Exploring Parental Challenges and the Role of Nurses in Promoting Routine Childhood Vaccination
Amor L. Becite | Cliff Richard T. Mabasa | Melba C. Palcon | Edna S. Fajardo
Discipline: Mental Health Nursing
Abstract:
This study examines the challenges of routine immunization in low-income communities of
District II, Tondo, Manila, highlighting the role of public health nurses in addressing these
barriers. Using a descriptive quantitative correlational design, data were collected from 150
parents through a structured questionnaire, revealing significant challenges in three key areas:
logistical and resource constraints (GWM = 3.57), community and societal attitudes (GWM =
3.58), and support and infrastructure (GWM = 3.68). Financial limitations and educational gaps
were identified as primary logistical barriers, while vaccine hesitancy was influenced by family
and societal norms. Additionally, the absence of health personnel and limited resources further
hindered immunization efforts. A strong correlation was found between these challenges and
the support provided by nurses, emphasizing their critical role in mitigating immunization
barriers. To enhance their effectiveness, the study proposes targeted training programs in data
management, community engagement, infrastructure management, financial guidance, and
immunization advocacy, ultimately strengthening immunization efforts and improving public
health outcomes in low-income communities.
References:
- Al‐Lela, O. Q., Bahari, M. B., Salih, M. R., Al‐Abbassi, M. G., Elkalmi, R. M., & Jamshed, S. Q. (2014). Factors underlying inadequate parents’ awareness regarding pediatric immunization: Findings of cross-sectional study in Mosul–Iraq. BMC Pediatrics, 14, 29. https://doi.org/10.1186/1471-2431-14-29
- Albers, A. N., Thaker, J., & Newcomer, S. R. (2022). Barriers to and facilitators of early childhood immunization in rural areas of the United States: A systematic review of the literature. Preventive Medicine Reports. https://doi.org/10.1016/j.pmedr.2022.101804
- Amit, A. M. L., Pepito, V. C. F., Sumpaico‑Tanchanco, L., & Dayrit, M. M. (2022). COVID‑19 vaccine brand hesitancy and other challenges to vaccination in the Philippines. PLOS Global Public Health, 2(1). https://doi.org/10.1371/journal.pgph.0000165
- Añabieza, M. (2023). Reaching Every Purok Strategy [PowerPoint slides]. UNICEF; Department of Health, Republic of the Philippines.
- Arceo, E., Dizon, J. C., Chavez, M., Cordero, P. K., de Leon, M. R., de Luna, J., … Tiongco, R. E. (2021). Knowledge, attitude, and practices of mothers from a rural community in Pampanga, Philippines toward childhood immunization: A cross-sectional survey. Vacunas, 22(3), 167–172. https://doi.org/10.1016/j.vacun.2020.12.002
- Balgovind, P., & Mohammadnezhad, M. (2022). Factors affecting childhood immunization: Thematic analysis of parents and healthcare workers’ perceptions. Human Vaccines & Immunotherapeutics, 18(6). https://doi.org/10.1080/21645515.2022.2137338
- Barría, R. M. (2021). Nursing and its essential role in vaccination against COVID‑19: New challenge in a pandemic scenario. Investigación y Educación en Enfermería, 39(3). https://orcid.org/0000-0002-3764-5254
- Beck, A. M., Piontek, A. J., Wiedenman, E. M., & Gilbert, A. (2022). Perceptions of COVID‑19 mitigation strategies between rural and non‑rural adults in the US: How public health nurses can fill the gap. Nursing Reports, 12(1), 188–197. https://doi.org/10.xxxx/xxxxxx (add DOI if available)
- Benner, P. (1982). From novice to expert. The American Journal of Nursing, 82(3), 402–407. https://doi.org/10.2307/3462928
- Creswell, J. W. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). SAGE Publications.
- Damnjanović, K., Graeber, J., Ilić, S., Lam, W. Y., Lep, Ž., Morales, S., Pulkkinen, T., & Vingerhoets, L. (2018). Parental decision‑making on childhood vaccination. Frontiers in Psychology, 9, 735. https://doi.org/10.3389/fpsyg.2018.00735
- Decouttere, C., De Boeck, K., & Vandaele, N. (2021). Advancing sustainable development goals through immunization: A literature review. Globalization and Health, 17(1), 95. https://doi.org/10.1186/s12992-021-00744-1
- Department of Health. (2023). Expanded program on immunization. Department of Health Philippines. Retrieved from https://doh.gov.ph/expanded-program-on-immunization
- Enyinnaya, J. C., Anderson, A. A., Kelp, N. C., Long, M., & Duncan, C. G. (2024). The social ecology of health beliefs and misinformation framework: Examining the impact of misinformation on vaccine uptake through individual and sociological factors. Vaccine. https://doi.org/10.xxxx/xxxxxx
- Etikan, I., Musa, S. A., & Alkassim, R. S. (2016). Comparison of convenience sampling and purposive sampling. American Journal of Theoretical and Applied Statistics, 5(1), 1–4. https://doi.org/10.11648/j.ajtas.20160501.11
- Field, A. (2013). Discovering statistics using IBM SPSS statistics (4th ed.). SAGE Publications.
- Gilmore, B., Gerlach, N., Lopes, C. A., Bhattacharyya, S., de Claro, V., Ndejjo, R., … Tchetchia, A. (2022). Community engagement to support COVID‑19 vaccine uptake: A living systematic review protocol. BMJ Open, 12(9). https://doi.org/10.1136/bmjopen-2022-063057
- Hao, F., & Shao, W. (2022). Understanding the influence of political orientation, social network, and economic recovery on COVID‑19 vaccine uptake among Americans. Vaccine, 40(14), 2191–2201. https://doi.org/10.1016/j.vaccine.2022.02.066
- Hobani, F., & Alhalal, E. (2022). Factors related to parents’ adherence to childhood immunization. BMC Public Health, 22(1), 819. https://doi.org/10.1186/s12889-022-12975-y
- Hopkins, K. L., Underwood, T., Iddrisu, I., Woldemeskel, H., Bon, H. B., Brouwers, S., … Lihemo, G. (2023). Community-based approaches to increase COVID‑19 vaccine uptake and demand: Lessons learned from four UNICEF-supported interventions. Vaccines, 11(7). https://doi.org/10.3390/vaccines11071180
- Lee, J., & Huang, Y. (2022). COVID‑19 vaccine hesitancy: The role of socioeconomic factors and spatial effects. Vaccines, 10(3), 352. https://doi.org/10.3390/vaccines10030352
- MacKenzie, N. E., Tutelman, P. R., Chambers, C. T., Parker, J. A., MacDonald, N. E., McMurtry, C. M., … Boerner, K. E. (2021). Understanding parents’ use of a knowledge translation tool to manage children’s vaccination pain. Pain Reports, 6(1). https://doi.org/10.1097/PR9.0000000000000907
- McKee, C., & Bohannon, K. (2016). Exploring the reasons behind parental refusal of vaccines. The Journal of Pediatric Pharmacology and Therapeutics, 21(2), 104–109. https://doi.org/10.5863/1551-6776-21.2.104
- Migriño, J. Jr., Gayados, B., Birol, K. R. J., De Jesus, L., Lopez, C. W., Mercado, W. C., … Tulagan, G. (2020). Factors affecting vaccine hesitancy among families with children 2 years old and younger in two urban communities in Manila, Philippines. Western Pacific Surveillance and Response Journal, 11(2), 20–26. https://doi.org/10.5365/wpsar.2019.10.2.006
- Nuwarda, R. F., Ramzan, I., Weekes, L., & Kayser, V. (2022). Vaccine hesitancy: Contemporary issues and historical background. Vaccines, 10(10), 1595. https://doi.org/10.3390/vaccines10101595
- Oku, A., Oyo‑Ita, A., Glenton, C., Fretheim, A., Ames, H., Muloliwa, A., … Lewin, S. (2017). Perceptions and experiences of childhood vaccination communication strategies among caregivers and health workers in Nigeria: A qualitative study. PLOS ONE, 12(11), e0186733. https://doi.org/10.1371/journal.pone.0186733
- Quero, R. A. D., Puno, P. A. A., Qua, A. M. P., Quiroz, R. J. T., Quenery, T. J. L., Polido, P. J. B., … Pua, J. C. (2019). A cross-sectional study on the knowledge, attitude, and practices (KAP) of mothers and caregivers on immunization in Quezon City. BMC Public Health, 19, 101. https://doi.org/10.1186/1471-2458-12-578
- Seidman, G., & Atun, R. (2017). Does task shifting yield cost savings and improve efficiency for health systems? A systematic review of evidence from low-income and middle-income countries. Human Resources for Health, 15, 1–13. https://doi.org/10.1186/s12960-017-0200-9
- Singh, S., Sahu, D., Agrawal, A., & Vashi, M. D. (2019). Barriers and opportunities for improving childhood immunization coverage in slums: A qualitative study. Preventive Medicine Reports, 14, 100858. https://doi.org/10.1016/j.pmedr.2019.100858
- UNICEF Philippines. (2022, October 21). Philippines in top 5 countries globally for zero‑dose children. Retrieved from https://www.unicef.org/philippines/press-releases/philippines-top-5-country-world-zero-dose-children
- UNICEF Philippines. (2023). Country office annual report 2023. Retrieved from https://www.unicef.org/reports/country-regional-divisional-annual-reports-2023/Philippines
- Usman, S., Bologna, L., & Stamidis, K. V. (2019). The CORE Group Partners Project in North East Nigeria: Community engagement strategies to combat skepticism and build trust for vaccine acceptance. The American Journal of Tropical Medicine and Hygiene, 101(4 Suppl), 68. https://doi.org/10.4269/ajtmh.19-0143
- While, A. (2021). Evidence-based strategies to promote vaccine acceptance. British Journal of Community Nursing, 26(7), 338–343. https://doi.org/10.12968/bjcn.2021.26.7.338
- Wolf, E. R., O’Neil, J., Pecsok, J., Etz, R. S., Opel, D. J., Wasserman, R., & Krist, A. H. (2020). Insights from caregivers and clinicians on missed pediatric wellness appointments. The Annals of Family Medicine, 18(1), 30–34. https://doi.org/10.xxxx/xxxxxx (add DOI if available)
- World Health Organization. (2022). Regional committee for the Western Pacific seventy‑second session. Retrieved from https://apps.who.int/gb/who_covid19/
- World Health Organization. (2023). Ten threats to global health in 2019. Retrieved from https://www.who.int/news-room/spotlight/ten-threats-to-global-health-in-2019.
- World Health Organization & United Nations Children’s Fund. (2022, July). The State of the World’s Children 2022: Immunization – A chance to reach every child. UNICEF. Retrieved from https://www.unicef.org/press-releases/WUENIC2022release
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