Barriers to measles immunization: the beliefs and attitudes of caregivers in Goroka, Eastern Highlands Province, Papua New Guinea

ABSTRACT

In Papua New Guinea, measles remains a public health problem and the majority of measles cases occur in non-immunized children. In Goroka, measles vaccine coverage for the 9-month-old group was 44%. The parents or caregivers are important in measles prevention as children's immunization depends on their compliance. This study aimed to determine the factors that hinder caregivers from having their children vaccinated for measles prevention in the Goroka District, Eastern Highlands Province. A cross-sectional study was conducted in July-August 2003, using pre-constructed questionnaires and interviews. There was a total of 120 respondents who were caregivers or parents of children whose ages ranged from 6 to 12 months and who attended health care centres where immunization services were provided. The main reasons for not bringing their children to clinic for immunization were limited access to health centres, especially to maternal and child health (MCH) clinics; too long a waiting time at the clinic; concern that too many injections were being given to their children; the side-effects of the vaccine; being sent away and asked to come back the next day for immunization; and a bad reception from health workers. Funerals or election-related events in the area also affected the attendance at the clinic. In order to improve the vaccine coverage, the use of a mobile MCH clinic should be re-established. Health workers should utilize the opportunities to pass on necessary information on immunization to caregivers, as well as being mindful to use communication that will prevent misunderstanding by the mothers. It is important for all health workers to recognize that their performance and attitude can greatly improve the overall vaccine coverage in Papua New Guinea.