Insights into vaccine hesitancy from systems thinking, Rwanda
Bull. W.H.O. (Online)
; 99(11): 783-794, 2021. Tables, figures
Artículo
en Inglés
| AIM (África)
| ID: biblio-1343734
Biblioteca responsable:
CG1.1
ABSTRACT
Objective To investigate vaccine hesitancy leading to underimmunization and a measles outbreak in Rwanda and to develop a conceptual, community-level model of behavioural factors. Methods Local immunization systems in two Rwandan communities (one recently experienced a measles outbreak) were explored using systems thinking, human-centred design and behavioural frameworks. Data were collected between 2018 and 2020 from discussions with 11 vaccination service providers (i.e. hospital and health centre staff ); interviews with 161 children's caregivers at health centres; and nine validation interviews with health centre staff. Factors influencing vaccine hesitancy were categorized using the 3Cs framework confidence, complacency and convenience. A conceptual model of vaccine hesitancy mechanisms with feedback loops was developed. Findings/ A comparison of service providers' and caregivers' perspectives in both rural and peri-urban settings showed that similar factors strengthened vaccine uptake (i) high trust in vaccines and service providers based on personal relationships with health centre staff; (ii) the connecting role of community health workers; and (iii) a strong sense of community. Factors identified as increasing vaccine hesitancy (e.g. service accessibility and inadequate follow-up) differed between service providers and caregivers and between settings. The conceptual model could be used to explain drivers of the recent measles outbreak and to guide interventions designed to increase vaccine uptake. Conclusion The application of behavioural frameworks and systems thinking revealed vaccine hesitancy mechanisms in Rwandan communities that demonstrate the interrelationship between immunization services and caregivers' vaccination behaviour. Confidencebuilding social structures and context-dependent challenges that affect vaccine uptake were also identified.
Texto completo:
Disponible
Contexto en salud:
Agenda de Salud Sostenible para las Américas
/
ODS3 - Salud y Bienestar
/
ODS3 - Meta 3.3 Poner fin a las enfermedades desatendidas y detener enfermedades transmisibles
Problema de salud:
Objetivo 5: Medicamentos, vacunas y tecnologías sanitarias
/
Meta 3.3: Poner fin a las enfermedades desatendidas y detener enfermedades transmisibles
/
Sarampión
Base de datos:
AIM (África)
Asunto principal:
Análisis de Sistemas
/
Aceptación de la Atención de Salud
/
Vacunación
/
Cobertura de Vacunación
Tipo de estudio:
Estudio pronóstico
/
Investigación cualitativa
Límite:
Niño
/
Humanos
País/Región como asunto:
Africa
Idioma:
Inglés
Revista:
Bull. W.H.O. (Online)
Año:
2021
Tipo del documento:
Artículo
Institución/País de afiliación:
East African Community Regional Centre of Excellence for Vaccines, Immunization and Health Supply Chain Management, University of Rwanda/RW
/
Leuven University Vaccinology Center, KU Leuven/BE
/
Massachusetts General Hospital Institute for Technology Assessment, Harvard Medical School/US
/
Research Center for Access-to-Medicines/BE
/
Research Center for Access-to-Medicines, Naamsestraat/BE
/
System Dynamics Group, University of Bergen/NO