Background

Sub-Saharan Africa continues with very low hepatitis B (HBV) birth dose vaccination coverage. To guide policy on HBV vaccine for newborns, we explored perceptions, barriers and preferences of pregnant women regarding HBV and the HBV birth dose vaccination

Methods

We conducted eight focus groups discussions (FGDs) among 70 pregnant women, stratified by rural-urban residence, age and education level, using a structured focus group discussion guide to explore birth dose awareness, perceptions, barriers and preferences. Data were transcribed, coded and analysed using framework analysis.

Results

Perceptions related to HBV and liver cancer causes and prevention were diverse; most FGD participants did not perceive illnesses as distinctly different. Older women-groups, both urban and rural, had never heard about HBV, but were aware of liver cancer, viewing the disease as fatal. No FGD participants were aware of HBV birth dose. Concerns included vaccine safety, its availability to women who deliver outside the health system and mistrust in health-care worker (HCWs) when handling newborns. Rural-dwelling groups perceived absence of HBV services, while FGDs with young participants believed vaccine side-effects hampered birth dose planning. Most women-groups preferred (i) oral to injectable vaccines; (ii) receiving birth dose education during antenatal, to media-based education; (iii) that newborns receive the birth dose immediately after delivery in the mother's presence.

Conclusion

Although the birth dose is acceptable among pregnant women, planners need to continuously engage them as key stakeholders during planning to address concerns, in order to raise confidence, maximize uptake and strengthen HBV eradication efforts.

中文翻译：

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乌干达新生儿乙型肝炎出生剂量疫苗接种：对孕妇的看法、障碍和偏好的定性调查

背景

撒哈拉以南非洲地区的乙型肝炎 (HBV) 出生剂量疫苗接种覆盖率仍然很低。为了指导新生儿乙型肝炎疫苗的政策，我们探讨了孕妇对乙型肝炎和乙型肝炎出生剂量疫苗接种的看法、障碍和偏好

方法

我们对 70 名孕妇进行了 8 次焦点小组讨论 (FGD)，按照城乡居住地、年龄和教育水平进行分层，使用结构化焦点小组讨论指南来探讨出生剂量意识、看法、障碍和偏好。使用框架分析对数据进行转录、编码和分析。

结果

人们对乙型肝炎和肝癌的病因和预防的看法各不相同；大多数 FGD 参与者并不认为疾病有明显不同。城市和农村的老年女性群体从未听说过乙型肝炎，但知道肝癌，认为这种疾病是致命的。没有 FGD 参与者知道 HBV 出生剂量。人们的担忧包括疫苗的安全性、在卫生系统外分娩的妇女能否获得疫苗以及在处理新生儿时对医护人员 (HCW) 的不信任。农村居民群体认为缺乏乙肝服务，而年轻参与者的 FGD 则认为疫苗副作用阻碍了出生剂量计划。大多数女性群体更喜欢 (i) 口服疫苗而不是注射疫苗；(ii) 在产前接受出生剂量教育，以媒体为基础的教育；(iii) 新生儿在分娩后立即在母亲在场的情况下接受出生剂量。

结论

尽管孕妇的出生剂量是可以接受的，但规划者需要在规划过程中不断让她们作为关键利益相关者参与解决问题，以提高信心、最大限度地提高乙肝病毒的吸收率并加强乙肝根除工作。