Barriers and facilitators to hepatitis B birth dose vaccination

Perspectives from healthcare providers and pregnant women accessing antenatal care in Nigeria

Bibliographic Data

ID19594580
AuthorsCatherine Freeland (0000-0002-1876-2105, Hepatitis B Foundation, corresponding author), Florence A Kanu (0000-0003-3574-722X, Centers for Disease Control and Prevention, corresponding author), Yahaya Mohammed (0000-0003-0075-9511, African Field Epidemiology Network, corresponding author), Ugochukwu Uzoechina Nwokoro (0000-0003-3819-3699, African Field Epidemiology Network, corresponding author), Hardeep Sandhu (Centers for Disease Control and Prevention, corresponding author), Hadley Ikwe (Centers for Disease Control and Prevention, corresponding author), Belinda Uba (African Field Epidemiology Network, corresponding author), Adeyelu Asekun (Centers for Disease Control and Prevention, corresponding author), Charles Akataobi (African Field Epidemiology Network, corresponding author), Adefisoye Adewole (0000-0002-2120-8746, African Field Epidemiology Network, corresponding author), Rhoda Fadahunsi (African Field Epidemiology Network, corresponding author), Margeret Wisdom (African Field Epidemiology Network, corresponding author), Okeke Lilian Akudo (African Field Epidemiology Network, corresponding author), Gideon Ugbenyo (African Field Epidemiology Network, corresponding author), Edwin Simple (African Field Epidemiology Network, corresponding author), Ndadilnasiya Waziri (African Field Epidemiology Network, corresponding author), James Jacob Vasumu (corresponding author), Abubakar Umar Bahuli (corresponding author), Suleiman Saidu Bashir (corresponding author), Abdullahi Isa (corresponding author), George Onyemachi Ugwu, George Ugwu (University of Nigeria, corresponding author), Emmanuel Ikechukwu Obi, Emmanuel Ikechukwu (corresponding author), Haj Binta (University of Nigeria, corresponding author), Bassey Okposen Bassey (National Primary Health Care Development Agency, corresponding author), Faisal Shuaib (0000-0003-1818-3776, National Primary Health Care Development Agency, corresponding author), Omotayo Bolu (0000-0002-9758-3032, Centers for Disease Control and Prevention, corresponding author), Rania A Tohme (0000-0003-4441-0338, Centers for Disease Control and Prevention, corresponding author)
EditorsEdina Amponsah-Dacosta (0000-0002-3913-0457)
Year2023
Volume3
Issue6
Pagese0001332
Publication date2023-06-08
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0001332
PMID37289735
OpenAlexW4379930059
LanguageEN
Citations received3
References cited20

Nigeria is estimated to have the largest number of children worldwide, living with chronic hepatitis B virus (HBV) infection, the leading cause of liver cancer. Up to 90% of children infected at birth develop chronic HBV infection. A birth dose of the hepatitis B vaccine (HepB-BD) followed by at least two additional vaccine doses is recommended for prevention. This study assessed barriers and facilitators of HepB-BD administration and uptake, using structured interviews with healthcare providers and pregnant women in Adamawa and Enugu States, Nigeria. The Consolidated Framework for Implementation Sciences Research (CFIR) guided data collection and analysis. We interviewed 87 key informants (40 healthcare providers and 47 pregnant women) and created a codebook for data analysis. Codes were developed by reviewing the literature and reading a subsample of queries line-by-line. The overarching themes identified as barriers among healthcare providers were: the lack of hepatitis B knowledge, limited availability of HepB-BD to vaccination days only, misconceptions about HepB-BD vaccination, challenges in health facility staffing capacity, costs associated with vaccine transportation, and concerns related to vaccine wastage. Facilitators of timely HepB-BD vaccination included: vaccine availability, storage, and hospital births occurring during immunization days. Overarching themes identified as barriers among pregnant women were lack of hepatitis B knowledge, limited understanding of HepB-BD importance, and limited access to vaccines for births occurring outside of a health facility. Facilitators were high vaccine acceptance and willingness for their infants to receive HepB-BD if recommended by providers. Findings indicate the need for enhanced HepB-BD vaccination training for HCWs, educating pregnant women on HBV and the importance of timely HepB-BD, updating policies to enable HepB-BD administration within 24 hours of birth, expanding HepB-BD availability in public and private hospital maternity wards for all facility births, and outreach activities to reach home births

Family medicine · HBsAg · Health care · Hepatitis B · Hepatitis B vaccine · Hepatitis B virus · Vaccination · Hepatitis B Virus Studies · Medicine · Nursing · Vaccine Coverage and Hesitancy · Viral Infections and Outbreaks Research · Immunology

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