6 research outputs found
Misinformation, infighting, backlash, and an âendlessâ recovery; policymakers recount challenges and mitigating measures after a vaccine scare in the Philippines
Background Vaccine scares undermine longstanding global health achievements. Remarkably little data has documented the lived experiences of policymakers working amidst vaccine scares and navigating their fallout. As a result, chances and challenges of large-scale national recuperation efforts are poorly understood. Objective This study aims to explore the perspectives of policymakers involved in ongoing efforts to boost vaccine confidence in the Philippines following a 2017 Dengvaxia scare and the current COVID-19 pandemic. Methods Between August and November 2020, we conducted 19 semi-structured narrative interviews with purposively selected policymakers from governmental agencies and non-governmental organizations in the Philippines. Interviews were conducted online, transcribed, and analyzed following the tenets of reflexive thematic analysis. Results We present results as an emerging model that draws on a chronology conveyed by policymakers in their own words. The Dengvaxia scare proved âa decisive wedgeâ that splintered Filipino society and pitted governmental agencies against one another. The scare stoked distorted vaccination narratives, which were âaccelerated rapidlyâ via social media, and ignited feelings of uncertainty among policymakers of how to convey clear, accurate health messaging and how to prevent drops in care-seeking more broadly. Conclusions Efforts to regain trust placed exceptional burdens on an already-strained health system. Respondent-driven recommendations on how to reinforce vaccine confidence and improve vaccination rollout include: developing clear vaccine messages, fostering healthcare providersâ and policymakersâ communication skills, and rebuilding trust within, toward and across governmental agencies. Further research on how to build enabling environments and rebuild trust in and across institutions remains paramount
How can human-centered design build a story-based video intervention that addresses vaccine hesitancy and bolsters vaccine confidence in the Philippines? A mixed method protocol for project SALUBONG
Introduction Since the onset of a dengue vaccine controversy in late 2017, vaccine confidence has plummeted in the Philippines, leading to measles and polio outbreaks in early 2019. This protocol outlines a human-centered design (HCD) approach to co-create and test an intervention that addresses vaccine hesitancy (VH) via narrative and empathy with and among families and healthcare workers.Methods and analysis âSalubongâ is a Filipino term that means to welcome someone back into oneâs life, reinforcing notions of family ties and friendships. We apply this sentiment to vaccines. Following the phases of HCD, guided by a theoretical framework, and drawing from locally held understandings of faith and acceptance, we will conduct in-depth interviews (IDIs) and focus group discussions (FGDs) in rural and urban Filipino communities that witnessed dramatic increases in measles cases in recent years. During qualitative engagements with caretakers, providers, and policymakers, we will collect narratives about family and community perceptions of childhood vaccinations, public health systems and opportunities to restore faith. IDIs and FGDs will continuously inform the development of (and delivery mechanisms for) story-based interventions. Once developed, we will test our co-created interventions among 800 caretakers and administer a VH questionnaire prior to and immediately following the intervention encounter. We will use the feedback gained through the survey and Kano-style questionnaires to further refine the intervention. Considering the data collection challenges posed by the ongoing COVID-19 pandemic, we have developed workarounds to conduct data collection primarily online. We will use systematic online debriefings to facilitate comprehensive participation of the full research team.Ethics and dissemination Ethical approval has been granted by the Institutional Review Board of the Research Institute for Tropical Medicine (number 2019â44) and Ethical Commission of Heidelberg University, Faculty of Medicine (S-833/2019). Study findings will be disseminated in scientific conferences and published in peer-reviewed journals
Mass drug administration and the sustainable control of schistosomiasis: Community health workers are vital for global elimination efforts
Objectives: Schistosomiasis control is centred on preventive chemotherapy through mass drug administration (MDA). However, endemic countries continue to struggle to attain target coverage rates and patient compliance. In the Philippines, barangay health workers (BHWs) play a vital role in the coordination of MDA, acting as advocates, implementers, and educators. The aim of this study was to determine whether BHW knowledge and attitudes towards schistosomiasis and MDA is sufficient and correlated with resident knowledge and drug compliance.
Methods: A cross-sectional survey was conducted in 2015 among 2186 residents and 224 BHWs in the province of Northern Samar, the Philippines using a structured survey questionnaire.
Results: BHWs showed good familiarity on how schistosomiasis is acquired and diagnosed. Nevertheless, both BHWs and residents had poor awareness of the signs and symptoms of schistosomiasis, disease prevention, and treatment options. There was no correlation between the knowledge scores of the BHWs and the residents (r = 0.080, p = 0.722). KruskalâWallis analysis revealed significant differences in BHW knowledge scores between the low (3.29, 95% confidence interval 3.16â3.36), moderate (3.61, 95% confidence interval 3.49â3.69), and high (4.05, 95% confidence interval 3.77â4.13) compliance village groups (p = 0.002), with the high compliance areas having the highest mean knowledge scores.
Conclusions: This study highlights the importance of community health workers in obtaining the World Health Organization drug coverage rate of 75% and improving compliance with MDA in the community. Investing in the education of community health workers with appropriate disease-specific training is crucial if disease elimination is ultimately to be achieved
Mass drug administration and the sustainable control of schistosomiasis: an evaluation of treatment compliance in the rural Philippines
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background
Preventive chemotherapy is the current global control strategy for schistosomiasis. The WHO target coverage rate is at least 75% for school-aged children. In the Philippines, the reported national coverage rate (43.5%) is far below the WHO target. This study examined the factors associated with non-compliance to mass drug administration.
Methods
A cross-sectional survey was conducted in 2015 among 2189 adults in the province of Northern Samar, the Philippines using a structured face-to-face survey questionnaire.
Results
The overall rate of non-compliance to mass drug administration (MDA) in the last treatment round was 27%. Females (aOR = 1.67, P = 0.033) were more likely to be non-compliant. Respondents who believed that schistosomiasis was acquired by open defecation and poor sanitation (aOR = 1.41, P = 0.015), and by drinking unclean water (aOR = 2.09, P = 0.001) were more likely to refuse treatment. Uncertainties on whether schistosomiasis can be treated (aOR = 2.39, P = 0.033), their fear of adverse reactions to praziquantel (aOR = 1.94, P = 0.021), misconceptions about alternative forms of treatment (aOR = 1.45, P = 0.037), and that praziquantel is used for purposes other than deworming (aOR = 2.15, P = 0.021) were all associated with a higher odd of non-compliance. In contrary, being a farmer (aOR = 0.62, P =0.038), participation in past MDA (aOR = 0.30, P < 0.001), informed about impending MDA (aOR = 0.08, P < 0.001), and having heard of schistosomiasis (aOR = 0.22, P = 0.045) were all significantly associated with reduced non-compliance.
Conclusions
To improve drug compliance for schistosomiasis there is an urgent need for intensive health education campaigns before conducting MDA that would not only provide disease specific information, but also deal with prevailing misconceptions about transmission, prevention, treatment, and drug side-effects.This work was supported by Australian National Health and Medical Research Council
âRespect my opinion and I'll respect yours!â: Exploring the challenges, concerns, and informational needs of vaccineâhesitant caregivers and pregnant women in the Philippines
Abstract Background Despite the instrumental role of vaccines, public confidence is declining, and antiâvaccine movements have increased worldwide. With the goal of informing policy decisions and the development of interventions, we explore the concerns and challenges related to vaccine uptake (of childhood, maternal, and COVIDâ19 vaccines) among parents or caregivers of underâtwo children and pregnant women in urban and rural communities in the Philippines. Methods Between May and June 2022, we conducted combined inâperson and online interviews with purposively selected caregivers and pregnant women in the Calabarzon region (Naic, Cavite and Tanay, Rizal), and National Capital Region (Pasay and Muntinlupa Cities), Philippines. A total of 43 interviews were completed, audioârecorded, transcribed, and analyzed according to the tenets of hermeneutic phenomenology. Results Our results, grounded on the social ecological model, underlined the interplays of contextual or logistical challenges on vaccine uptake, respondentsâ overarching concerns about vaccines, and their informational needs that affected their vaccine decisionâmaking. Respondents described that the longâestablished maternal and childhood vaccines no longer represent a highârisk concern but highlighted their fears and hesitancy particularly to newer vaccines. Conclusion Our findings underscore the multilayered challenges in vaccine decisionâmaking among caregivers and pregnant women. The volatility of vaccine decisionâmaking necessitates rethinking the current immunization process, recalibrating the health workforce, and reinvigorating the health information delivery channels for more inclusive and responsive health care