Browsing by Author "Chemos, Justine"

Now showing 1 - 1 of 1
  • No Thumbnail Available
    Item
    Caregivers’ perspectives on malaria vaccine uptake for children under five at Mbale regional referral hospital.
    (Busitema University, 2026) Chemos, Justine
    Background: Malaria accounts for 76% of global under-five malaria deaths, with Uganda recording ~16 deaths daily, ten of which are children under five. The R21/Matrix-M vaccine was integrated into Uganda's routine immunization schedule in April 2025 across 105 high-transmission districts at 6, 7, 8 and 18 months. Despite free provision, post-introduction coverage attrition is well documented: Cameroon reported dose-one coverage of 31.2% and dose-three coverage of 17.7% one year after rollout. Local evidence on caregivers' perspectives at Mbale Regional Referral Hospital (MRRH), a center serving 4.6 million people in Eastern Uganda, was absent, constraining contextually appropriate intervention design. Methods: A descriptive qualitative design was conducted at the Young Child Clinic, MRRH, Uganda. Purposive sampling recruited 16 participants: 12 mothers of children under five attending immunization services and 4 nursing/midwifery staff. In-depth interviews were conducted in English and local languages, audio-recorded and transcribed verbatim. Thematic analysis following Braun and Clarke's (2006) framework was applied, with data saturation guiding sample size. Ethical approval was obtained from the Busitema University Faculty of Health Sciences Research and Ethics Committee (BUFHS-REC). Results: Five themes emerged. First, caregivers had a foundational awareness of the vaccine's protective purpose, yet knowledge of the dosing schedule was limited and health worker training was inconsistent. Second, experiences with uptake were largely positive, though vaccination decisions were often conditioned on spousal approval and financial control, while long waiting times were a recurring frustration. Third, barriers operated across multiple levels: transport costs, geographic distance, fear of side effects, community myths about infertility and population control, vaccine stockouts and inadequate staffing. Fourth, key facilitators included parental responsibility reinforced by direct exposure to malaria morbidity, trust in health workers, family social support and free vaccine provision. Fifth, participants recommended multi-channel community awareness campaigns using radio and VHTs, staffing augmentation, satellite outreach immunization points, sustained vaccine supply chain management and structured refresher training for health workers. Conclusion and recommendation: Malaria vaccine uptake at MRRH is shaped by a complex interplay of knowledge gaps, community misconceptions, gendered decision-making, logistical barriers and health system constraints. The Ministry of Health should implement targeted, multi-channel communication that leverages radio, VHTs, and peer-educator networks to correct misconceptions. Health facility managers should augment immunization staffing and extend service hours, while the National Medical Stores must maintain buffer stocks to prevent stockouts. Health workers require structured hands-on refresher training beyond CMEs, and immunization programs should institutionalize male partner engagement to address gendered access barriers, thereby optimizing vaccine completion among children under five in high-burden settings. Keywords: Malaria vaccine, caregivers' perspectives, vaccine uptake, children under five, barriers, facilitators, Uganda, qualitative study, Mbale Regional Referral Hospital