Understanding reporting practices and perceptions of barriers in adverse events following immunisation surveillance: A cross–sectional survey of paediatricians in Kerala, India

Abstract

PurposeThe role of health care professionals (HCPs) is central to adverse event following immunisation (AEFI) surveillance. A cross–sectional survey was conducted among paediatricians practising in Kerala, India, to assess their knowledge and reporting behaviour in AEFI surveillance as well as to identify barriers to reporting. ResultsA random sample of 380 paediatricians were contacted of whom, 243 (63.9%) participated in the survey. The understanding scores were distributed as follows: 30.9% very high or high, 40.3% moderate, and 28.8% low. Formal training was significantly associated with higher understanding scores, and increased AEFI detection and reporting. Only 42.0% of respondents had formal training; paediatricians in the public sector had higher access to training than those in the private sector. There were 141 respondents (58.0%) who identified an AEFI in the previous year, of whom 66 (46.8%) reported it. The main barriers to AEFI reporting were: difficulties with reporting process (28.9%); fear of raising public alarm (28.1%); time constraints (22.3%); fear of personal consequences (15.7%); and belief that health authorities rarely take useful action (11.6%). ConclusionTraining in AEFI surveillance should be prioritised for HCPs with greater emphasis in medical education programmes. Study showed that a user–friendly reporting mechanism and a blame–free culture are crucial to improve AEFI reporting practices.