Health service providers' views on barriers and drivers to childhood vaccination of FDMN/Rohingya refugees

A qualitative study in Cox's Bazar, Bangladesh

Bibliographic Data

ID22091037
AuthorsSarah Reda (0000-0002-5037-8373, Robert Koch Institute), Heide Weishaar (0000-0003-1150-0265, Robert Koch Institute), Sadika Akhter (0000-0003-1807-4406, Deakin University), Basel Karo (0000-0003-2178-1654, Robert Koch Institute), Jorge Martínez (0000-0003-4377-6872, World University of Bangladesh), Aarti Singh (0000-0001-6968-8542, World University of Bangladesh), Cath Jackson (0000-0002-8835-8845, Valid International (United Kingdom), corresponding author)
Year2024
Volume12
Pages1359082-1359082
Publication date2024-07-09
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2024.1359082
PMID39045160
OpenAlexW4400453856
LanguageEN
Citations received1
References cited33

Background: Despite established vaccination programs, vaccine-preventable diseases persist among about 900,000 Forcibly Displaced Myanmar Nationals (FDMN)/Rohingya refugees in the world's largest refugee settlement in Bangladesh. Health service providers (HSPs) play a key role in the delivery of childhood vaccination programs. This study explored their views on individual and context barriers and drivers to childhood vaccination in this setting. Methods: Informed by the theoretical framework of the Capability-Opportunity-Motivation-Behavior (COM-B) model for behavior change, this qualitative study collected data through eight focus group discussions (FGDs) with community health workers (CHWs) and vaccinators in selected camps with high or low vaccination coverage rates, and through 11 in-depth interviews (IDIs) with key informants working in strategic, management, and administrative roles. Findings: Barriers and drivers were evident across all COM factors for HSPs and caregivers. Among HSPs, knowledge around vaccination acted both as a barrier and driver, while communication skills and confidence in vaccination served as drivers. Caregivers' lack of awareness of vaccination, concerns and mistrust were described as main barriers. Context barriers included information system deficiencies, family dynamics, HSPs' working conditions, and vaccination site accessibility. Context drivers included effective communication, mobilization, and incentives. Differences between high and low coverage camps in Cox's Bazar included variations in HSPs' knowledge, communication strategies, incentive use, and stakeholder collaboration. Discussion: For better vaccination coverage in the camps, context-related changes regarding collaboration, health workforce and the use of incentives seem necessary. Caregivers' mistrust toward vaccination needs to be considered under the social and historical background of the Rohingya community, and further addressed with targeted communication and campaigning

Business · Environmental health · Focus group · Geography · Incentive · Political science · Public relations · Qualitative research · Refugee · Service provider · Sociology · Stakeholder · Vaccination · Workforce · Asian Geopolitics and Ethnography · Medicine · Migration, Health and Trauma · Vaccine Coverage and Hesitancy · Immunology · Marketing

Tools

Open DOIOpen Access