Abstract
Background: We investigated pregnant women, community leaders, healthcare workers (HCWs) and programme managers’ perceptions of maternal vaccination in Kampala, Uganda. Methods: We conducted focus group discussions, key informant interviews and in-depth discussions with HCWs (3), community leaders (3), pregnant women (8) and programme managers (10) between November 2019 and October 2020. Data were analysed thematically. Results: Pregnant women, community leaders and some HCWs had limited maternal immunisation knowledge. There was confusion over what constitutes a vaccine. Pregnant women may not receive vaccines because of mistrust of government; use of expired vaccines; reliance on traditional medicine; religious beliefs; fear of side effects; HCWs attitudes; and logistical issues. The key facilitators of maternal vaccination were a desire to prevent diseases, positive influences from HCWs and information about vaccine side effects. Community leaders and some pregnant women highlighted that pregnant women do not make decisions about maternal vaccination independently and are influenced by different individuals, including other pregnant women, older people, partners, relatives (parents), community leaders, HCWs and the government. Conclusions: Our results indicate that public health messaging should target all community members, including partners and parents of pregnant women as well as HCWs, to improve knowledge of and confidence in maternal vaccines.
Highlights
Infectious diseases cause morbidity and mortality in the antenatal, postpartum, neonatal and early infant periods [1]
A total of 135 participants took part in this study, including 28 healthcare workers (HCWs) divided into three focus group discussions (FGDs), 10 programme managers for key informant interviews (KIIs), 25 community leaders divided into three FGDs and 72 pregnant women, 12 of whom took part in in-depth interviews (IDIs) and 60 took part in 8 FGDs
Awareness of Maternal Vaccines While some HCWs, programme managers and pregnant women demonstrated an awareness of available maternal vaccines, a few community leaders and most pregnant women referred to different types of treatments given during antenatal care (ANC), such as malaria prophylaxis/treatment (e.g., Fansidar) and antiretroviral treatment for HIV as vaccines
Summary
Infectious diseases cause morbidity and mortality in the antenatal, postpartum, neonatal and early infant periods [1]. Maternal immunisation programmes have made great progress in preventing and reducing infection rates in mother and infant [2]. To maintain these achievements, it is important to ensure that existing and new maternal vaccination programmes are tailored to the contexts in which they are being delivered. Conclusions: Our results indicate that public health messaging should target all community members, including partners and parents of pregnant women as well as HCWs, to improve knowledge of and confidence in maternal vaccines
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