed in all but one study [ 44 ].…”

“…In some settings, MHCPs perceived certain religious denominations restricted pregnant women from accessing antenatal care visits and hence uptake of the influenza vaccine [ 44 ]. In Kenya, when MHCPs were asked about what intervention they thought would help to address the religious restrictions toward vaccination, MHCPs proposed attending Sunday church services to discuss health concerns and provide information to pregnant women there to reach a larger demographic [ 44 ]:…”

Antenatal care providers’ attitudes and beliefs towards maternal vaccination in Kenya

“…Inclusion criteria were being listed as an active ANC provider in one of the participating clinics or hospitals and agreeing to respond to the survey. The survey was specifically developed for this study based on information collected in the qualitative phase of the study, which included 111 semi-structured interviews with ANC providers 17 and pilot tested by the study team in all sites. Participants were recruited both as a convenience sample from study facilities and referral through the healthcare workers and colleagues.…”

Antenatal care providers’ attitudes and beliefs towards maternal vaccination in Kenya

“…The research staff visited the 150 clinics and hospitals and distributed a quantitative knowledge, attitude and behavior (KAB) survey to the antenatal care (ANC) providers (see extended data for questionnaire 13 ). The survey was developed based on information collected in the qualitative phase of the study, which included 111 semi-structured interviews with ANC providers 14 and pilot tested by the study team in all sites. Participants were recruited both as a convenience sample from study facilities and referral through the healthcare workers and colleagues.…”