Using photovoice methodology to uncover individual-level, health systems, and contextual barriers to uptake of second dose of measles containing vaccine in Western Area Urban, Sierra Leone, 2020
Background: Vaccination coverage for the second dose of the measles-containing vaccine (MCV2) among children has remained stagnant in Sierra Leone at nearly 67% since its introduction in 2015. Identifying community-specific barriers faced by caregivers in accessing MCV2 services for their children a...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | Vaccine: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590136223000797 |
| _version_ | 1797752913347477504 |
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| author | Shibani Kulkarni Atsuyoshi Ishizumi Oliver Eleeza Palak Patel Mohamed Feika Samilia Kamara Jerikatu Bangura Unisa Jalloh Musa Koroma Zainab Sankoh Henry Sandy Mame Toure Thompson Uwhomena Igbu Tom Sesay Ruby N. Fayorsey Neetu Abad |
| author_facet | Shibani Kulkarni Atsuyoshi Ishizumi Oliver Eleeza Palak Patel Mohamed Feika Samilia Kamara Jerikatu Bangura Unisa Jalloh Musa Koroma Zainab Sankoh Henry Sandy Mame Toure Thompson Uwhomena Igbu Tom Sesay Ruby N. Fayorsey Neetu Abad |
| author_sort | Shibani Kulkarni |
| collection | DOAJ |
| description | Background: Vaccination coverage for the second dose of the measles-containing vaccine (MCV2) among children has remained stagnant in Sierra Leone at nearly 67% since its introduction in 2015. Identifying community-specific barriers faced by caregivers in accessing MCV2 services for their children and by health workers in delivering MCV2 is key to informing strategies to improve vaccination coverage. Methods: We used Photovoice, a participatory method using photographs and narratives to understand community barriers to MCV2 uptake from March- September 2020. Six female and five male caregivers of MCV2-eligible children (15–24 months of age), and six health care workers (HCWs) in Freetown, Sierra Leone participated. After having an orientation to photovoice, they photographed barriers related to general immunization and MCV2 uptake in their community. This was followed by facilitated discussions where participants elaborated on the barriers captured in the photos. Transcripts from the six immunization-related discussions were analyzed to deduce themes through open-ended coding. A photo exhibition was held for participants to discuss the barriers and suggested solutions with decision-makers, such as the ministry of health. Results: We identified and categorized nine themes into three groups: 1) individual or caregiver level barriers (e.g., caregivers’ lack of knowledge on MCV2, concerns about vaccine side effects, and gender-related barriers); 2) health system barriers, such as HCWs’ focus on children below one year and usage of old child health cards; and 3) contextual barriers, such as poverty, poor infrastructure, and the COVID-19 pandemic. Participants suggested the decision-makers to enhance community engagement with caregivers and HCW capacity including, increasing accountability of their work using performance-based approaches, among different strategies to improve MCV2 uptake. Conclusion: Photovoice can provide nuanced understanding of community issues affecting MCV2. As a methodology, it should be integrated in broader intervention planning activities to facilitate the translation of community-suggested strategies into action. |
| first_indexed | 2024-03-12T17:11:35Z |
| format | Article |
| id | doaj.art-b6691a2ffa9642d296b84fbe2b750788 |
| institution | Directory Open Access Journal |
| issn | 2590-1362 |
| language | English |
| last_indexed | 2024-03-12T17:11:35Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Vaccine: X |
| spelling | doaj.art-b6691a2ffa9642d296b84fbe2b7507882023-08-06T04:38:17ZengElsevierVaccine: X2590-13622023-08-0114100338Using photovoice methodology to uncover individual-level, health systems, and contextual barriers to uptake of second dose of measles containing vaccine in Western Area Urban, Sierra Leone, 2020Shibani Kulkarni0Atsuyoshi Ishizumi1Oliver Eleeza2Palak Patel3Mohamed Feika4Samilia Kamara5Jerikatu Bangura6Unisa Jalloh7Musa Koroma8Zainab Sankoh9Henry Sandy10Mame Toure11Thompson Uwhomena Igbu12Tom Sesay13Ruby N. Fayorsey14Neetu Abad15U.S. Centers for Disease Control and Prevention, Atlanta GA, USA; Corresponding author at: U.S. Centers for Disease Control and Prevention, 1600 Clifton Road, Mailstop H21-6, Atlanta, GA 30329, USA.U.S. Centers for Disease Control and Prevention, Atlanta GA, USAICAP Sierra Leone, Freetown, Sierra LeoneU.S. Centers for Disease Control and Prevention, Atlanta GA, USAICAP Sierra Leone, Freetown, Sierra LeoneICAP Sierra Leone, Freetown, Sierra LeoneICAP Sierra Leone, Freetown, Sierra LeoneICAP Sierra Leone, Freetown, Sierra LeoneICAP Sierra Leone, Freetown, Sierra LeoneICAP Sierra Leone, Freetown, Sierra LeoneICAP Sierra Leone, Freetown, Sierra LeoneICAP Sierra Leone, Freetown, Sierra LeoneWorld Health Organization, Freetown, Sierra LeoneSierra Leone Ministry of Health and Sanitation, Freetown, Sierra LeoneICAP, NY, USAU.S. Centers for Disease Control and Prevention, Atlanta GA, USABackground: Vaccination coverage for the second dose of the measles-containing vaccine (MCV2) among children has remained stagnant in Sierra Leone at nearly 67% since its introduction in 2015. Identifying community-specific barriers faced by caregivers in accessing MCV2 services for their children and by health workers in delivering MCV2 is key to informing strategies to improve vaccination coverage. Methods: We used Photovoice, a participatory method using photographs and narratives to understand community barriers to MCV2 uptake from March- September 2020. Six female and five male caregivers of MCV2-eligible children (15–24 months of age), and six health care workers (HCWs) in Freetown, Sierra Leone participated. After having an orientation to photovoice, they photographed barriers related to general immunization and MCV2 uptake in their community. This was followed by facilitated discussions where participants elaborated on the barriers captured in the photos. Transcripts from the six immunization-related discussions were analyzed to deduce themes through open-ended coding. A photo exhibition was held for participants to discuss the barriers and suggested solutions with decision-makers, such as the ministry of health. Results: We identified and categorized nine themes into three groups: 1) individual or caregiver level barriers (e.g., caregivers’ lack of knowledge on MCV2, concerns about vaccine side effects, and gender-related barriers); 2) health system barriers, such as HCWs’ focus on children below one year and usage of old child health cards; and 3) contextual barriers, such as poverty, poor infrastructure, and the COVID-19 pandemic. Participants suggested the decision-makers to enhance community engagement with caregivers and HCW capacity including, increasing accountability of their work using performance-based approaches, among different strategies to improve MCV2 uptake. Conclusion: Photovoice can provide nuanced understanding of community issues affecting MCV2. As a methodology, it should be integrated in broader intervention planning activities to facilitate the translation of community-suggested strategies into action.http://www.sciencedirect.com/science/article/pii/S2590136223000797MCV2Immunization barriersPhotovoiceCommunity participationSHOWeD |
| spellingShingle | Shibani Kulkarni Atsuyoshi Ishizumi Oliver Eleeza Palak Patel Mohamed Feika Samilia Kamara Jerikatu Bangura Unisa Jalloh Musa Koroma Zainab Sankoh Henry Sandy Mame Toure Thompson Uwhomena Igbu Tom Sesay Ruby N. Fayorsey Neetu Abad Using photovoice methodology to uncover individual-level, health systems, and contextual barriers to uptake of second dose of measles containing vaccine in Western Area Urban, Sierra Leone, 2020 Vaccine: X MCV2 Immunization barriers Photovoice Community participation SHOWeD |
| title | Using photovoice methodology to uncover individual-level, health systems, and contextual barriers to uptake of second dose of measles containing vaccine in Western Area Urban, Sierra Leone, 2020 |
| title_full | Using photovoice methodology to uncover individual-level, health systems, and contextual barriers to uptake of second dose of measles containing vaccine in Western Area Urban, Sierra Leone, 2020 |
| title_fullStr | Using photovoice methodology to uncover individual-level, health systems, and contextual barriers to uptake of second dose of measles containing vaccine in Western Area Urban, Sierra Leone, 2020 |
| title_full_unstemmed | Using photovoice methodology to uncover individual-level, health systems, and contextual barriers to uptake of second dose of measles containing vaccine in Western Area Urban, Sierra Leone, 2020 |
| title_short | Using photovoice methodology to uncover individual-level, health systems, and contextual barriers to uptake of second dose of measles containing vaccine in Western Area Urban, Sierra Leone, 2020 |
| title_sort | using photovoice methodology to uncover individual level health systems and contextual barriers to uptake of second dose of measles containing vaccine in western area urban sierra leone 2020 |
| topic | MCV2 Immunization barriers Photovoice Community participation SHOWeD |
| url | http://www.sciencedirect.com/science/article/pii/S2590136223000797 |
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