PDF(Pubmed)
Abstract：
UNASSIGNED: Despite established vaccination programs, vaccine-preventable diseases persist among about 900,000 Forcibly Displaced Myanmar Nationals (FDMN)/Rohingya refugees in the world\'s largest refugee settlement in Bangladesh. Health service providers (HSPs) play a key role in the delivery of childhood vaccination programs. This study explored their views on individual and context barriers and drivers to childhood vaccination in this setting.
UNASSIGNED: Informed by the theoretical framework of the Capability-Opportunity-Motivation-Behavior (COM-B) model for behavior change, this qualitative study collected data through eight focus group discussions (FGDs) with community health workers (CHWs) and vaccinators in selected camps with high or low vaccination coverage rates, and through 11 in-depth interviews (IDIs) with key informants working in strategic, management, and administrative roles.
UNASSIGNED: Barriers and drivers were evident across all COM factors for HSPs and caregivers. Among HSPs, knowledge around vaccination acted both as a barrier and driver, while communication skills and confidence in vaccination served as drivers. Caregivers\' lack of awareness of vaccination, concerns and mistrust were described as main barriers. Context barriers included information system deficiencies, family dynamics, HSPs\' working conditions, and vaccination site accessibility. Context drivers included effective communication, mobilization, and incentives. Differences between high and low coverage camps in Cox\'s Bazar included variations in HSPs\' knowledge, communication strategies, incentive use, and stakeholder collaboration.
UNASSIGNED: For better vaccination coverage in the camps, context-related changes regarding collaboration, health workforce and the use of incentives seem necessary. Caregivers\' mistrust toward vaccination needs to be considered under the social and historical background of the Rohingya community, and further addressed with targeted communication and campaigning.
UNASSIGNED: Informed by the theoretical framework of the Capability-Opportunity-Motivation-Behavior (COM-B) model for behavior change, this qualitative study collected data through eight focus group discussions (FGDs) with community health workers (CHWs) and vaccinators in selected camps with high or low vaccination coverage rates, and through 11 in-depth interviews (IDIs) with key informants working in strategic, management, and administrative roles.
UNASSIGNED: Barriers and drivers were evident across all COM factors for HSPs and caregivers. Among HSPs, knowledge around vaccination acted both as a barrier and driver, while communication skills and confidence in vaccination served as drivers. Caregivers\' lack of awareness of vaccination, concerns and mistrust were described as main barriers. Context barriers included information system deficiencies, family dynamics, HSPs\' working conditions, and vaccination site accessibility. Context drivers included effective communication, mobilization, and incentives. Differences between high and low coverage camps in Cox\'s Bazar included variations in HSPs\' knowledge, communication strategies, incentive use, and stakeholder collaboration.
UNASSIGNED: For better vaccination coverage in the camps, context-related changes regarding collaboration, health workforce and the use of incentives seem necessary. Caregivers\' mistrust toward vaccination needs to be considered under the social and historical background of the Rohingya community, and further addressed with targeted communication and campaigning.
摘要：
■尽管建立了疫苗接种计划，在孟加拉国世界上最大的难民定居点中，约有900,000名被迫流离失所的缅甸国民（FDMN）/罗兴亚难民仍然存在疫苗可预防的疾病。卫生服务提供者（HSP）在儿童疫苗接种计划的实施中起着关键作用。这项研究探讨了他们对这种情况下儿童疫苗接种的个人和背景障碍和驱动因素的看法。
■了解到行为改变的能力-机会-动机-行为（COM-B）模型的理论框架，这项定性研究通过与社区卫生工作者（CHW）和疫苗接种人员在选定的疫苗接种率高或低的营地进行的八次焦点小组讨论（FGD）收集数据，并通过对战略工作的关键线人进行11次深度访谈(IDI)，管理,和管理角色。
■障碍和驱动因素在HSP和护理人员的所有COM因素中都很明显。在HSP中，关于疫苗接种的知识既是障碍又是驱动因素，而沟通技巧和对疫苗接种的信心则是驱动因素。护理人员缺乏疫苗接种意识，担忧和不信任被描述为主要障碍。背景障碍包括信息系统缺陷，家庭动态,HSPs\'工作条件,和疫苗接种部位的可达性。上下文驱动程序包括有效的沟通，动员,和激励措施。考克斯巴扎尔的高覆盖率和低覆盖率阵营之间的差异包括HSP知识的差异，沟通策略,激励使用，和利益相关者合作。
■为了提高营地的疫苗接种覆盖率，与上下文相关的合作变化，卫生劳动力和激励措施的使用似乎是必要的。照顾者对疫苗接种的不信任需要在罗兴亚社区的社会和历史背景下考虑，并通过有针对性的沟通和竞选活动进一步解决。
■了解到行为改变的能力-机会-动机-行为（COM-B）模型的理论框架，这项定性研究通过与社区卫生工作者（CHW）和疫苗接种人员在选定的疫苗接种率高或低的营地进行的八次焦点小组讨论（FGD）收集数据，并通过对战略工作的关键线人进行11次深度访谈(IDI)，管理,和管理角色。
■障碍和驱动因素在HSP和护理人员的所有COM因素中都很明显。在HSP中，关于疫苗接种的知识既是障碍又是驱动因素，而沟通技巧和对疫苗接种的信心则是驱动因素。护理人员缺乏疫苗接种意识，担忧和不信任被描述为主要障碍。背景障碍包括信息系统缺陷，家庭动态,HSPs\'工作条件,和疫苗接种部位的可达性。上下文驱动程序包括有效的沟通，动员,和激励措施。考克斯巴扎尔的高覆盖率和低覆盖率阵营之间的差异包括HSP知识的差异，沟通策略,激励使用，和利益相关者合作。
■为了提高营地的疫苗接种覆盖率，与上下文相关的合作变化，卫生劳动力和激励措施的使用似乎是必要的。照顾者对疫苗接种的不信任需要在罗兴亚社区的社会和历史背景下考虑，并通过有针对性的沟通和竞选活动进一步解决。
