基于新型 Omale INDEPT FORCIS 框架的 COVID-19 疫苗接种接受度的决定因素及对后续流行病的建议:对尼日利亚埃邦伊州社区成员的定性研究。

IF 4.5 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH International Journal for Equity in Health Pub Date : 2024-10-28 DOI:10.1186/s12939-024-02284-3
Ugwu I Omale, Azuka S Adeke, Onyinyechukwu U Oka, Cordis O Ikegwuonu, Osarhiemen Iyare, Olaedo O Nnachi, Victor U Uduma, Chidinma I Amuzie, Glory E Nkwo, Ugochi I A Nwali, Okechukwu O Ukpabi, Ifeyinwa M Okeke, Richard L Ewah
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引用次数: 0

摘要

背景:史无前例的 COVID-19 大流行已成为具有全球公共卫生重要性的地方病。大规模接种 COVID-19 疫苗是一项重要的全球控制策略,但也面临着接受度有限的挑战。由于全球化,COVID-19/类似疾病疫苗接种的接受度以及在任何特定环境下的决定因素都是重要的全球公共卫生问题。本研究采用新颖务实的框架,探讨了尼日利亚埃邦伊州大流行期间社区成员接受 COVID-19 疫苗接种的决定因素,并就如何在后续疫情爆发/大流行期间提高疫苗接种接受度提出了政策相关建议:这项定性研究基于新颖务实的 "疫苗接种接受度的个人经历和感知以及自满、信心、便利和强迫(四个'顺式')决定因素概念框架 - Omale INDEPT FORCIS 框架"。2022 年 4 月 26 日和 27 日,我们用当地语言和皮金英语与 100 名特意挑选的 15 岁及以上、在社区居住至少一年并同意/同意的社区成员进行了 20 次半结构化面对面焦点小组讨论。采用演绎法(部分采用归纳法)对数据进行了专题分析:结果:COVID-19 疫苗接种接受度的决定因素多种多样且具有重要意义,其中包括与个人相关的因素(个人经历、对 COVID-19、COVID-19 疫苗/接种以及接种过程/系统的看法和知识、社会人口学、个人状况(如怀孕));COVID-19 疫苗接种接受度的决定因素(个人经历、对 COVID-19与 COVID-19 疫苗/接种相关(安全性/副作用、有效性、快速生产);与 COVID-19 疫苗接种过程/系统相关(实际可用性/可及性);与家庭、群体和其他个人相关(经历、感知和行动);与更广泛的地方、国家、国际和全球(LONING)背景相关(社会政治、经济、历史、卫生系统因素)。更广泛的 LONING 背景因素包括前所未有的虚假信息/阴谋论、非持续性的 COVID-19 风险/行为改变沟通、特殊控制政策/措施(封锁、社会/物理疏远、使用口罩等)的执行和不执行或终止、强制性 COVID-19 风险/行为改变沟通、社会/物理疏远、使用口罩等)。这些因素包括:强制 COVID-19 疫苗接种政策、提供激励措施、过去有关埃博拉病毒性疾病爆发的经验、尼日利亚卫生系统及其国际/全球合作伙伴的(不)可信度、尼日利亚政府的(不)可信度以及不良/良好治理,包括埃邦伊州政府未能在封锁期间向人们分发 COVID-19 止痛药:这些证据揭示了影响人们接受 COVID-19 疫苗接种的复杂而又相互关联的、具体的、潜在的和与政策相关的特殊龙8国际娱乐城决定因素,并强调有必要采取协调一致的综合龙8国际娱乐城战略(涉及所有相关龙8国际娱乐城利益相关者/政策制定者)来解决这些决定因素,以提高埃邦伊州/尼日利亚和类似环境中社区成员在随后的疫情爆发/大流行中对疫苗接种的接受程度。
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Determinants of COVID-19 vaccination acceptance based on the novel Omale INDEPT FORCIS Framework and recommendations for subsequent pandemics: a qualitative study among community members in Ebonyi state, Nigeria.

Background: The unprecedented COVID-19 pandemic has become an endemic disease of global public health importance. Mass COVID-19 vaccination has been an essential global control strategy amidst challenges of limited acceptance. Because of globalization, COVID-19/similar diseases vaccination acceptance and the determinants in any particular setting are important global public health issues. Using a novel and pragmatic framework, this study explored determinants of COVID-19 vaccination acceptance among community members during the pandemic in Ebonyi state, Nigeria, and made policy-relevant recommendations on how to increase vaccination acceptance in subsequent outbreaks/pandemics.

Methods: This qualitative study was based on the novel and pragmatic Individual Experiences and Perceptions and Complacency, Confidence, Convenience, and Compulsion (Four 'Cis') Determinants of Vaccination Acceptance Conceptual Framework - Omale INDEPT FORCIS Framework. On April 26 and 27, 2022, 20 semi-structured face-to-face focus group discussions were conducted in local language and pidgin English with 100 purposively selected consenting/assenting community members aged 15 years and above who had resided in the community for at least one year. Data was analysed using deductive (with some inductive) thematic analytic approach.

Results: The many, diverse, and significant determinants of COVID-19 vaccination acceptance found were factors that were individual-related (individual experiences and perceptions and knowledge about COVID-19, COVID-19 vaccine/vaccination, and the vaccination process/system, sociodemographic, individual's condition (e.g. pregnancy)); COVID-19-related (factuality, transmissibility, frequency, severity, fatality); COVID-19 vaccine/vaccination-related (safety/side-effects, effectiveness, speedy production); COVID-19 vaccination process/system-related (real availability/accessibility); family, group, and other individual-related (experiences and perceptions and actions); and broader local, national, international, and global (LONING) context-related (socio-political, economic, historic, health system factors). The broader LONING contextual factors included the unprecedented disinformation/conspiracy theories, non-sustained COVID-19 risk/behaviour change communication, enforcement and non-enforcement or termination of peculiar control policies/measures (lockdowns, social/physical distancing, use of face mask etc.), mandatory COVID-19 vaccination policies, provision of incentives, past experiences regarding the Ebola viral disease outbreak, (un)trustworthiness of the Nigerian health system and her international/global partners, and the (un)trustworthiness of the governments in Nigeria and bad/good governance, inclusive of the failure of the Ebonyi state government to distribute the COVID-19 palliatives to the people during the lockdowns.

Conclusion: The evidence illuminates complex and interrelated, specific underlying, and peculiar policy-relevant LONING determinants of COVID-19 vaccination acceptance and emphasizes the need for concerted and comprehensive LONING strategies (involving all the relevant LONING stakeholders/policy makers) in addressing these determinants to increase vaccination acceptance among community members in subsequent outbreaks/pandemics in Ebonyi state/Nigeria and similar settings.

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来源期刊
CiteScore
7.80
自引率
4.20%
发文量
162
审稿时长
28 weeks
期刊介绍: International Journal for Equity in Health is an Open Access, peer-reviewed, online journal presenting evidence relevant to the search for, and attainment of, equity in health across and within countries. International Journal for Equity in Health aims to improve the understanding of issues that influence the health of populations. This includes the discussion of political, policy-related, economic, social and health services-related influences, particularly with regard to systematic differences in distributions of one or more aspects of health in population groups defined demographically, geographically, or socially.
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