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25,463 reports · page 294 of 2547

Peer-reviewed articleEurope PMC9 Apr 2026

Managers perspectives on the implementation of the Prevention of Mother-to-Child Transmission policy in South Africa.

Background Despite significant progress in South Africa in reducing mother-to-child transmission of human immunodeficiency virus (HIV) infection, challenges remain. This is evident by the incidence and prevalence of HIV in pregnancy and transmission during breastfeeding. This study is aimed at ascertaining the perceptions of prevention of mother-to-child transmission (PMTCT) managers regarding the challenges experienced during the implementation of the PMTCT policy at public health service delivery platforms across all provinces of South Africa. Aim To examine the perceptions and views of PMTCT managers regarding the challenges experienced during implementation of the policy. Setting The study was conducted in all nine provinces of South Africa. Methods An exploratory-qualitative descriptive research design was utilised. The study population was the PMTCT managers. Data were collected from a sample of 11 PMTCT managers, seven at the provincial level, three at the district level, and one at the national level, using in-depth semi-structured interviews from April 2021 to July 2022. The participants were purposefully selected based on their expertise and experiences related to the study topic. Results The participants shared the views, experiences and challenges encountered during the PMTCT policy implementation. Four themes were generated: policy design and change management, system and service delivery constraints, provider-level determinants and client-level determinants. It is imperative that recommendations shared be implemented to support the full implementation of the PMTCT policy, enabling the country to achieve the elimination of mother-to-child transmission by 2030 and an HIV-free generation. Conclusion The article confirmed that the Prevention of Mother-to-Child Transmission policy is partially implemented in South Africa which may derail the country to achieve eMTCT by 2030. Contribution The article propose guidelines towards full implementation of the Prevention of Mother-to-Child Transmission policy across all service delivery platforms across South Africa.

Peer-reviewed articleEurope PMC1 May 2025

Randomized Controlled Trial of Impact of Mobile Health Technologies on Human Papillomavirus Vaccination Uptake in Mothers of Vaccine-Eligible Girls in Lagos, Nigeria (mHealth-HPVac).

Purpose Expanding high-risk human papillomavirus (HPV) vaccine coverage in resource-constrained settings is critical to bridging the cervical cancer gap and achieving the global action plan for elimination. Mobile health (mHealth) technology via short message services (SMS) has the potential to improve HPV vaccination uptake. The mHealth-HPVac study evaluated the effectiveness of mHealth interventions in increasing HPV vaccine uptake among mothers of unvaccinated girls aged 9-14 years in Lagos, Nigeria. Methods A randomized controlled trial was conducted at the Lagos University Teaching Hospital between June 2024 and March 2025. We randomly assigned n = 180 eligible mothers to either a text message (intervention) or a usual care (control) arm. The primary analysis was conducted using the intention-to-treat principle. Bivariable and multivariable logistic regression models were performed to compare HPV vaccination uptake between the two arms, adjusting for potential confounders using odds ratios (ORs) and 95% CIs. Results mHealth intervention significantly increased HPV vaccination uptake among mothers of vaccine-eligible girls (adjusted odds ratio [adj OR], 3.05 [95% CI, 1.61 to 5.77]; P = .001). Higher education level was also significantly associated with increased vaccine uptake (adj OR, 3.35 [95% CI, 1.77 to 6.33]; P < .001). There were no significant interaction effects by baseline characteristics on the association between mHealth intervention and HPV vaccine uptake. Conclusion The study showed that mHealth interventions significantly improve HPV vaccine uptake. Integrating mHealth strategies into routine immunization programs could be a scalable and cost-effective approach to increasing HPV vaccination coverage. However, future multicenter studies should consider using cluster randomization at the facility level to better optimize mobile interventions for diverse populations, identify the key drivers of successful SMS-based mHealth interventions, and gain deeper insights into the complex barriers to HPV vaccination uptake.

Okunade KS, Fayinto AI, Adekanye TV et al.

SurvivalNGRead at source

Peer-reviewed articleEurope PMC9 Sept 2025

Exploration of the social determinants of diarrhoea, rotavirus vaccine uptake, and vaccine 'fatigue' in Ethiopia, Kenya, and Malawi.

Diarrhoea due to rotavirus remains a significant cause of child mortality in developing regions. Caregivers' perspectives on the social determinants of gastroenteritis and childhood vaccination, including the rotavirus vaccine, were explored through focus group discussions in Ethiopia (n = 6), Kenya (n = 14), and Malawi (n = 10), using a combination of thematic and framework analysis approaches. The results show that diarrhoea was perceived to be a burden in all three countries, particularly among infants, due to challenges in WASH (water, sanitation, and hygiene) infrastructures and poverty. Prevention strategies mentioned by the caregivers focussed on enhancing WASH interventions without mention of vaccination. Participants however expressed a lack of agency to address WASH at community level in informal settlements where the studies were conducted. Antibiotics were seen as "strong medications" and often purchased without prescription for treatment of diarrhoea, raising concerns on Anti-Microbial Resistance (AMR), while home remedies such as rice porridge were used for less severe diarrhoea symptoms. Perceived or experiential benefits and safety of previous vaccines promoted vaccine uptake in all three countries. On the other hand, limited understanding of vaccines, concerns about side effects, perceived excessive vaccination, mistrust of vaccines or suspicions of existing vaccines undermined individuals' willingness to vaccinate children. Our results highlight that a lack of attention to socio-determinants of poor health in contexts where there are several vaccines and yet a high incidence of vaccine-preventable diseases may undermine vaccine confidence. Multi-sectoral interventions to tackle social determinants of diarrhoea and improve community understanding of vaccines are required to improve overall community health outcomes.

Phiri MM, Osman R, Weldegebriel S et al.

SurvivalProtectionETKEMWRead at source

Peer-reviewed articleEurope PMC17 Dec 2024

Serotype distribution of remaining invasive pneumococcal disease after extensive use of ten-valent and 13-valent pneumococcal conjugate vaccines (the PSERENADE project): a global surveillance analysis.

Background Widespread use of pneumococcal conjugate vaccines (PCVs) has reduced vaccine-type invasive pneumococcal disease (IPD). We describe the serotype distribution of IPD after extensive use of ten-valent PCV (PCV10; Synflorix, GSK) and 13-valent PCV (PCV13; Prevenar 13, Pfizer) globally. Methods IPD data were obtained from surveillance sites participating in the WHO-commissioned Pneumococcal Serotype Replacement and Distribution Estimation (PSERENADE) project that exclusively used PCV10 or PCV13 (hereafter PCV10 and PCV13 sites, respectively) in their national immunisation programmes and had primary series uptake of at least 70%. Serotype distribution was estimated for IPD cases occurring 5 years or more after PCV10 or PCV13 introduction (ie, the mature period when the serotype distribution had stabilised) using multinomial Dirichlet regression, stratified by PCV product and age group (<5 years, 5-17 years, 18-49 years, and ≥50 years). Findings The analysis included cases occurring primarily between 2015 and 2018 from 42 PCV13 sites (63 362 cases) and 12 PCV10 sites (6806 cases) in 41 countries. Sites were mostly high income (36 [67%] of 54) and used three-dose or four-dose booster schedules (44 [81%]). At PCV10 sites, PCV10 serotypes caused 10·0% (95% CI 6·3-12·9) of IPD cases in children younger than 5 years and 15·5% (13·4-19·3) of cases in adults aged 50 years or older, while PCV13 serotypes caused 52·1% (49·2-65·4) and 45·6% (40·0-50·0), respectively. At PCV13 sites, PCV13 serotypes caused 26·4% (21·3-30·0) of IPD cases in children younger than 5 years and 29·5% (27·5-33·0) of cases in adults aged 50 years or older. The leading serotype at PCV10 sites was 19A in children younger than 5 years (30·6% [95% CI 18·2-43·1]) and adults aged 50 years or older (14·8% [11·9-17·8]). Serotype 3 was a top-ranked serotype, causing about 9% of cases in children younger than 5 years and 14% in adults aged 50 years or older at both PCV10 and PCV13 sites. Across all age and PCV10 or PCV13 strata, the proportion of IPD targeted by higher-valency PCVs beyond PCV13 was 4·1-9·7% for PCV15, 13·5-36·0% for PCV20, 29·9-53·8% for PCV21, 15·6-42·0% for PCV24, and 31·5-50·1% for PCV25. All top-ten ranked non-PCV13 serotypes are included in at least one higher-valency PCV. Interpretation The proportion of IPD due to serotypes included in PCVs in use was low in mature PCV10 and PCV13 settings. Serotype distribution differed between PCV10 and PCV13 sites and age groups. Higher-valency PCVs target most remaining IPD and are expected to extend impact. Funding Bill & Melinda Gates Foundation as part of the WHO Pneumococcal Vaccines Technical Coordination Project.

Garcia Quesada M, Peterson ME, Bennett JC et al.

SurvivalRead at source

Peer-reviewed articleEurope PMC2 Oct 2024

Trends and inequalities in oral rehydration therapy and continued feeding for children under five with diarrhoea in Sierra Leone.

Background Sierra Leone has improved child health outcomes in recent decades. However, diarrhoeal diseases remain a public health concern, particularly among children under five. This study investigates the trends and inequalities in oral rehydration therapy and continued feeding for children under five with diarrhoea in Sierra Leone in 2008, 2013 and 2019. Methods The analysis utilised data from the Sierra Leone Demographic Health Survey rounds conducted in 2008, 2013, and 2019. The software utilised for the calculation of various measures of inequality, including simple difference, ratio, population-attributable risk, and population-attributable fraction, was the World Health Organization Health Equity Assessment Toolkit. An inequality assessment was conducted for six stratifiers: maternal age, maternal economic status, maternal level of education, place of residence, sex of the child, and sub-national region. Results Our findings reveal that children under five with diarrhoea receiving oral rehydration therapy and continued feeding increased from 56.5% in 2008 to 59.7% in 2019 in Sierra Leone. Children of mothers aged 20-49 had more coverage over time than those with mothers aged 15-19. Children of mothers who are wealthy, more educated, and living in urban areas show a decrease in coverage with time compared to the poor, the lowly educated, and those residing in rural areas. Male children had higher coverage than female children. Regional inequality decreased slightly from 21.5 percentage points in 2008 to 21.2 percentage points in 2019. Conclusion The findings revealed a mixed picture of progress in oral rehydration therapy and continued feeding for children under five in Sierra Leone. While national coverage has increased, inequalities persist. Children of older mothers and those from disadvantaged backgrounds have experienced improvements, while children of younger, wealthier, and more educated mothers in urban areas have seen a decline in coverage. The gender and regional inequalities remain. Expanding community-based health programs, providing subsidised or free supplies, and strengthening health systems in underserved areas are key strategies to ensure equitable and effective healthcare for all children in Sierra Leone.

Osborne A, Bangura C

SurvivalSLRead at source

Peer-reviewed articleEurope PMC13 Jul 2023

"She vaccinated my baby and that's all…" Immunisation decision-making and experiences among refugee mothers resettled in Aotearoa New Zealand.

Background To prevent disease outbreaks, refugee children must be age-appropriately immunised. This qualitative study gained an in-depth understanding of refugee mothers' vaccine decision-making and experiences accessing immunisation services for their children post-resettlement in Aotearoa New Zealand. Methods An interpretive description methodology involving focus groups with refugee mothers (N = 45) was conducted in Auckland, one of the resettlement locations. Mothers were asked about their perceptions of vaccine-preventable diseases and vaccines, their experiences of attending immunisation events, and their suggestions for improvements to immunisation services. Data were analysed following the phases of reflexive thematic analysis. Results Four themes were constructed. Do I have a choice? Mothers displayed pro-vaccination sentiments and parental obligation to vaccinate their children to protect their health, which underpinned their compliance with the national vaccine schedule. Transnational vaccine perceptions and behaviours It was evident that comparing their health experiences in their origin countries reinforced their positive perceptions of and trust in vaccines, health providers and their recommendations, the health system and government in New Zealand. Information sharing with their transnational networks had the potential to influence vaccine perceptions and behaviours in home and host countries. Unanswered questions and concerns Mothers discussed how many of their questions and concerns about immunisations and post-vaccine management went unanswered. Relationships and experiences matter Mothers stressed the importance of who vaccinated their child and how it was administered, highlighting that health providers' demeanour and competence influence their immunisation experiences. Conclusions Health providers are encouraged to focus on creating a positive immunisation experience for refugee background families. Qualified interpreters and provision of culturally and linguistically appropriate information are required. Transnationalism at the individual level appears to influence vaccine perceptions and behaviours among refugee-background mothers. Future research focusing on caregivers with child(ren) who are not fully vaccinated would be beneficial.

Charania NA

SurvivalDevelopmentNZRead at source

Peer-reviewed articleEurope PMC1 Nov 2023

The COVID-19 pandemic and disruptions to maternal and child health services in public primary care Malaysia: a retrospective time-series analysis.

Introduction The COVID-19 pandemic has posed significant challenges to healthcare systems worldwide. Maintaining essential health services, including maternal and child health (MCH), while addressing the pandemic is an enormous task. This study aimed to assess the impact of the COVID-19 pandemic on the utilisation of MCH services in Malaysian public primary care. Methods A retrospective analysis was conducted using national administrative data from 1124 public primary care clinics. Eight indicators were selected to measure service utilisation covering antenatal, postnatal, women's health, child health, and immunisation services. Interrupted time-series analysis was used to evaluate changes in levels and trends of indicators during four different periods: pre-pandemic (January 2019-February 2020), during pandemic and first lockdown (March-May 2020), after the first lockdown was lifted (June-December 2020) and after the second lockdown was implemented (January-June 2021). Results Most indicators showed no significant trend in monthly utilisation prior to the pandemic. The onset of the pandemic and first lockdown implementation were associated with significant decreasing trends in child health (-19.23%), women's health (-10.12%), antenatal care (-8.10%), contraception (-6.50%), postnatal care (-4.85%) and postnatal care 1-week (-3.52%) indicators. These indicators showed varying degrees of recovery after the first lockdown was lifted. The implementation of the second lockdown caused transient reduction ranging from -11.29% to -25.92% in women's health, contraception, child and two postnatal indicators, but no sustained reducing trend was seen afterwards. Two immunisation indicators appeared unaffected throughout the study period. Conclusion The COVID-19 pandemic significantly impacted MCH services utilisation in Malaysia. While most MCH services were negatively affected by the lockdown implementation with varying degrees of recovery, infant immunisation showed resilience throughout. This highlights the need for a targeted preparedness plan to ensure the resilience of MCH services in future crises.

Mohd Ujang IR, Hamidi N, Ab Hamid J et al.

SurvivalDevelopmentMYRead at source

Peer-reviewed articleEurope PMC23 Mar 2023

A multilevel analysis of individual and community-level factors associated with childhood immunisation in Bangladesh: Evidence from a pooled cross-sectional survey.

Introduction Previous studies on childhood vaccinations in Bangladesh relied on single-level analyses and ignored the clustering and hierarchical structure of data collected from people living in different geographical units. This study, therefore, aimed to investigate the association between individual and community-level factors of full childhood immunisation with an improved analytical approach. Methods Participants were 13,752 children aged 12-59 months. Data were extracted from the Bangladesh Demographic and Health Survey (BDHS) conducted in 2007, 2011, 2014, and 2017-18. A two-level multilevel logistic regression method was used to analyse the data. Results Approximately 87% of the children were fully immunised. In the fully adjusted model, at the individual level, mothers who had primary and above education (Adjusted odds ratio [AOR] = 1.78; 95% Confidence Interval [CI]: 1.57, 2.01), mass media exposure (AOR = 1.14; 95% CI: 1.00, 1.30), having vaccination cards (AOR = 3.65; 95% CI: 3.23, 4.14), and having at least 4 antenatal care (ANC) visits (AOR = 1.24; 95% CI: 1.06, 1.44) were strongly associated with full childhood immunisation. At community-level, rural residency (AOR = 1.25; 95% CI: 1.08, 1.44), community women's education (AOR = 1.24; 95% CI: 1.07, 1.43), and community ANC utilisation (AOR = 1.38; 95% CI: 1.19, 1.61) were significantly associated with full childhood immunisation. Conclusion Along with individual-level factors, community-level factors have a significant effect on childhood immunisation. Policymakers should target improving community-level characteristics, such as community poverty, education levels, and the number of community-level ANC visits, to increase the national level of childhood immunisation. Public health intervention programs aiming at increasing awareness of childhood immunisation should include elements at both individual and community levels.

Sarder MA, Lee KY, Keramat SA et al.

SurvivalBDRead at source

Every report we find, newest first.

How to use the reports

Managers perspectives on the implementation of the Prevention of Mother-to-Child Transmission policy in South Africa.

Randomized Controlled Trial of Impact of Mobile Health Technologies on Human Papillomavirus Vaccination Uptake in Mothers of Vaccine-Eligible Girls in Lagos, Nigeria (mHealth-HPVac).

Caregiver acceptance of human papillomavirus vaccine for their female children in Chileka, Blantyre, Malawi.

Exploration of the social determinants of diarrhoea, rotavirus vaccine uptake, and vaccine 'fatigue' in Ethiopia, Kenya, and Malawi.

The role of new hepatitis B vaccines in South Africa.

Serotype distribution of remaining invasive pneumococcal disease after extensive use of ten-valent and 13-valent pneumococcal conjugate vaccines (the PSERENADE project): a global surveillance analysis.

Trends and inequalities in oral rehydration therapy and continued feeding for children under five with diarrhoea in Sierra Leone.

"She vaccinated my baby and that's all…" Immunisation decision-making and experiences among refugee mothers resettled in Aotearoa New Zealand.

The COVID-19 pandemic and disruptions to maternal and child health services in public primary care Malaysia: a retrospective time-series analysis.

A multilevel analysis of individual and community-level factors associated with childhood immunisation in Bangladesh: Evidence from a pooled cross-sectional survey.

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