Acceptance of a Malaria Vaccine by Caregivers in Kenya
Acceptance of a Malaria Vaccine by Caregivers in Kenya
During consultations with sick children, a total of 2,003 caregivers completed the exit interviews between January and May 2010. Of the caregivers interviewed, 93.5% were female and 6.5% were male (Table 1). Most of the caregivers (77%) were in the prime reproductive age group of 20–34 years. Majority of the caregivers interviewed were related to the child; mothers made up over 90% of the caregivers, while fathers represented 6% and grandparents approximately 2%. Most caregivers interviewed were from the Western Province (17.4%) and the fewest were from Nairobi Province (7.0%). Most respondents (97%) took their children to health facilities at the district and lower levels, which primarily included dispensaries, followed by district hospitals and health centres. Overall, 72% of the caregivers were interviewed in government health facilities or those operated by local authorities (Table 1).
Of the 2,016 sick children whose caregivers were interviewed, 53% were male and 47% were female (Table 2). One third of the children were infants less than 12 months old and approximately another third was between one and two years old.
Out of 1,973 children with fever, 752 (38.1%) were clinically diagnosed with malaria. However, of the 1,970 that underwent malaria testing using either microscopic blood smear examination or a rapid test kit, 317 (16%) of children tested positive (Table 2). The proportion of children who tested positive for malaria, in each province was as follows: 60% of cases in the Western Province, 48% in Nyanza, 42% in Eastern Province, 39% in the Coast region, 34% in the Rift Valley, and 33% in the North Eastern Province. The proportion in Nairobi and Central provinces were 13.5% and 13.7%, respectively.
Overall, about 88% of caregivers answered that they would support the vaccine for both a young child in their community and for their own child, while approximately 7% of respondents did not know whether they would support the vaccine and 5% would not support it (Table 3). Analysis of the distribution by province reveals that approval is highest in Nyanza (98.9%), Coast (98.7%), Eastern (97.8%), Central (96.7%), Western (95.4%), Rift Valley (91%) and Nairobi (87%). North Eastern Province had the lowest approval with 23% of caregivers stating that they would support child immunization with the possible malaria vaccine. Results were comparable for responses to vaccinating a child within the community and one's own child (Table 3).
Caregivers were asked to explain why they would accept or not accept a child to be immunized with the possible malaria vaccine. Over 92% of caregivers cited reduced mortality and morbidity as a reason they would accept their child, as well as a child in the community to be vaccinated. Furthermore, about 49% of caregivers who stated that they would not accept the vaccine cited the combination of possible side effects and incomplete protection provided by vaccines as reasons.
About 86% of caregivers interviewed had attended school in the past. Out of these, 94% would accept a child to be vaccinated in their community, while 3% would not and 3% did not know. Similar results were observed when caregivers were asked if they would accept their own child to be vaccinated (Table 4). Only 56% of those who had never attended school supported the vaccine in the community, and 55% for their own child.
Of the caregivers who had attended school, 60% indicated that the highest level of education they completed was primary school. Out of these participants, 95% stated their support for the possible vaccine at the community level, and 94% supported its use for their own child. About 39% of caregivers had completed secondary school education or higher, and of this group, 92% approved of the vaccine in the community and a similar proportion approved for their own child.
No literacy was reported by 32% of caregivers. For those without literacy, only 70% would accept the malaria vaccine for the community and 69% for their own child. About 64% of caregivers were able to read and write. Out of these, 96% would accept a child in their community to be vaccinated with the malaria vaccine and 95% would accept their own child to be vaccinated. Four per cent of caregivers indicated that they could read but could not write, and 73.5 and 71.4% of these reported they would accept the malaria vaccine for the community and for their own child, respectively.
Results
Socio Demographic Characteristics of Caregivers
During consultations with sick children, a total of 2,003 caregivers completed the exit interviews between January and May 2010. Of the caregivers interviewed, 93.5% were female and 6.5% were male (Table 1). Most of the caregivers (77%) were in the prime reproductive age group of 20–34 years. Majority of the caregivers interviewed were related to the child; mothers made up over 90% of the caregivers, while fathers represented 6% and grandparents approximately 2%. Most caregivers interviewed were from the Western Province (17.4%) and the fewest were from Nairobi Province (7.0%). Most respondents (97%) took their children to health facilities at the district and lower levels, which primarily included dispensaries, followed by district hospitals and health centres. Overall, 72% of the caregivers were interviewed in government health facilities or those operated by local authorities (Table 1).
Characteristics of Children
Of the 2,016 sick children whose caregivers were interviewed, 53% were male and 47% were female (Table 2). One third of the children were infants less than 12 months old and approximately another third was between one and two years old.
Out of 1,973 children with fever, 752 (38.1%) were clinically diagnosed with malaria. However, of the 1,970 that underwent malaria testing using either microscopic blood smear examination or a rapid test kit, 317 (16%) of children tested positive (Table 2). The proportion of children who tested positive for malaria, in each province was as follows: 60% of cases in the Western Province, 48% in Nyanza, 42% in Eastern Province, 39% in the Coast region, 34% in the Rift Valley, and 33% in the North Eastern Province. The proportion in Nairobi and Central provinces were 13.5% and 13.7%, respectively.
Caregiver Responses to the Potential Malaria Vaccination
Overall, about 88% of caregivers answered that they would support the vaccine for both a young child in their community and for their own child, while approximately 7% of respondents did not know whether they would support the vaccine and 5% would not support it (Table 3). Analysis of the distribution by province reveals that approval is highest in Nyanza (98.9%), Coast (98.7%), Eastern (97.8%), Central (96.7%), Western (95.4%), Rift Valley (91%) and Nairobi (87%). North Eastern Province had the lowest approval with 23% of caregivers stating that they would support child immunization with the possible malaria vaccine. Results were comparable for responses to vaccinating a child within the community and one's own child (Table 3).
Caregivers were asked to explain why they would accept or not accept a child to be immunized with the possible malaria vaccine. Over 92% of caregivers cited reduced mortality and morbidity as a reason they would accept their child, as well as a child in the community to be vaccinated. Furthermore, about 49% of caregivers who stated that they would not accept the vaccine cited the combination of possible side effects and incomplete protection provided by vaccines as reasons.
Educational Factors and Acceptance of the Vaccine
About 86% of caregivers interviewed had attended school in the past. Out of these, 94% would accept a child to be vaccinated in their community, while 3% would not and 3% did not know. Similar results were observed when caregivers were asked if they would accept their own child to be vaccinated (Table 4). Only 56% of those who had never attended school supported the vaccine in the community, and 55% for their own child.
Of the caregivers who had attended school, 60% indicated that the highest level of education they completed was primary school. Out of these participants, 95% stated their support for the possible vaccine at the community level, and 94% supported its use for their own child. About 39% of caregivers had completed secondary school education or higher, and of this group, 92% approved of the vaccine in the community and a similar proportion approved for their own child.
No literacy was reported by 32% of caregivers. For those without literacy, only 70% would accept the malaria vaccine for the community and 69% for their own child. About 64% of caregivers were able to read and write. Out of these, 96% would accept a child in their community to be vaccinated with the malaria vaccine and 95% would accept their own child to be vaccinated. Four per cent of caregivers indicated that they could read but could not write, and 73.5 and 71.4% of these reported they would accept the malaria vaccine for the community and for their own child, respectively.