Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review.

Using meta-ethnographic methods, we conducted a systematic review of qualitative research to understand gender-related reasons at individual, family, community and health facility levels why millions of children in low and middle income countries are still not reached by routine vaccination programm...

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Main Authors: Sonja Merten, Adriane Martin Hilber, Christina Biaggi, Florence Secula, Xavier Bosch-Capblanch, Pem Namgyal, Joachim Hombach
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC4552892?pdf=render
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author Sonja Merten
Adriane Martin Hilber
Christina Biaggi
Florence Secula
Xavier Bosch-Capblanch
Pem Namgyal
Joachim Hombach
author_facet Sonja Merten
Adriane Martin Hilber
Christina Biaggi
Florence Secula
Xavier Bosch-Capblanch
Pem Namgyal
Joachim Hombach
author_sort Sonja Merten
collection DOAJ
description Using meta-ethnographic methods, we conducted a systematic review of qualitative research to understand gender-related reasons at individual, family, community and health facility levels why millions of children in low and middle income countries are still not reached by routine vaccination programmes. A systematic search of Medline, Embase, CINAHL, Cochrane Library, ERIC, Anthropological Lit, CSA databases, IBSS, ISI Web of Knowledge, JSTOR, Soc Index and Sociological Abstracts was conducted. Key words were built around the themes of immunization, vaccines, health services, health behaviour, and developing countries. Only papers, which reported on in-depth qualitative data, were retained. Twenty-five qualitative studies, which investigated barriers to routine immunisation, were included in the review. These studies were conducted between 1982 and 2012; eighteen were published after 2000. The studies represent a wide range of low- to middle income countries including some that have well known coverage challenges. We found that women's low social status manifests on every level as a barrier to accessing vaccinations: access to education, income, as well as autonomous decision-making about time and resource allocation were evident barriers. Indirectly, women's lower status made them vulnerable to blame and shame in case of childhood illness, partly reinforcing access problems, but partly increasing women's motivation to use every means to keep their children healthy. Yet in settings where gender discrimination exists most strongly, increasing availability and information may not be enough to reach the under immunised. Programmes must actively be designed to include mitigation measures to facilitate women's access to immunisation services if we hope to improve immunisation coverage. Gender inequality needs to be addressed on structural, community and household levels if the number of unvaccinated children is to substantially decrease.
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spelling doaj.art-1028e3823225416f9c13078b2a8ef5092022-12-22T02:45:58ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01108e013522210.1371/journal.pone.0135222Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review.Sonja MertenAdriane Martin HilberChristina BiaggiFlorence SeculaXavier Bosch-CapblanchPem NamgyalJoachim HombachUsing meta-ethnographic methods, we conducted a systematic review of qualitative research to understand gender-related reasons at individual, family, community and health facility levels why millions of children in low and middle income countries are still not reached by routine vaccination programmes. A systematic search of Medline, Embase, CINAHL, Cochrane Library, ERIC, Anthropological Lit, CSA databases, IBSS, ISI Web of Knowledge, JSTOR, Soc Index and Sociological Abstracts was conducted. Key words were built around the themes of immunization, vaccines, health services, health behaviour, and developing countries. Only papers, which reported on in-depth qualitative data, were retained. Twenty-five qualitative studies, which investigated barriers to routine immunisation, were included in the review. These studies were conducted between 1982 and 2012; eighteen were published after 2000. The studies represent a wide range of low- to middle income countries including some that have well known coverage challenges. We found that women's low social status manifests on every level as a barrier to accessing vaccinations: access to education, income, as well as autonomous decision-making about time and resource allocation were evident barriers. Indirectly, women's lower status made them vulnerable to blame and shame in case of childhood illness, partly reinforcing access problems, but partly increasing women's motivation to use every means to keep their children healthy. Yet in settings where gender discrimination exists most strongly, increasing availability and information may not be enough to reach the under immunised. Programmes must actively be designed to include mitigation measures to facilitate women's access to immunisation services if we hope to improve immunisation coverage. Gender inequality needs to be addressed on structural, community and household levels if the number of unvaccinated children is to substantially decrease.http://europepmc.org/articles/PMC4552892?pdf=render
spellingShingle Sonja Merten
Adriane Martin Hilber
Christina Biaggi
Florence Secula
Xavier Bosch-Capblanch
Pem Namgyal
Joachim Hombach
Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review.
PLoS ONE
title Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review.
title_full Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review.
title_fullStr Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review.
title_full_unstemmed Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review.
title_short Gender Determinants of Vaccination Status in Children: Evidence from a Meta-Ethnographic Systematic Review.
title_sort gender determinants of vaccination status in children evidence from a meta ethnographic systematic review
url http://europepmc.org/articles/PMC4552892?pdf=render
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