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      Factors affecting the implementation of childhood vaccination communication strategies in Nigeria: a qualitative study

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          Abstract

          Background

          The role of health communication in vaccination programmes cannot be overemphasized: it has contributed significantly to creating and sustaining demand for vaccination services and improving vaccination coverage. In Nigeria, numerous communication approaches have been deployed but these interventions are not without challenges. We therefore aimed to explore factors affecting the delivery of vaccination communication in Nigeria.

          Methods

          We used a qualitative approach and conducted the study in two states: Bauchi and Cross River States in northern and southern Nigeria respectively. We identified factors affecting the implementation of communication interventions through interviews with relevant stakeholders involved in vaccination communication in the health services. We also reviewed relevant documents. Data generated were transcribed verbatim and analysed using thematic analysis.

          Results

          We used the SURE framework to organise the identified factors (barriers and facilitators) affecting vaccination communication delivery. We then grouped these into health systems and community level factors. Some of the commonly reported health system barriers amongst stakeholders interviewed included: funding constraints, human resource factors (health worker shortages, training deficiencies, poor attitude of health workers and vaccination teams), inadequate infrastructure and equipment and weak political will. Community level factors included the attitudes of community stakeholders and of parents and caregivers. We also identified factors that appeared to facilitate communication activities. These included political support, engagement of traditional and religious institutions and the use of organised communication committees.

          Conclusions

          Communication activities are a crucial element of immunization programmes. It is therefore important for policy makers and programme managers to understand the barriers and facilitators affecting the delivery of vaccination communication so as to be able to implement communication interventions more effectively.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12889-017-4020-6) contains supplementary material, which is available to authorized users.

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          Most cited references34

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          Qualitative data analysis for applied policy research

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            Health communication and vaccine hesitancy.

            Health communication is an evolving field. There is evidence that communication can be an effective tool, if utilized in a carefully planned and integrated strategy, to influence the behaviours of populations on a number of health issues, including vaccine hesitancy. Experience has shown that key points to take into account in devising and implementing a communication plan include: (i) it is necessary to be proactive; (ii) communication is a two-way process; (iii) knowledge is important but not enough to change behaviour; and (iv) communication tools are available and can be selected and used creatively to promote vaccine uptake. A communication strategy, incorporating an appropriate selection of the available communication tools, should be an integral part of every immunization programme, addressing the specific factors that influence hesitancy in the target populations.
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              Exposing concerns about vaccination in low- and middle-income countries: a systematic review.

              Concerns about vaccination lead to under- and no-vaccination. Our objective is to synthesise and expose evidence on individuals' and communities' concerns about vaccination to influence current debates on strategies to improve vaccination coverage in low- and middle-income countries.
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                Author and article information

                Contributors
                afyoku@yahoo.com
                oyo_ita@yahoo.com
                claire.glenton@fhi.no
                atle.fretheim@fhi.no
                gloryeteng@yahoo.com
                heather.ames@fhi.no
                muloliwa@yahoo.com.br
                J.Kaufman@latrobe.edu.au
                sophie.hill@latrobe.edu.au
                Julie.cliff@gmail.com
                ycartier@iuhpe.org
                x.bosch@unibas.ch
                radagabriel@gmail.com
                simon.lewin@fhi.no
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                15 February 2017
                15 February 2017
                2017
                : 17
                : 200
                Affiliations
                [1 ]ISNI 0000 0001 0291 6387, GRID grid.413097.8, Community Medicine Department, , University of Calabar, ; P.M.B 1115, Calabar Municipality, Cross River State Nigeria
                [2 ]ISNI 0000 0001 1541 4204, GRID grid.418193.6, , Norwegian Institute of Public Health, ; Postboks 4404 Nydalen, 0403 Oslo, Norway
                [3 ]ISNI 0000 0004 1936 8921, GRID grid.5510.1, Institute of Health and Society, , University of Oslo, ; P.O box 1130, Blindern, 0318 Oslo Norway
                [4 ]ISNI 0000 0001 0291 6387, GRID grid.413097.8, Sociology Department, , University of Calabar, ; P.M.B 1115, Calabar Municipality, Cross River State Nigeria
                [5 ]Departamento de Saúde, Direcção Provincial de Saúde de Nampula, Av. SamoraMachel n° 1016 R/C, C.P. N° 14, Nampula, Mozambique
                [6 ]ISNI 0000 0001 2342 0938, GRID grid.1018.8, Centre for Health Communication and Participation, , School of Psychology and Public Health, La Trobe University, Health Sciences 2, ; Victoria, 3086 Australia
                [7 ]GRID grid.8295.6, Faculdade de Medicina, , Universidade Eduardo Mondlane, ; Maputo, Mozambique
                [8 ]International Union for Health Promotion and Education, 42 Blvd. de la Libération, 95203 St. Denis, Cedex France
                [9 ]ISNI 0000 0004 0587 0574, GRID grid.416786.a, , Swiss Tropical and Public Health Institute, ; Socinstrasse 57, 4051 Basel, Switzerland
                [10 ]ISNI 0000 0004 1937 0642, GRID grid.6612.3, , University of Basel, ; Petersplatz 1, 4003 Basel, Switzerland
                [11 ]ISNI 0000 0001 2157 0406, GRID grid.7870.8, Evidence-based Healthcare Program, , Pontificia Universidad Católica de Chile, ; Avda. Libertador Bernardo O’Higgins 340, Santiago, Chile
                [12 ]ISNI 0000 0000 9155 0024, GRID grid.415021.3, Health Systems Research Unit, , South African Medical Research Council, ; Francie van Zijl Drive, Parowvallei, PO Box 19070, 7505 Tygerberg, South Africa
                Author information
                http://orcid.org/0000-0001-7521-9515
                Article
                4020
                10.1186/s12889-017-4020-6
                5311723
                28202001
                1770a4bf-d5dd-4d57-b15e-bf8d7ef80de9
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 13 August 2016
                : 11 January 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100005416, The Research Council of Norway;
                Award ID: 220873
                Award Recipient :
                Funded by: FundRef http://dx.doi.org/10.13039/501100001322, South African Medical Research Council;
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Public health
                communication strategies,vaccination,nigeria,barriers,facilitators,qualitative study
                Public health
                communication strategies, vaccination, nigeria, barriers, facilitators, qualitative study

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