Parents' Acceptability and Health Workers' Perspectives of Pneumococcal Conjugate Vaccination for Under-Fives in Ile-Ife, Nigeria

Abstract

Background: Pneumococcus, apart from being the commonest bacterial cause of Respiratory tract infections (RTIs) also causes a wide array of morbidities which can all be prevented with the administration of potent Pneumococcal conjugate vaccine. Despite its effectiveness and availability, Pneumococcal vaccines are not part of routine immunization in Nigeria. This study assessed parents' acceptability and health worker's perspectives of Pneumococcal Conjugate Vaccination for under-fives.

Methods:  The cross-sectional survey was conducted in Ife Central Local Government Area, Osun state. An interviewer-administered questionnaire was used to collect information from 400 parents of under-fives selected via multi-stage random sampling. In-depth interviews were conducted for the heads of immunization units in four selected facilities in the local government area. Data were analysed using SPSS version-16.

Result: More respondents were females, married and had tertiary education. About three-fifth (59.2%) of parents had good knowledge about RTIs though majority (79.00%) were unaware of Pneumococcal Conjugate Vaccine (PCV). most parents (93.5%) were willing to accept PCV for their children but only 43.5% of them could afford to pay for the cost of the vaccine at the prevailing market price. Most health workers (three out of four) interviewed were not aware of PCV. Most parents (96.25%) and all health workers interviewed wanted PCV incorporated into the National Program on Immunization (NPI). Parents with good knowledge about respiratory tract infections (RTIs) were significantly willing to accept PCV for their underfives (p= 0.005). Younger parents less than 35years, parents with lower educational attainments and low income groups significantly could not afford to pay for the cost of vaccines. (p=0.014, 0.001 and <0.001 respectively).

Conclusion: Though almost three fifth of parents surveyed had good knowledge about RTIs, awareness about PCV was poor and most of them were unable to afford PCV. There is an overwhelming need to incorporate PCV in to the NPI, as both parents and health workers agreed. Aside from overcoming a major financial barrier to vaccine access, this will also make PCV widely available to parents who are already willing to accept the vaccine for their children.