Enhancing Routine Childhood Vaccination Uptake in the Cape Metropolitan District, South Africa: Perspectives and Recommendations from Point-of-Care Vaccinators
Abstract
:1. Introduction
2. Methods
2.1. Study Design, Setting and Study Sites
2.2. Study Population and Sample Size
2.3. Data Collection and Analysis
2.4. Ethics Approval
3. Results
3.1. Reported Challenges and Barriers to Optimal Vaccination Coverage in the Cape Metro
3.2. Efforts to Mitigate Challenges Encountered
3.2.1. Efforts Directed at Demand-Side Challenges
“What we did now in the clinic or so previously, we let everyone come and they wait three, four, five hours but now we have an appointment system in place; 8 o’clock, 10 o’clock, 12 o’clock and 2 o’clock and it works for them”. Explaining further, she said… “It works for us, then the mothers don’t sit so long. You don’t get this moaning and groaning too much anymore. Because I know my appointment is for 12 o’clock, so I come to the clinic at 11:30. I sit for an hour and a half, and then I go. Where [as] I used to come at 7:30 at the gate, then I leave at 1 o’clock. So we are having an appointment system in place and that is also helping with our immunizations.”
“We have computers now. We book them on the computer and then we write on their cards. … The computer is reminding them the day before the appointment. Even when you are still busy with them here, after you have checked them in on the computer, the message goes through to their phone. And then also reminds them a day before, about their appointment.”
“For me alone, I am doing what you call it: a certificate of the children at 18 months. I try not to miss it. When I reach to 18 months, only in [facility name], I give them the certificate, to tell them that you reached 18 months, you did a good job. Now I am discharging you from my room, you are going to room 4 next time for 2 years. They like it and everyone, they are so motivated.”
“…And what we did again in [facility name], we went to the police station to discuss with them the affidavit; [for example] if the child is coming from the country [from a rural area to the city], we must get the name of the person [that] will be responsible for the child [a sworn affidavit of ownership or guardianship of the child]. The person we can reach.” And, in this area they know, all of my children, they come to my room. They are already changed [that is, they now have the correct names preferred by their parents or legal guardians] and I changed them all. Then I give them that thingy [affidavit of correct identification], that is going to go with the card of the baby when they go to school.”(Participant C8.D2)
3.2.2. Efforts Directed at Supply-Side Challenges
“Then there is a queue marshal. The queue marshal doesn’t have any clinic experience, now she is coming to work in the clinic. Her job is to educate but she herself knows nothing… if they could get trained queue marshals, that will also help us. Because then she can do the health education.”(Participant C9.D1)
3.2.3. Structural Suggestions and Recommendations to Improve Vaccination Coverage
“The EPI is a wonderful poster [but] it doesn’t explain a little bit more in-depth. …If that EPI [chart] could be expanded to add on another column [which explains the purpose/or advantage of each vaccine], [and] if that can be placed at point of care, just above where the immunisations get given, that would sort of help a lot in terms of credibility [and] in terms of me explaining…”
“The problem that I encounter, the other mothers are willing but because of their bosses. Their employers don’t give them off days to come for their immunisation. Because others they want but still when we give proof of attendance that they were here, still they don’t get paid for that day. They say they can’t give them because they are not taking that proof of attendance written by a professional nurse. It must be written by a doctor…”(Participant C7.D1)
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Demand-Side Challenges | Illustrative Quotes |
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Supply-side challenges | |
Staff shortages |
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Contextual challenges | |
Substance abuse |
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Gang-related activities |
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Oduwole, E.O.; Laurenzi, C.A.; Mahomed, H.; Wiysonge, C.S. Enhancing Routine Childhood Vaccination Uptake in the Cape Metropolitan District, South Africa: Perspectives and Recommendations from Point-of-Care Vaccinators. Vaccines 2022, 10, 453. https://doi.org/10.3390/vaccines10030453
Oduwole EO, Laurenzi CA, Mahomed H, Wiysonge CS. Enhancing Routine Childhood Vaccination Uptake in the Cape Metropolitan District, South Africa: Perspectives and Recommendations from Point-of-Care Vaccinators. Vaccines. 2022; 10(3):453. https://doi.org/10.3390/vaccines10030453
Chicago/Turabian StyleOduwole, Elizabeth O., Christina A. Laurenzi, Hassan Mahomed, and Charles S. Wiysonge. 2022. "Enhancing Routine Childhood Vaccination Uptake in the Cape Metropolitan District, South Africa: Perspectives and Recommendations from Point-of-Care Vaccinators" Vaccines 10, no. 3: 453. https://doi.org/10.3390/vaccines10030453