How is the restrictive vaccine vial opening policy of the childhood vaccination programme experienced by health care workers and health facility users? A qualitative study in rural Guinea-Bissau

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2025-04-03 DOI:10.1016/j.puhe.2025.02.038

Julie Odgaard Vedel , Jailson Sydenei Dias Martins , Igualdino Da Silva Borges , Quique Bassat , Ane Bærent Fisker , Maria Maixenchs

{"title":"How is the restrictive vaccine vial opening policy of the childhood vaccination programme experienced by health care workers and health facility users? A qualitative study in rural Guinea-Bissau","authors":"Julie Odgaard Vedel , Jailson Sydenei Dias Martins , Igualdino Da Silva Borges , Quique Bassat , Ane Bærent Fisker , Maria Maixenchs","doi":"10.1016/j.puhe.2025.02.038","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>Any remaining doses of unpreserved multi-dose vaccines must be discarded 6 h after reconstitution. In many countries, these multi-dose vaccines are only opened if a certain number of children are present. In Guinea-Bissau, this results in health facilities (HFs) limiting BCG, measles, and yellow fever vaccinations to predefined days.</div><div>This study aims to explore views, perceptions and experiences of caregivers of vaccine-eligible children and health care workers (HCWs) on the vaccination programme and restrictive vial opening policy (RVOP).</div></div><div><h3>Study design</h3><div>A qualitative study nested within an ongoing vaccine trial in rural Guinea-Bissau.</div></div><div><h3>Methods</h3><div>Focus group discussions (FGDs) and semi-structured interviews were conducted in the regions Biombo, Oio, and Farim and a thematic networks analysis was performed.</div></div><div><h3>Results</h3><div>Vaccines were well considered, and no caregivers (n = 29, 4 FGDs) or HCWs (n = 9), expressed negative perceptions of vaccines.</div><div>Most caregivers reported several difficulties in seeking and obtaining vaccinations, especially unpreserved multi-dose vaccines, including vaccine stock-outs, HCW strikes, cost/availability of transportation, and waiting time at HFs. Many stated returning to the same HFs repeatedly was their only option for obtaining vaccinations.</div><div>Most HCWs perceived the RVOP as a logical result of limited vaccine availability but balancing vaccine uptake and dose wastage negatively affected their sense of purpose and job satisfaction.</div><div>To optimize the vaccination process, many participants recommended abandoning the RVOP, and allocating more resources to the HFs.</div></div><div><h3>Conclusions</h3><div>The RVOP afflicts both caregivers and HCWs and is one of several persisting barriers for vaccinations in rural Guinea-Bissau that should be addressed.</div></div>","PeriodicalId":49651,"journal":{"name":"Public Health","volume":"242 ","pages":"Pages 332-339"},"PeriodicalIF":3.9000,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0033350625001234","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}

引用次数: 0

Abstract

Objectives

Any remaining doses of unpreserved multi-dose vaccines must be discarded 6 h after reconstitution. In many countries, these multi-dose vaccines are only opened if a certain number of children are present. In Guinea-Bissau, this results in health facilities (HFs) limiting BCG, measles, and yellow fever vaccinations to predefined days.

This study aims to explore views, perceptions and experiences of caregivers of vaccine-eligible children and health care workers (HCWs) on the vaccination programme and restrictive vial opening policy (RVOP).

Study design

A qualitative study nested within an ongoing vaccine trial in rural Guinea-Bissau.

Methods

Focus group discussions (FGDs) and semi-structured interviews were conducted in the regions Biombo, Oio, and Farim and a thematic networks analysis was performed.

Results

Vaccines were well considered, and no caregivers (n = 29, 4 FGDs) or HCWs (n = 9), expressed negative perceptions of vaccines.

Most caregivers reported several difficulties in seeking and obtaining vaccinations, especially unpreserved multi-dose vaccines, including vaccine stock-outs, HCW strikes, cost/availability of transportation, and waiting time at HFs. Many stated returning to the same HFs repeatedly was their only option for obtaining vaccinations.

Most HCWs perceived the RVOP as a logical result of limited vaccine availability but balancing vaccine uptake and dose wastage negatively affected their sense of purpose and job satisfaction.

To optimize the vaccination process, many participants recommended abandoning the RVOP, and allocating more resources to the HFs.

Conclusions

The RVOP afflicts both caregivers and HCWs and is one of several persisting barriers for vaccinations in rural Guinea-Bissau that should be addressed.

查看原文本刊更多论文

卫生保健工作者和卫生设施使用者对儿童疫苗接种规划的限制性疫苗瓶开放政策有何体会？几内亚比绍农村的定性研究

目的任何未保存的多剂量疫苗在重组后6小时必须丢弃。在许多国家，这些多剂量疫苗只有在一定数量的儿童在场的情况下才开放。在几内亚比绍，这导致卫生机构将卡介苗、麻疹和黄热病疫苗接种限制在预定的日期。本研究旨在探讨符合接种条件的儿童的照料者和卫生保健工作者（HCWs）对疫苗接种规划和限制性开瓶政策（RVOP）的看法、看法和经验。研究设计在几内亚比绍农村正在进行的一项疫苗试验中进行定性研究。方法在Biombo、Oio和Farim地区进行焦点小组讨论（fgd）和半结构化访谈，并进行专题网络分析。结果疫苗得到了很好的考虑，没有护理人员（n = 29, 4名FGDs）或医护人员（n = 9）对疫苗表示负面看法。大多数护理人员报告说，在寻找和获得疫苗，特别是未保存的多剂量疫苗方面存在一些困难，包括疫苗缺货、卫生工作者罢工、运输成本/可用性以及卫生工作者的等待时间。许多人说，反复返回同一个营地是他们获得疫苗接种的唯一选择。大多数卫生保健工作者认为RVOP是疫苗供应有限的必然结果，但平衡疫苗摄取和剂量浪费对他们的目标感和工作满意度产生负面影响。为了优化疫苗接种过程，许多与会者建议放弃RVOP，并向卫生组织分配更多资源。RVOP困扰着护理人员和卫生保健工作者，是几内亚比绍农村地区疫苗接种的几个持续障碍之一，应予以解决。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.