In-depth reasons for the high proportion of zero-dose children in underserved populations of Ethiopia: Results from a qualitative study
Increasing attention is being given to reach children who fail to receive routine vaccinations, commonly designated as zero-dose children. A comprehensive understanding of the supply- and demand-side barriers is essential to inform zero-dose strategies in high-burden countries and achieve global imm...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-01-01
|
| Series: | Vaccine: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590136224000275 |
| _version_ | 1797302509524484096 |
|---|---|
| author | Gashaw Andargie Biks Fisseha Shiferie Dawit Abraham Tsegaye Wondwossen Asefa Legese Alemayehu Tamiru Wondie Gobena Seboka Adrienne Hayes Uche RalphOpara Meseret Zelalem Kidist Belete Jen Donofrio Samson Gebremedhin |
| author_facet | Gashaw Andargie Biks Fisseha Shiferie Dawit Abraham Tsegaye Wondwossen Asefa Legese Alemayehu Tamiru Wondie Gobena Seboka Adrienne Hayes Uche RalphOpara Meseret Zelalem Kidist Belete Jen Donofrio Samson Gebremedhin |
| author_sort | Gashaw Andargie Biks |
| collection | DOAJ |
| description | Increasing attention is being given to reach children who fail to receive routine vaccinations, commonly designated as zero-dose children. A comprehensive understanding of the supply- and demand-side barriers is essential to inform zero-dose strategies in high-burden countries and achieve global immunization goals. This qualitative study aimed to identify the barriers for reaching zero-dose and under-immunized children and what and explore gender affects access to vaccination services for children in Ethiopia. Data was collected between March-June 2022 using key informant interviews and focus group discussions with participants in underserved settings. The high proportion of zero-dose children was correlated with inadequate information being provided by health workers, irregularities in service provision, suboptimal staff motivation, high staff turnover, closure and inaccessibility of health facilities, lack of functional health posts, service provision limited to selected days or hours, and gender norms viewing females as responsible for childcare. Demand-side barriers included religious beliefs, cultural norms, fear of vaccine side effects, and lack of awareness and sustained interventions. Recommendations to increase vaccination coverage include strengthening health systems such as services integration, human resources capacity building, increasing incentives for health staff, integrating vaccination services, bolstering the EPI budget especially from the government side, and supporting reliable outreach and static immunization services. Additionally, immunization policy should be revised to include gender considerations including male engagement strategies to improve uptake of immunization services. |
| first_indexed | 2024-03-07T23:38:50Z |
| format | Article |
| id | doaj.art-ee6010a39142459fb7d755ff136c9e3d |
| institution | Directory Open Access Journal |
| issn | 2590-1362 |
| language | English |
| last_indexed | 2024-03-07T23:38:50Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Vaccine: X |
| spelling | doaj.art-ee6010a39142459fb7d755ff136c9e3d2024-02-20T04:19:40ZengElsevierVaccine: X2590-13622024-01-0116100454In-depth reasons for the high proportion of zero-dose children in underserved populations of Ethiopia: Results from a qualitative studyGashaw Andargie Biks0Fisseha Shiferie1Dawit Abraham Tsegaye2Wondwossen Asefa3Legese Alemayehu4Tamiru Wondie5Gobena Seboka6Adrienne Hayes7Uche RalphOpara8Meseret Zelalem9Kidist Belete10Jen Donofrio11Samson Gebremedhin12Project HOPE, Ethiopia Country Office, Addis Ababa, Ethiopia; Corresponding author.Project HOPE, Ethiopia Country Office, Addis Ababa, EthiopiaProject HOPE, Ethiopia Country Office, Addis Ababa, EthiopiaProject HOPE Headquarter, Washington, DC, United StatesProject HOPE, Ethiopia Country Office, Addis Ababa, EthiopiaProject HOPE, Ethiopia Country Office, Addis Ababa, EthiopiaProject HOPE, Ethiopia Country Office, Addis Ababa, EthiopiaProject HOPE Headquarter, Washington, DC, United StatesProject HOPE Headquarter, Washington, DC, United StatesMaternal and Child Health, Minister of Health, Addis Ababa, EthiopiaUSAID Ethiopia Country Office, Addis Ababa, EthiopiaBill and Melinda Gates Foundation, United StatesSchool of Public Health, Addis Ababa University, Addis Ababa, EthiopiaIncreasing attention is being given to reach children who fail to receive routine vaccinations, commonly designated as zero-dose children. A comprehensive understanding of the supply- and demand-side barriers is essential to inform zero-dose strategies in high-burden countries and achieve global immunization goals. This qualitative study aimed to identify the barriers for reaching zero-dose and under-immunized children and what and explore gender affects access to vaccination services for children in Ethiopia. Data was collected between March-June 2022 using key informant interviews and focus group discussions with participants in underserved settings. The high proportion of zero-dose children was correlated with inadequate information being provided by health workers, irregularities in service provision, suboptimal staff motivation, high staff turnover, closure and inaccessibility of health facilities, lack of functional health posts, service provision limited to selected days or hours, and gender norms viewing females as responsible for childcare. Demand-side barriers included religious beliefs, cultural norms, fear of vaccine side effects, and lack of awareness and sustained interventions. Recommendations to increase vaccination coverage include strengthening health systems such as services integration, human resources capacity building, increasing incentives for health staff, integrating vaccination services, bolstering the EPI budget especially from the government side, and supporting reliable outreach and static immunization services. Additionally, immunization policy should be revised to include gender considerations including male engagement strategies to improve uptake of immunization services.http://www.sciencedirect.com/science/article/pii/S2590136224000275Supply and demand barrierQualitativeGender normsKey informant interviewFocus group discussion |
| spellingShingle | Gashaw Andargie Biks Fisseha Shiferie Dawit Abraham Tsegaye Wondwossen Asefa Legese Alemayehu Tamiru Wondie Gobena Seboka Adrienne Hayes Uche RalphOpara Meseret Zelalem Kidist Belete Jen Donofrio Samson Gebremedhin In-depth reasons for the high proportion of zero-dose children in underserved populations of Ethiopia: Results from a qualitative study Vaccine: X Supply and demand barrier Qualitative Gender norms Key informant interview Focus group discussion |
| title | In-depth reasons for the high proportion of zero-dose children in underserved populations of Ethiopia: Results from a qualitative study |
| title_full | In-depth reasons for the high proportion of zero-dose children in underserved populations of Ethiopia: Results from a qualitative study |
| title_fullStr | In-depth reasons for the high proportion of zero-dose children in underserved populations of Ethiopia: Results from a qualitative study |
| title_full_unstemmed | In-depth reasons for the high proportion of zero-dose children in underserved populations of Ethiopia: Results from a qualitative study |
| title_short | In-depth reasons for the high proportion of zero-dose children in underserved populations of Ethiopia: Results from a qualitative study |
| title_sort | in depth reasons for the high proportion of zero dose children in underserved populations of ethiopia results from a qualitative study |
| topic | Supply and demand barrier Qualitative Gender norms Key informant interview Focus group discussion |
| url | http://www.sciencedirect.com/science/article/pii/S2590136224000275 |
| work_keys_str_mv | AT gashawandargiebiks indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT fissehashiferie indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT dawitabrahamtsegaye indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT wondwossenasefa indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT legesealemayehu indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT tamiruwondie indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT gobenaseboka indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT adriennehayes indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT ucheralphopara indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT meseretzelalem indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT kidistbelete indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT jendonofrio indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy AT samsongebremedhin indepthreasonsforthehighproportionofzerodosechildreninunderservedpopulationsofethiopiaresultsfromaqualitativestudy |