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Influenza vaccination of pregnant women : engaging clinicians to reduce missed opportunities for vaccination

Giduthuri, Joseph G. and Purohit, Vidula and Maire, Nicolas and Kudale, Abhay and Utzinger, Jürg and Schindler, Christian and Weiss, Mitchell G.. (2019) Influenza vaccination of pregnant women : engaging clinicians to reduce missed opportunities for vaccination. Vaccine, 37 (14). pp. 1910-1917.

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Official URL: https://edoc.unibas.ch/69844/

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Abstract

Antenatal influenza vaccination (AIV) is an effective intervention for protecting pregnant women and their newborns against influenza. Although the World Health Organization recommends AIV at any stage of pregnancy, in low- and middle-income countries, including India, it is rarely provided. Research suggests that antenatal care (ANC) provider practices explain much of this limited coverage. Our study in urban Pune, India, assessed the feasibility of a two-stage clinician-engagement strategy to reduce missed opportunities for AIV in urban private-practice ANC clinics.; Clinicians were randomized to intervention and control groups in slum and middle-class study sites. Intervention-group clinicians (active clinicians) were assessed on vaccination-related views and practices, and were presented with authoritative AIV recommendations from global, academic and professional medical organizations. In a second meeting after a community survey, findings concerning vaccination-related views and experiences were explained to active clinicians. Assessments of community vaccination views were not provided to control-group clinicians. Both groups maintained logs of ANC clinic visit vaccination status throughout the 11-month study period to enable identification of missed and taken opportunities for vaccination. Analyses were restricted to visits of women in their third trimester without previous AIV in the current pregnancy.; Overall, 30 clinicians participated. After first and second interactions, active clinicians in middle-class communities vaccinated at 12.2% and 37.8%, respectively. Middle-class control clinicians vaccinated at <0.2% throughout the study. This difference in AIV taken opportunities between middle-class active and control clinics was statistically significant (p < 0.05) after first and second interactions. In slum-community sites, active clinicians' AIV activity was minimal throughout.; Our approach for engaging clinicians effectively reduced missed opportunities for AIV in urban middle-class settings of Pune. It may also improve maternal vaccination for other conditions. The absence of any similar effect in slum-based clinics likely reflects critical limitations of vaccine access.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Biostatistics > Biostatistics - Frequency Modelling (Schindler)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Eco System Health Sciences > Health Impact Assessment (Utzinger)
UniBasel Contributors:Giduthuri, Joseph Gnanouday and Maire, Nicolas and Utzinger, Jürg and Schindler, Christian and Weiss, Mitchell G.
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:0264-410X
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:20 Mar 2019 13:35
Deposited On:20 Mar 2019 13:35

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