Cargando…

Confronting ‘chaos’: a qualitative study assessing public health officials’ perceptions of the factors affecting Tanzania’s COVID-19 vaccine rollout

OBJECTIVES: Mass COVID-19 vaccination in Africa is required to end the pandemic. In low-income settings, street-level bureaucrats (SLBs), or public officials who interact directly with citizens, are typically responsible for carrying out vaccination plans and earning community confidence in vaccines...

Descripción completa

Detalles Bibliográficos
Autores principales: Yamanis, Thespina, Carlitz, Ruth, Gonyea, Olivia, Skaff, Sophia, Kisanga, Nelson, Mollel, Henry
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9890278/
https://www.ncbi.nlm.nih.gov/pubmed/36720575
http://dx.doi.org/10.1136/bmjopen-2022-065081
_version_ 1784880916436353024
author Yamanis, Thespina
Carlitz, Ruth
Gonyea, Olivia
Skaff, Sophia
Kisanga, Nelson
Mollel, Henry
author_facet Yamanis, Thespina
Carlitz, Ruth
Gonyea, Olivia
Skaff, Sophia
Kisanga, Nelson
Mollel, Henry
author_sort Yamanis, Thespina
collection PubMed
description OBJECTIVES: Mass COVID-19 vaccination in Africa is required to end the pandemic. In low-income settings, street-level bureaucrats (SLBs), or public officials who interact directly with citizens, are typically responsible for carrying out vaccination plans and earning community confidence in vaccines. The study interviewed SLBs to assess their perceptions of the factors affecting COVID-19 vaccination rollout in Tanzania. METHODS: We interviewed 50 SLBs (19 rural; 31 urban) responsible for implementing COVID-19 vaccination microplans across four diverse regions and districts of Tanzania in September 2021. Moreover, we conducted six in-depth interviews with non-governmental organisation representatives and seven focus group discussions with health facility governing committees. We asked for their perceptions of factors facilitating and challenging vaccine rollout according to three preidentified domains: political, health system and community. We analysed translated transcripts using a thematic analysis approach. RESULTS: Political factors facilitating mass vaccination included the executive leadership change from a denialist president to a president who accepted vaccines and promoted transparency. Global integration, commercially and politically, also motivated vaccine acceptance. Political challenges included community confusion that emerged from the consecutive presidents’ divergent communications and messaging by prominent religious antivaccination leaders. Health system factors facilitating vaccination included scaling up of immunisation sites and campaigns. Urban district officials reported greater access to vaccination sites, compared with rural officials. Limited financial resources for paying healthcare workers and for transport fuel and a lack of COVID-19 testing compromised mass vaccination. Furthermore, SLBs reported being inadequately trained on COVID-19 vaccine benefits and side effects. Having community sources of accurate information was critical to mass vaccination. Challenges at the community level included patriarchal gender dynamics, low risk perception, disinformation that the vaccine has satanic elements, and lack of trust in coronavirus vaccines. CONCLUSION: Mass COVID-19 vaccination in Tanzania will require greater resources and investment in training SLBs to mitigate mistrust, overcome misinformation, and engage communities.
format Online
Article
Text
id pubmed-9890278
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-98902782023-02-01 Confronting ‘chaos’: a qualitative study assessing public health officials’ perceptions of the factors affecting Tanzania’s COVID-19 vaccine rollout Yamanis, Thespina Carlitz, Ruth Gonyea, Olivia Skaff, Sophia Kisanga, Nelson Mollel, Henry BMJ Open Health Policy OBJECTIVES: Mass COVID-19 vaccination in Africa is required to end the pandemic. In low-income settings, street-level bureaucrats (SLBs), or public officials who interact directly with citizens, are typically responsible for carrying out vaccination plans and earning community confidence in vaccines. The study interviewed SLBs to assess their perceptions of the factors affecting COVID-19 vaccination rollout in Tanzania. METHODS: We interviewed 50 SLBs (19 rural; 31 urban) responsible for implementing COVID-19 vaccination microplans across four diverse regions and districts of Tanzania in September 2021. Moreover, we conducted six in-depth interviews with non-governmental organisation representatives and seven focus group discussions with health facility governing committees. We asked for their perceptions of factors facilitating and challenging vaccine rollout according to three preidentified domains: political, health system and community. We analysed translated transcripts using a thematic analysis approach. RESULTS: Political factors facilitating mass vaccination included the executive leadership change from a denialist president to a president who accepted vaccines and promoted transparency. Global integration, commercially and politically, also motivated vaccine acceptance. Political challenges included community confusion that emerged from the consecutive presidents’ divergent communications and messaging by prominent religious antivaccination leaders. Health system factors facilitating vaccination included scaling up of immunisation sites and campaigns. Urban district officials reported greater access to vaccination sites, compared with rural officials. Limited financial resources for paying healthcare workers and for transport fuel and a lack of COVID-19 testing compromised mass vaccination. Furthermore, SLBs reported being inadequately trained on COVID-19 vaccine benefits and side effects. Having community sources of accurate information was critical to mass vaccination. Challenges at the community level included patriarchal gender dynamics, low risk perception, disinformation that the vaccine has satanic elements, and lack of trust in coronavirus vaccines. CONCLUSION: Mass COVID-19 vaccination in Tanzania will require greater resources and investment in training SLBs to mitigate mistrust, overcome misinformation, and engage communities. BMJ Publishing Group 2023-01-31 /pmc/articles/PMC9890278/ /pubmed/36720575 http://dx.doi.org/10.1136/bmjopen-2022-065081 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Health Policy
Yamanis, Thespina
Carlitz, Ruth
Gonyea, Olivia
Skaff, Sophia
Kisanga, Nelson
Mollel, Henry
Confronting ‘chaos’: a qualitative study assessing public health officials’ perceptions of the factors affecting Tanzania’s COVID-19 vaccine rollout
title Confronting ‘chaos’: a qualitative study assessing public health officials’ perceptions of the factors affecting Tanzania’s COVID-19 vaccine rollout
title_full Confronting ‘chaos’: a qualitative study assessing public health officials’ perceptions of the factors affecting Tanzania’s COVID-19 vaccine rollout
title_fullStr Confronting ‘chaos’: a qualitative study assessing public health officials’ perceptions of the factors affecting Tanzania’s COVID-19 vaccine rollout
title_full_unstemmed Confronting ‘chaos’: a qualitative study assessing public health officials’ perceptions of the factors affecting Tanzania’s COVID-19 vaccine rollout
title_short Confronting ‘chaos’: a qualitative study assessing public health officials’ perceptions of the factors affecting Tanzania’s COVID-19 vaccine rollout
title_sort confronting ‘chaos’: a qualitative study assessing public health officials’ perceptions of the factors affecting tanzania’s covid-19 vaccine rollout
topic Health Policy
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9890278/
https://www.ncbi.nlm.nih.gov/pubmed/36720575
http://dx.doi.org/10.1136/bmjopen-2022-065081
work_keys_str_mv AT yamanisthespina confrontingchaosaqualitativestudyassessingpublichealthofficialsperceptionsofthefactorsaffectingtanzaniascovid19vaccinerollout
AT carlitzruth confrontingchaosaqualitativestudyassessingpublichealthofficialsperceptionsofthefactorsaffectingtanzaniascovid19vaccinerollout
AT gonyeaolivia confrontingchaosaqualitativestudyassessingpublichealthofficialsperceptionsofthefactorsaffectingtanzaniascovid19vaccinerollout
AT skaffsophia confrontingchaosaqualitativestudyassessingpublichealthofficialsperceptionsofthefactorsaffectingtanzaniascovid19vaccinerollout
AT kisanganelson confrontingchaosaqualitativestudyassessingpublichealthofficialsperceptionsofthefactorsaffectingtanzaniascovid19vaccinerollout
AT mollelhenry confrontingchaosaqualitativestudyassessingpublichealthofficialsperceptionsofthefactorsaffectingtanzaniascovid19vaccinerollout