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Gender determinants of vaccination status in children : evidence from a meta-ethnographic systematic review
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
 
ID 3246970
Author(s) Merten, Sonja; Martin Hilber, Adriane; Biaggi, Christina; Secula, Florence; Bosch-Capblanch, Xavier; Namgyal, Pem; Hombach, Joachim
Author(s) at UniBasel Merten, Sonja
Martin Hilber, Adriane
Bosch-Capblanch, Xavier
Year 2015
Title Gender determinants of vaccination status in children : evidence from a meta-ethnographic systematic review
Journal PLoS ONE
Volume 10
Number 8
Pages / Article-Number e0135222
Mesh terms Age Factors; Child; Humans; Public Health Surveillance; Qualitative Research; Sex Factors; Socioeconomic Factors; Vaccination, statistics & numerical data
Abstract Using meta-ethnographic methods, we conducted a systematic review of qualitative research to understand gender-related reasons at individual, family, community and health facility levels why millions of children in low and middle income countries are still not reached by routine vaccination programmes. A systematic search of Medline, Embase, CINAHL, Cochrane Library, ERIC, Anthropological Lit, CSA databases, IBSS, ISI Web of Knowledge, JSTOR, Soc Index and Sociological Abstracts was conducted. Key words were built around the themes of immunization, vaccines, health services, health behaviour, and developing countries. Only papers, which reported on in-depth qualitative data, were retained. Twenty-five qualitative studies, which investigated barriers to routine immunisation, were included in the review. These studies were conducted between 1982 and 2012; eighteen were published after 2000. The studies represent a wide range of low- to middle income countries including some that have well known coverage challenges. We found that women's low social status manifests on every level as a barrier to accessing vaccinations: access to education, income, as well as autonomous decision-making about time and resource allocation were evident barriers. Indirectly, women's lower status made them vulnerable to blame and shame in case of childhood illness, partly reinforcing access problems, but partly increasing women's motivation to use every means to keep their children healthy. Yet in settings where gender discrimination exists most strongly, increasing availability and information may not be enough to reach the under immunised. Programmes must actively be designed to include mitigation measures to facilitate women's access to immunisation services if we hope to improve immunisation coverage. Gender inequality needs to be addressed on structural, community and household levels if the number of unvaccinated children is to substantially decrease.
Publisher Public Library of Science
ISSN/ISBN 1932-6203
edoc-URL http://edoc.unibas.ch/dok/A6438868
Full Text on edoc No
Digital Object Identifier DOI 10.1371/journal.pone.0135222
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/26317975
ISI-Number WOS:000360299100025
Document type (ISI) Journal Article, Review
 
   

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