Vaccination hesitancy among mobile pastoralists in Chad: a qualitative study

Abstract

Background: Demand-side barriers to vaccination among rural and mobile pastoralists in Chad are not well understood. We hypothesize that mobile pastoralist in Chad face specific demand-side barriers to access vaccination services. Understanding the factors that caregivers in these communities consider, explicitly or implicitly, in order to decide whether or not to vaccinate a child are essential elements to increasing acceptance of vaccination. Methods: A qualitative study was conducted in a rural health district in southern Chad with 12 KII and four FGDs) comprising 35 participants (men and women). Participants were caregivers, traditional chiefs, local and religious leaders, and health officials and staff. We conducted a content analysis using pre-defined set of categories for vaccination hesitancy. Results: The demand-side barriers reported most frequently in FGDs were mistrust of the EPI and polio vaccination outreach services (53%, n = 94), followed by health system issues (34%, n = 94), and concerns related to potential harm of vaccines (13%, n = 94). Concerns identified by participants followed similar pattern with issues on mistrust being most frequently reported and issues with harm least frequently reported. Conclusion: Local health systems must plan for the periodic presence of pastoralist communities in their zones of responsibility and create more mutual trust.