Abstract
BackgroundMidwives are well placed to promote vaccination awareness throughout a women’s pregnancy and strengthen childhood vaccination demand following hospital discharge. In Perth, Western Australia, Aboriginal children experience some of the lowest vaccination coverage rates across the nation. To identify factors preventing greater vaccination uptake amongst the target population, a theory-based study was conducted with midwives across two Perth maternity hospitals to explore behavioural attributes, knowledge, attitudes and beliefs surrounding vaccination provision and the vaccines administered to Aboriginal children.MethodsA purpose-designed questionnaire was distributed to midwives working in two Perth public maternity hospitals. The proximal constructs of The Theory of Planned Behavior were used to frame the questionnaire to enable the barriers to greater vaccination coverage to be identified and behaviourally situated. Descriptive statistics described the demographics of the study sample. Chi-square and the Fisher’s exact test were used to identify associations between midwife characteristics and awareness of the coverage rates. Significance was set at α = 0.05.ResultsOf the 58 midwives who completed the study questionnaire, 77.2% were unaware of the sub-optimal vaccination coverage in Perth’s Aboriginal children. Level of education (p = 0.53) and years worked as a practising midwife (p = 0.47) were not found to be associated with an awareness of the coverage rates. Approximately, 50% of midwives reported some concern over the efficacy of childhood vaccines, 44.4% did not feel confident with their knowledge of vaccines, while 33.3% do not routinely discuss childhood vaccinations with parents prior to hospital discharge.ConclusionsKey findings in the study identified that a range of educational, leadership and system-based issues are affecting midwives’ capacity to play a more substantial role in influencing vaccination coverage in Perth’s Aboriginal children.
Highlights
Midwives are well placed to promote vaccination awareness throughout a women’s pregnancy and strengthen childhood vaccination demand following hospital discharge
Internal conflict may occur in midwives who have vaccination beliefs that contrast with information they are required to provide to new parents by their regulatory body (Nursing and Midwifery Board of Australia [NMBA]) if it is perceived to reduce a mother’s available options [1]
Questionnaire A pre-piloted questionnaire [12] based on theoretical framework [13] was used to identify the behavioural barriers in the vaccine-associated practise of midwives working in two maternity hospitals in the Perth metropolitan area
Summary
Midwives are well placed to promote vaccination awareness throughout a women’s pregnancy and strengthen childhood vaccination demand following hospital discharge. Despite midwives being one of the most commonly accessed healthcare providers that pregnant women discuss vaccinations with, a considerable proportion of parent’s report that inadequate vaccine information is provided during the perinatal period [3, 5, 6]. This can result in certain downstream effects such as parental uncertainty as they contemplate vaccination during their child’s early years
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