A qualitative analysis of vaccine decision makers’ conceptualization and fostering of ‘community engagement’ in India
| Autor: | Beth E. Meyerson, Catherine Sherwood-Laughlin, Tapati Dutta, Priscilla A. Barnes, Jill Nicholson-Crotty, Jon Agley |
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| Rok vydání: | 2020 |
| Předmět: |
Concept Formation
Decision Making Information Dissemination India 03 medical and health sciences 0302 clinical medicine Health care Humans 030212 general & internal medicine Sociology Child Qualitative Research Health policy Vaccines 030505 public health Community engagement Conceptualization Immunization Programs business.industry lcsh:Public aspects of medicine Research Health Policy Administrative Personnel Community Participation Public Health Environmental and Occupational Health Health services research lcsh:RA1-1270 Public relations Health equity Outreach 0305 other medical science business |
| Zdroj: | International Journal for Equity in Health International Journal for Equity in Health, Vol 19, Iss 1, Pp 1-14 (2020) |
| ISSN: | 1475-9276 |
| DOI: | 10.1186/s12939-020-01290-5 |
| Popis: | Background Globally, and in India, research has highlighted the importance of community engagement in achieving national vaccination goals and in promoting health equity. However, community engagement is not well-defined and remains an underutilized approach. There is also paucity of literature on community engagement’s effectiveness in achieving vaccination outcomes. To address that gap, this study interviewed Indian vaccination decision makers to derive a shared understanding of the evolving conceptualization of community engagement, and how it has been fostered during India’s Decade of Vaccines (2010-2020). Methods Semi-structured interviews were conducted with 25 purposefully sampled national-level vaccine decision makers in India, including policymakers, immunization program heads, and vaccine technical committee leads. Participants were identified by their ‘elite’ status among decisionmakers in the Indian vaccination space. Schutz’ Social Phenomenological Theory guided development of an a priori framework derived from the Social Ecological Model. The framework helped organize participants’ conceptualizations of communities, community engagement, and related themes. Inter-rater reliability was computed for a subsample of coded interviews, and findings were validated in a one-day member check-in meeting with study participants and teams. Results The interviews successfully elucidated participants’ understanding of key terminology (“community”) and approaches to community engagement propagated by the vaccine decision makers. Participants conceptualized ‘communities’ as vaccine-eligible children, their parents, frontline healthcare workers, and vaccination influencers. Engagement with those communities was understood to mean vaccine outreach, capacity-building of healthcare workers, and information dissemination. However, participants indicated that there were neither explicit policy guidelines defining community engagement nor pertinent evaluation metrics, despite awareness that community engagement is complex and under-researched. Examples of different approaches to community engagement ranged from vaccine imposition to empowered community vaccination decision-making. Finally, participants proposed an operational definition of community engagement and discussed concerns related to implementing it. Conclusions Although decision makers had different perceptions about what constitutes a community, and how community engagement should optimally function, the combined group articulated its importance to ensure vaccination equity and reiterated the need for concerted political will to build trust with communities. At the same time, work remains to be done both in terms of research on community engagement as well as development of appropriate implementation and outcome metrics. |
| Databáze: | OpenAIRE |
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